Socioeconomic position and adverse childhood experiences as risk factors for health-related behaviour change and employment adversity during the COVID-19 pandemic: insights from a prospective cohort study in the UK
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Abstract
Background
Non-pharmaceutical interventions to reduce the spread of COVID-19 may have disproportionately affected already disadvantaged populations.
Methods
We analysed data from 2710 young adult participants of the Avon Longitudinal Study of Parents and Children. We assessed the associations of socioeconomic position (SEP) and Adverse Childhood Experiences (ACEs, e.g. abuse, neglect, measures of family dysfunction) with changes to health-related behaviours (meals, snacks, exercise, sleep, alcohol and smoking/vaping), and to financial and employment status during the first UK lockdown between March–June 2020.
Results
Experiencing 4+ ACEs was associated with reporting decreased sleep quantity during lockdown (OR 1.53, 95% CI: 1.07–2.18) and increased smoking and/or vaping (OR 1.85, 95% CI: 0.99–3.43); no other associations were seen between ACEs or SEP and health-related behaviour changes. Adverse financial and employment changes were more likely for people with low SEP and for people who had experienced multiple ACEs; e.g. a history of 4+ ACEs was associated with being furloughed or on other leave during lockdown (OR 1.92, 95% CI: 1.35–2.74).
Conclusions
In this sample of young adults, there was little evidence that lockdown worsened inequalities in health-related behaviours. However, adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities and demonstrating the need for support into adulthood for those with a history of ACEs.
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SciScore for 10.1101/2021.05.18.21257397: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25] The questionnaire was developed and deployed using REDCap (Research Electronic Data CAPture tools), a secure web application for online data collection hosted at the University of Bristol.[29] ACEs: ACE measures were derived from questions relating to multiple forms of ACEs reported by participants and their mothers at multiple timepoints from birth to 23 years of age. REDCapsuggested: (REDCap, RRID:SCR_003445)Imputed values were combined using Rubin’s rules[34] and trace plots used to check convergence of estimates. Rubin’ssuggested: NoneResults from OddPub: We did not detect open …
SciScore for 10.1101/2021.05.18.21257397: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
NIH rigor criteria are not applicable to paper type.Table 2: Resources
Software and Algorithms Sentences Resources 25] The questionnaire was developed and deployed using REDCap (Research Electronic Data CAPture tools), a secure web application for online data collection hosted at the University of Bristol.[29] ACEs: ACE measures were derived from questions relating to multiple forms of ACEs reported by participants and their mothers at multiple timepoints from birth to 23 years of age. REDCapsuggested: (REDCap, RRID:SCR_003445)Imputed values were combined using Rubin’s rules[34] and trace plots used to check convergence of estimates. Rubin’ssuggested: NoneResults from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:This study has limitations. The sample size and thus statistical power was restricted as the questionnaire was online only - invites were only sent to those participants for whom the study had a valid email address, impacting participants who prefer to complete questionnaires on paper. Self-reported measures were used, so associations may have been biased by measurement error and reporting biases. ALSPAC participants are more socioeconomically advantaged and less ethnically diverse than the national average, and mothers of participants included in this study had higher educational attainment compared to the rest of the ALSPAC cohort. Results therefore may not be generalisable to the UK population. Although ALSPAC participants are in the age group most likely to be affected by lockdown in terms of employment18, their similar ages meant we could not study the effect of age on the outcomes. Finally, our SEP measure was solely based on participants’ occupations, but individual’s income, education, or residential area may also determine negative impacts of lockdown. Conclusion: The results of this study support findings from routine data that the financial and employment situation of adults with lower occupational social class are more likely to have been adversely affected by the COVID-19 non-pharmaceutical interventions.[35] However, importantly, our findings also highlight the economic adversity experienced by adults who have been exposed to ACEs. Despite the long-reaching cons...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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