Purpose In Great Britain, few studies documented mental health trends in young adults in the years preceding 2020, the mental health dimensions affected, and how these compare with changes observed during the COVID-19 pandemic. Methods Long-term trends in mental health among 16–34 year old men and women between 1991 and 2018, and changes between 2018–19 and July–September 2020 were examined using all waves from the British Household Panel Study (1991–2008), the UK Household Longitudinal Study (2009–20), and the first five UKHLS COVID-19 waves administered in April, May, June, July, and September 2020. Findings are based on the GHQ-12 continuous score (0–36), clinically significant cases (4 + /12) and severe cases (7 + /12) for mental distress, and item endorsements. Results Between 1991 and 2018, the prevalence of cases (4 + /12) increased from 14–22% to 19–32% across groups. Increases were largest in women aged 16–24. In April 2020, the risk of caseness (4 + /12) increased across groups by 55% to 80% compared to the 2018–19 baseline. This increase, however, rapidly diminished over time: in July–September 2020, there was only a higher risk of caseness (4 + /12) in men aged 25–34 (prevalence ratio = 1.29, 95% CI 1.01–1.65) compared to the 2018–19 baseline. Conclusion Whereas distress surged in April 2020, its return to pre-pandemic levels by September 2020 highlights the nuanced impact that the pandemic may have over time. Given the magnitude of the decline in mental health over the past decade, attention must be given to young adults once the pandemic ends.

BackgroundDespite concerns about mental health problems among those aged 16–24 in England, which social groups have been most at risk, both over the past decade and during the COVID-19 pandemic, remains unclear.MethodsWe examined trends in psychological distress among young adults 16–24 years old in England using data from the UK Household Longitudinal Study. Using longitudinal data as repeated cross-sectional waves, we examined differences over time in mean General Health Questionnaire (GHQ) scores from wave 1 (2009–2010) to wave 10 (2018–2019) and six COVID-19 waves collected between April and November 2020, by economic activity, cohabitation with parents, parental education, area deprivation, ethnicity, age and sex.ResultsCompared with 2009–2010, increases in GHQ scores in 2018–2019 were higher in women than men (2.1 vs 1.3), those aged 16–18 than aged 22–24 (2.6 vs 0.9), those from white UK group versus other ethnic minorities, and those out of the labour force (3.6) or employed part time (2.2) than those employed full time (0.8). Compared with 2018–2019, psychological distress in 2020 also further increased among young adults residing in the most deprived areas (4.1 vs 1.2 in the least deprived areas). In 2020, losing one’s job or most of one’s work hours was associated with higher psychological distress and attenuated the differences between deprivation quartiles by 17%.ConclusionIn England, inequalities in psychological distress among young adults may have changed and increased during the COVID-19 pandemic. Investing in opportunities for young adults, particularly in more deprived areas, may be key to improve population levels of mental health.

A growing body of research from the United States informed by intersectionality theory indicates that racial identity, gender, and income are often entwined with one another as determinants of health in unexpectedly complex ways. Research of this kind from Canada is scarce, however. Using data pooled from ten cycles (2001-2013) of the Canadian Community Health Survey, we regressed hypertension (HT) and diabetes (DM) on income in subsamples of Black women (n = 3,506), White women (n = 336,341), Black men (n = 2,806) and White men (n = 271,260). An increase of one decile in income was associated with lower odds of hypertension and diabetes among White men (OR = .98, 95% CI (.97, .99); OR = .93, 95% CI (.92, .94)) and White women (OR = .95, 95% CI (.95, .96); OR = .90, 95% CI (.89, .91)). In contrast, an increase of one decile in income was not associated with either health outcome among Black men (OR = .99, 95% CI (.92, 1.06); OR = .99, 95% CI (.91, 1.08)) and strongly associated with both outcomes among Black women (OR = .86, 95% CI (.80, .92); OR = .83, 95% CI (.75, .92)). Our findings highlight the complexity of the unequal distribution of hypertension and diabetes, which includes inordinately high risks of both outcomes for poor Black women and an absence of associations between income and both outcomes for Black men in Canada. These results suggest that an intersectionality framework can contribute to uncovering health inequalities in Canada.

Cultural capital measures that include, but go beyond, educational attainment can improve prediction models of smoking in young male adults. New measures of cultural capital may thus contribute to our understanding of the social status-based resources that individuals can use towards health behaviours.

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The Interdisciplinary Study of Inequalities in Smoking (ISIS) is a cohort study investigating the joint effects of residents' socio-demographic characteristics and neighbourhood attributes on the social distribution of smoking in a young adult population. Smoking is a behaviour with an increasingly steep social class gradient; smoking prevalence among young adults is no longer declining at the same rate as among the rest of the population, and there is evidence of growing place-based disparities in smoking. ISIS was established to examine these pressing concerns. The ISIS sample comprises non-institutionalized individuals aged 18-25 years, who are proficient in English and/or French and who had been living at their current address in Montréal, Canada, for at least 1 year at time of first contact. Two waves of data have been collected: baseline data were collected November 2011-September 2012 (n = 2093), and a second wave of data was collected January-June 2014 (n = 1457). Data were collected from respondents using a self-administered questionnaire, developed by the research team based on sociological theory, which includes questions concerning social, economic, cultural and biological capital, and activity space as well as smoking behaviour. Data are available upon request from [katherine.frohlich@umontreal.ca].

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OBJECTIVES: Young adults face high prevalence rates for smoking. Recent evidence suggests that many people initiate smoking during young adulthood, but little is currently known about trends in initiation rates for this age group. METHODS:We examined rates of initiation to first cigarette (FC) and daily smoking (DS) during youth (5-17 years) and young adulthood (18-25 years) using nationally representative data from the 2001, 2003, 2005, 2007, 2009, 2011 and 2013 cycles of the Canadian Community Health Survey. We included all participants aged 25-26 to obtain seven mutually exclusive retrospective cohorts (n = 16 216). We used logistic regression to examine four correlates of smoking -sex, education, poverty status, and immigration status -and whether these factors modify time trends in smoking. RESULTS:We found that initiation rates decreased during youth (p < 0.001 for FC, p = 0.02 for DS) but not during young adulthood (p = 0.94 for FC, p = 0.28 for DS). We found that men and respondents with fewer educational credentials had relatively higher odds of initiating during young adulthood. Trends in young adulthood stayed constant across subgroups. Trends in youth were modified by education: participants who did not complete high school had no decrease in initiation to FC and DS while those with post-secondary education experienced a decrease in both outcomes. CONCLUSION:Tobacco control has failed to address smoking initiation during young adulthood. Given the considerable amount of initiation that occurs during this period, practitioners and policy-makers should direct more of their planning toward young adults.KEY WORDS: Smoking; young adult; socioeconomic factors; Canada La traduction du résumé se trouve à la fin de l'article.