Health behaviors and subsequent mental health problems during the COVID-19 pandemic: A longitudinal analysis of adults in the UK

Abstract

IntroductionPublic health mitigation policies aimed at slowing the spread of COVID-19 led to an increase in mental health problems (MHPs). This study examines the association between multiple pre-pandemic health behaviors and MHPs prior to, and during, the COVID-19 pandemic.MethodsWe analyzed a representative population sample of 11,256 adults (aged 20–65 years) from Understanding Society—The UK Household Longitudinal Study. Baseline data from participants interviewed in 2017/2019 (wave 9) were linked to web surveys conducted during the COVID-19 pandemic. We used latent class analysis (LCA) to identify mutually exclusive health behavior (physical activity, alcohol consumption, eating habits and smoking tobacco) clusters by gender, and examined the sociodemographic correlates of each cluster. We assessed how pre-pandemic latent classes of health behaviors were associated with changes in MHPs during the pandemic using fixed effects regression models.ResultsThree health behavior clusters were identified: positive (33%), moderate (24%), and high risk (43%), where similar behaviors clustered within individuals and sociodemographic circumstances. In particular, gender, age, migrant status and ethnicity were found to have strong associations with each cluster. Our results also demonstrated a clear association in MHPs with health behaviors both prior to, and during the pandemic. There were significant increases in MHPs between 2017/2019 and January 2021, with fluctuations coinciding with changes in public health mitigation policies. Assessments across the three clusters showed about 25.2%, 16.9%, and 0.7% increases in MHPs in the positive, moderate and high risk health behavior clusters, respectively.DiscussionThis study shows that pre-pandemic health behaviors were significantly associated with mental health before and during the pandemic. Holistic policy interventions and promotions targeting multiple health behaviors may be an effective strategy to improve mental health in the pandemic recovery period.

The clustering of multiple health and lifestyle behaviours among Swedish adolescents: A person-oriented analysis

“…Model fit indices are presented for sex and age separately (Supplementary Table 1). All participants were assigned to the cluster in which they had the highest probability of membership, which were well-identified, interpretable, and conceptually meaningful [42].…”

“…Therefore, understanding how multiple HLBs cluster is crucial in order to develop appropriate public health strategies and interventions [19, 28]. However, the clustering of health behaviours among adolescents, and the social and economic determinants of multiple HLBs among adolescents is understudied [24, 42], leading to a knowledge gap. This study will therefore contribute to the literature by assessing the patterning of multiple HLBs in the Swedish context.…”

COVID-19 and the Liver: A Complex and Evolving Picture

“…These measures, which included "stay at home" policies, travel restrictions, job losses, and banning of any kind of gathering, led to physical separation from family and friends and widespread social isolation. 17 This had a major impact on peoples' mental health, which, in many instances, was further aggravated by the adoption of unhealthy behaviours, including increased alcohol consumption, consumption of carbohydrate-rich foods, and reduced physical activity. 5,[7][8][9][10] In a survey involving >50,000 people from 11 countries 43% reported an increase in the frequency of drinking during lock-down, while 36% reported an increase in the amount of alcohol they drank on a typical day.…”

“…These measures, which included “stay at home” policies, travel restrictions, job losses, and banning of any kind of gathering, led to physical separation from family and friends and widespread social isolation. 17 This had a major impact on peoples’ mental health, which, in many instances, was further aggravated by the adoption of unhealthy behaviours, including increased alcohol consumption, consumption of carbohydrate-rich foods, and reduced physical activity. 5 , 7–10 …”

The clustering of multiple health and lifestyle behaviors among Swedish adolescents: a person-oriented analysis

“…Therefore, understanding how multiple HLBs cluster is crucial in order to develop appropriate public health strategies and interventions ( 19 , 28 ). However, the clustering of health behaviors among adolescents, and the socioeconomic and demographic determinants of multiple HLBs among adolescents is understudied ( 24 , 29 ), leading to a knowledge gap. This study will therefore contribute to the literature by assessing the patterning of multiple HLBs in the Swedish context.…”