Impact of school closures on the health and well-being of primary school children in Wales UK: a routine data linkage study using the HAPPEN Survey (2018–2020)

Abstract

ObjectivesThis study aimed to explore the relationship between initial school closures and children’s health by comparing health and well-being outcomes collected during school closures (April–June 2020) via HAPPEN (the Health and Attainment of Pupils in a Primary Education Network) with data from the same period in 2019 and 2018 via the HAPPEN Survey.SettingThe study was conducted online with 161 primary schools across Wales involved in the ‘HAPPEN At Home’ Survey.ParticipantsData were collected via the ‘HAPPEN At Home’ Survey capturing the typical health behaviours of children aged 8–11 years from 1333 participants across Wales. These data were compared with data in 2018 and 2019 also collected between April and June, from HAPPEN (2019 (n=1150) and 2018 (n=475)).Primary and secondary outcome measuresPrimary outcomes included validated measures of physical activity, screen time, diet and dental health, as well as well-being, competency and autonomy. Free school meal (FSM) status was used as a proxy for socioeconomic deprivation. Analyses were repeated stratifying by FSM.ResultsComparing responses between April–June in 2020 (n=1068), 2019 (n=1150) and 2018 (n=475), there were improvements in physical activity levels, sleep time, happiness and general well-being for children during school closures compared with previous years. However, children on FSM ate fewer fruits and vegetables (21% less at five or more portions of fruits and vegetables (95% CI: 5.7% to 37%)) and had lower self-assessed school competence compared with 2019. Compared with those not on FSM, they also spent less time doing physical activity (13.03%, 95% CI: 3.3% to 21.7%) and consumed more takeaways (16.3%, 95% CI: 2% to 30%) during school closures.ConclusionsThis study suggests that schools are important in reducing inequalities in physical health. The physical health (eg, physical activity and diet) of children eligible for FSM may be affected by prolonged school closures.

Primary school staff perspectives of school closures due to COVID-19, experiences of schools reopening and recommendations for the future: A qualitative survey in Wales

“…The longer term risks to children’s mental health must also be considered as evidence has highlighted associations between loneliness and episodes of depression, with worse outcomes in scenarios of forced isolation such as school closures and quarantine measures [ 58 ]. Much of this research however, is based on parent or staff perceptions of how children’s health has been affected and it will also be important to consider research regarding objective measures and accounts from children themselves [ 59 – 61 ]. Furthermore, for children’s mental health to be considered a key priority within education provision as highlighted in recommendations in this study and advocated for by UNICEF [ 62 ], this must also be reflected within wider education and public health policy and investment.…”

Factors influencing wellbeing in young people during COVID-19: A survey with 6291 young people in Wales

“…Previous research by HAPPEN on self-reported health behaviour measures from the first lockdown (April–June 2020) from children (aged 8–11) showed that children, as a group, were actually more physically active [ 36 ]. Whilst this provides a contrasting narrative, those on free school meals (used as a proxy for deprivation) who reported being less physically active.…”

Pre-COVID-19 pandemic health-related behaviours in children (2018-2020) and association with being tested for SARS-CoV-2 and testing positive for SARS-CoV-2 (2020-2021): a retrospective cohort study using survey data linked with routine health data in Wales, UK

“…This has impacted on their education and health-related behaviours such as nutrition and physical activity[2]. While a growing body of literature suggests children display fewer clinical symptoms[3], the COVID-19 pandemic has contributed to widened inequalities in children’s health, wellbeing and education[4,5]. Positive SARS-CoV-2 tests require periods of self-isolation, impacting children’s physical health and wellbeing, limiting opportunities for children to engage in health-promoting behaviours such as regular physical activity[6].…”

“…This has impacted on their education and healthrelated behaviours such as nutrition and physical activity [2]. While a growing body of literature suggests children display fewer clinical symptoms [3], the COVID-19 pandemic has contributed to widened inequalities in children's health, wellbeing and education [4,5].…”

“…Evidence has demonstrated the negative impact of the COVID-19 pandemic on children's health-related behaviours including reduced physical activity, increased sedentary behaviour and poorer nutrition [4,6]. However, it is unclear if this association is bidirectional, that is, whether these health behaviours may also be associated with risk of SARS-CoV-2 infection.…”