Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: Longitudinal analyses of the UK Household Longitudinal Study

Abstract

<jats:p>Background: There are concerns that COVID-19 mitigation measures including lockdown may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the COVID-19 lockdown and differences across population subgroups. Methods: Repeat cross-sectional and longitudinal analysis of the UK Household Longitudinal Survey, including representative samples of adults (aged 18+) interviewed in four surveys between 2015 and 2020 (n=48,426). 9,748 adults had complete data for longitudinal analyses. Psychological distress was assessed using the General Health Questionnaire-12 (GHQ). Binary outcomes were created for loneliness, current smoking and use of e-cigarettes. Alcohol consumption was assessed using three binary measures assessing frequent, binge and heavy drinking. Cross-sectional weighted prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential effects by age, gender, education level and ethnicity. Results: Psychological distress substantially increased one month into the COVID-19 lockdown, with the prevalence rising from 19.4% (95% CI 18.7%-20.0%) in 2017-19 to 30.3% (95% CI 29.1%-31.6%) in April 2020. Women's mental health was particularly affected, as was that of the most educated and young adults. Loneliness remained stable overall. Smoking and e-cigarette use declined and the proportion of people drinking on four or more days per week increased, as did binge drinking. Conclusions: Psychological distress increased one month into lockdown, particularly among women and young adults. Smoking declined, but the frequency of alcohol consumption increased. Effective treatment and prevention are required to mitigate adverse impacts on health.</jats:p>

The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK

“…Adults who experienced loss of income early in the lockdown reported higher levels of anxiety and mental distress (Bu et al, 2020a , 2020b ; Wright et al, 2020 ). On the other hand, there is also evidence of higher mental distress among employed adults, as well as among adults with higher levels of education (Niedzwiedz et al, 2020 ; Pierce et al, 2020 ). The relationship between mental health, wellbeing and ethnicity is unclear with some studies reporting no significant association (Iob et al, 2020 ; Xu & Banks, 2020 ), while others suggest higher levels of mental distress among Asian than White British adults (Niedzwiedz et al, 2020 ; Pierce et al, 2020 ).…”

Associations between vaping and Covid-19: Cross-sectional findings from the HEBECO study

“…Irrespective of discussions surrounding potential protective effects of nicotine and whether there are substantial concerns about inhaling and exhaling vapour during a respiratory virus pandemic, it seems likely that the Covid-19 pandemic will have affected rates of vaping. On the one hand, an increase in attempts to stop smoking during the Covid-19 pandemic has been documented ( Jackson et al, 2020a , 2020b ; Niedzwiedz et al, 2020 ), which could have increased uptake of vaping as a cessation aid. On the other hand, vape shops were shut during the UK lockdown, which might have reduced vaping.…”

Untitled

“…What can then explain the ethnic-gender specific increases in mental distress between 2017-2019 and April 2020? One possibility is that individuals' mental wellbeing during the pandemic is not only affected by health concerns and financial insecurity, but also by strict physical distancing measures, such as lockdowns [26]. In the UK, the first lockdown began on the 23rd of March 2020, one month before the follow-up interview, and lockdowns are likely to have an impact on social isolation and mental health [26,32].…”

“…One possibility is that individuals' mental wellbeing during the pandemic is not only affected by health concerns and financial insecurity, but also by strict physical distancing measures, such as lockdowns [26]. In the UK, the first lockdown began on the 23rd of March 2020, one month before the follow-up interview, and lockdowns are likely to have an impact on social isolation and mental health [26,32]. A recent briefing note has unveiled that the reduction in mental wellbeing among Pakistani and Bangladeshi men with respect to White British men is less attenuated among those Pakistanis and Bangladeshis who live in areas with relatively high concentrations of own ethnic group residents [25].…”

“…We use two waves of data from the UK Household Longitudinal Study (UKHLS or Understanding Society) [23,24], wave 9 (2017-2019) and the first monthly COVID-19 wave (April 2020) and join others [16,18,20,21,25,26] in their effort to understand the effects of the COVID-19 pandemic and the lockdown on mental wellbeing. We use sampling weights [27,28].…”