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

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.

Adverse Childhood Experiences (ACEs) and Environmental Exposures on Neurocognitive Outcomes in Children: Empirical Evidence, Potential Mechanisms, and Implications

“…Some studies have previously examined ACEs and SES separately or examined SES as a mediating factor, linking inaccessibility of resources to negative health consequences. However, more recent studies, especially in light of the COVID-19 pandemic, have considered ACEs inclusive of SES, rather than examining them as separate factors; this is due to how low SES is so often co-morbid with high ACEs and can be considered a negative household experience, a category of ACEs [ 10 , 11 ]. For instance, in literature examining the currently defined ACEs scale, low socioeconomic status is classified as an impactful form of trauma consistent among various racial and ethnic groups, classifying it as an ACE [ 12 ].…”

Impact of the pandemic on leisure physical activity and alcohol consumption – who were affected and who were not? Results from a Swedish longitudinal cohort study using two different methods to measure change

“…Several studies have concluded that high educational level (33,35,36) and/or high income (34) are associated with an increase in alcohol consumption during the pandemic. On the other hand, one study from the UK observed no associations between SES and change in alcohol consumption (37).…”