The influence of sex, gender, age, and ethnicity on psychosocial factors and substance use throughout phases of the COVID-19 pandemic

Abstract

Objectives The SARS-CoV-2 (COVID-19) pandemic has had profound physical and mental health effects on populations around the world. Limited empirical research has used a gender-based lens to evaluate the mental health impacts of the pandemic, overlooking the impact of public health measures on marginalized groups, such as women, and the gender diverse community. This study used a gender-based analysis to determine the prevalence of psychosocial symptoms and substance use (alcohol and cannabis use in particular) by age, ethnicity, income, rurality, education level, Indigenous status, and sexual orientation. Methods Participants in the study were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Those who agreed to participate were asked to self-report symptoms of depression, anxiety, pandemic stress, loneliness, alcohol use, and cannabis use across five phases of the pandemic as well as retrospectively before the pandemic. Results For all psychosocial outcomes, there was a significant effect of time with all five phases of the pandemic being associated with more symptoms of depression, anxiety, stress, and loneliness relative to pre-COVID levels (p < .0001). Gender was significantly associated with all outcomes (p < .0001) with men exhibiting lower scores (i.e., fewer symptoms) than women and gender diverse participants, and women exhibiting lower scores than the gender diverse group. Other significant predictors were age (younger populations experiencing more symptoms, p < .0001), ethnicity (Chinese/Taiwanese individuals experiencing fewer symptoms, p = .005), and Indigenous status (Indigenous individuals experiencing more symptoms, p < .0001). Alcohol use and cannabis use increased relative to pre-pandemic levels, and women reported a greater increase in cannabis use than men (p < .0001). Conclusions Our findings highlight the need for policy makers and leaders to prioritize women, gender-diverse individuals, and young people when tailoring public health measures for future pandemics.

Systematic review of mental health symptom changes by sex or gender in early-COVID-19 compared to pre-pandemic

“…Third, there were not enough studies to attempt subgroup analyses by sociodemographic or other factors, such as professional groups, for example. Cross-sectional studies have reported that there could be differences in mental health by sex or gender that are related to sociodemographic variables (e.g., age, race or ethnicity) and professional roles (e.g., health care workers) 80 , 81 . Cross-sectional analyses, however, do not allow us to determine if any identified associations or differences may have been present prior to the pandemic, and if so, to what degree.…”

COVID-19 Impact on Australian Patients with Substance Use Disorders: Emergency Department Admissions in Western Sydney before Vaccine Roll Out

“…A study using data on hospitalisations, medical visits, and emergency room visits from British Columbia showed that males (but not females) had increased risk of hospitalisation during the pandemic (adjusted risk ratio [aRR] 1.27 [95% CI: 1.17-1.37]), as did those with injection drug use (aRR 2.51 [2.14-2.95]), while women had lower risk of admission unless they were pregnant [30]. Another study from British Columbia showed, inter alia, female sex, Indigenous status, and phase of the pandemic have distinct effects on psychosocial outcomes, with women having more symptoms or more severe symptoms of depression, anxiety, loneliness, and stress than men, regardless of their age or ethnicity [31].…”

Higher Perceived Stress during the COVID-19 pandemic increased Menstrual Dysregulation and Menopause Symptoms

“…The Patient Health Questionnaire (PHQ-9) was used to measure self-reported symptoms of depression on a Likert scale from zero (not at all) to three (nearly everyday). Scores range from 0–27 with a score of 0–4 indicating minimal depression, 5–14 indicating mild to moderate depression and 15–27 indicating moderately severe to severe depression (Brotto et al, 2021).…”