Detrimental Health Behaviour Changes among Females Living in Rural Areas during the COVID-19 Pandemic.

Women are predicted to be disproportionately impacted by the COVID-19 pandemic due to increased carer responsibilities, loss of income, worry about the virus and a predominantly female healthcare workforce. Whilst there is emerging evidence that negative mental health impacts associated with the COVID-19 pandemic may be more pronounced for women than men, less attention has focussed on changes to health behaviours and health seeking experienced by women. Similarly, the impact of the pandemic in rural areas has not been investigated in detail. Our research questions were 'have females residing in rural areas experienced changes in alcohol consumption, unhealthy food consumption, smoking, exercise or health seeking during the COVID-19 pandemic?' and 'are there differences in health behaviour changes between rural females living with or without children?'. Net increases (scale of 0-1) in consumption of unhealthy food (95% CI 0.05, 0.22) and alcohol (95% CI 0.12, 0.29) were observed. Net decreases (scale of -1 to 0) in visits to the doctor (95% CI -0.23, -0.35) and other health professionals (95% CI -0.40, -0.54) were observed. Compared with females living without children, females who lived with children were significantly associated with increased alcohol consumption (OR 2.4 (95% CI 1.4, 4.1), decreased visits to the doctor (OR 1.9 (95% CI 1.1, 3.2) and decreased visits to other health professionals (OR 1.9 (95% CI 1.1, 3.3). Results suggest that public health approaches may be required to support females residing in rural areas to optimise their health behaviours during the pandemic, particularly for those living with children. Policies must be gender responsive to counteract worsening health and social inequities both during and after the pandemic.