Giorgio Di Gessa1, Jane Maddock2, Michael J Green3, Ellen J Thompson4, Eoin McElroy5, Helena L Davies6, Jessica Mundy6, Anna J Stevenson7, Alex S F Kwong8, Gareth J Griffith9, Srinivasa Vittal Katikireddi3, Claire L Niedzwiedz10, George B Ploubidis11, Emla Fitzsimons11, Morag Henderson11, Richard J Silverwood11, Nish Chaturvedi2, Gerome Breen12, Claire J Steves4, Andrew Steptoe1, David J Porteous7, Praveetha Patalay13. 1. Institute of Epidemiology and Health Care, University College London, UK. 2. MRC Unit for Lifelong Health and Ageing, University College London, UK. 3. MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK. 4. Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, UK. 5. Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK. 6. Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK. 7. Centre for Genomic and Experimental Medicine, University of Edinburgh, UK. 8. Division of Psychiatry, University of Edinburgh, UK; and MRC Integrative Epidemiology Unit, University of Bristol, UK. 9. MRC Integrative Epidemiology Unit, University of Bristol, UK. 10. Institute of Health & Wellbeing, University of Glasgow, UK. 11. Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK. 12. Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK; and Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK. 13. MRC Unit for Lifelong Health and Ageing, University College London, UK; and Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK.
Abstract
BACKGROUND: The COVID-19 pandemic has disrupted lives and livelihoods, and people already experiencing mental ill health may have been especially vulnerable. AIMS: Quantify mental health inequalities in disruptions to healthcare, economic activity and housing. METHOD: We examined data from 59 482 participants in 12 UK longitudinal studies with data collected before and during the COVID-19 pandemic. Within each study, we estimated the association between psychological distress assessed pre-pandemic and disruptions since the start of the pandemic to healthcare (medication access, procedures or appointments), economic activity (employment, income or working hours) and housing (change of address or household composition). Estimates were pooled across studies. RESULTS: Across the analysed data-sets, 28% to 77% of participants experienced at least one disruption, with 2.3-33.2% experiencing disruptions in two or more domains. We found 1 s.d. higher pre-pandemic psychological distress was associated with (a) increased odds of any healthcare disruptions (odds ratio (OR) 1.30, 95% CI 1.20-1.40), with fully adjusted odds ratios ranging from 1.24 (95% CI 1.09-1.41) for disruption to procedures to 1.33 (95% CI 1.20-1.49) for disruptions to prescriptions or medication access; (b) loss of employment (odds ratio 1.13, 95% CI 1.06-1.21) and income (OR 1.12, 95% CI 1.06 -1.19), and reductions in working hours/furlough (odds ratio 1.05, 95% CI 1.00-1.09) and (c) increased likelihood of experiencing a disruption in at least two domains (OR 1.25, 95% CI 1.18-1.32) or in one domain (OR 1.11, 95% CI 1.07-1.16), relative to no disruption. There were no associations with housing disruptions (OR 1.00, 95% CI 0.97-1.03). CONCLUSIONS: People experiencing psychological distress pre-pandemic were more likely to experience healthcare and economic disruptions, and clusters of disruptions across multiple domains during the pandemic. Failing to address these disruptions risks further widening mental health inequalities.
BACKGROUND: The COVID-19 pandemic has disrupted lives and livelihoods, and people already experiencing mental ill health may have been especially vulnerable. AIMS: Quantify mental health inequalities in disruptions to healthcare, economic activity and housing. METHOD: We examined data from 59 482 participants in 12 UK longitudinal studies with data collected before and during the COVID-19 pandemic. Within each study, we estimated the association between psychological distress assessed pre-pandemic and disruptions since the start of the pandemic to healthcare (medication access, procedures or appointments), economic activity (employment, income or working hours) and housing (change of address or household composition). Estimates were pooled across studies. RESULTS: Across the analysed data-sets, 28% to 77% of participants experienced at least one disruption, with 2.3-33.2% experiencing disruptions in two or more domains. We found 1 s.d. higher pre-pandemic psychological distress was associated with (a) increased odds of any healthcare disruptions (odds ratio (OR) 1.30, 95% CI 1.20-1.40), with fully adjusted odds ratios ranging from 1.24 (95% CI 1.09-1.41) for disruption to procedures to 1.33 (95% CI 1.20-1.49) for disruptions to prescriptions or medication access; (b) loss of employment (odds ratio 1.13, 95% CI 1.06-1.21) and income (OR 1.12, 95% CI 1.06 -1.19), and reductions in working hours/furlough (odds ratio 1.05, 95% CI 1.00-1.09) and (c) increased likelihood of experiencing a disruption in at least two domains (OR 1.25, 95% CI 1.18-1.32) or in one domain (OR 1.11, 95% CI 1.07-1.16), relative to no disruption. There were no associations with housing disruptions (OR 1.00, 95% CI 0.97-1.03). CONCLUSIONS: People experiencing psychological distress pre-pandemic were more likely to experience healthcare and economic disruptions, and clusters of disruptions across multiple domains during the pandemic. Failing to address these disruptions risks further widening mental health inequalities.
Authors: Syed Ahmar Shah; Sinead Brophy; John Kennedy; Louis Fisher; Alex Walker; Brian Mackenna; Helen Curtis; Peter Inglesby; Simon Davy; Seb Bacon; Ben Goldacre; Utkarsh Agrawal; Emily Moore; Colin R Simpson; John Macleod; Roxane Cooksey; Aziz Sheikh; Srinivasa Vittal Katikireddi Journal: EClinicalMedicine Date: 2022-05-20
Authors: Kishan Patel; Elaine Robertson; Alex S F Kwong; Gareth J Griffith; Kathryn Willan; Michael J Green; Giorgio Di Gessa; Charlotte F Huggins; Eoin McElroy; Ellen J Thompson; Jane Maddock; Claire L Niedzwiedz; Morag Henderson; Marcus Richards; Andrew Steptoe; George B Ploubidis; Bettina Moltrecht; Charlotte Booth; Emla Fitzsimons; Richard Silverwood; Praveetha Patalay; David Porteous; Srinivasa Vittal Katikireddi Journal: JAMA Netw Open Date: 2022-04-01
Authors: Charlotte Booth; Bożena Wielgoszewska; Michael J Green; Giorgio Di Gessa; Charlotte F Huggins; Gareth J Griffith; Alex S F Kwong; Ruth C E Bowyer; Jane Maddock; Praveetha Patalay; Richard J Silverwood; Emla Fitzsimons; Richard Shaw; Ellen J Thompson; Andrew Steptoe; Alun Hughes; Nishi Chaturvedi; Claire J Steves; Srinivasa Vittal Katikireddi; George B Ploubidis Journal: Soc Sci Med Date: 2022-07-20 Impact factor: 5.379
Authors: Mark Shevlin; Enya Redican; Philip Hyland; Sarah Butter; Orla McBride; Todd K Hartman; Jamie Murphy; Frédérique Vallières; Richard P Bentall Journal: PLoS One Date: 2022-09-21 Impact factor: 3.752
Authors: Madeleine L Smith; Annie Herbert; Amanda Hughes; Kate Northstone; Laura D Howe Journal: BMC Public Health Date: 2022-09-24 Impact factor: 4.135