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Pre-pandemic mental health and disruptions to healthcare, economic and housing outcomes during the COVID-19 pandemic: evidence from 12 UK longitudinal studies

Published online by Cambridge University Press:  30 September 2021

Giorgio Di Gessa
Affiliation:
Institute of Epidemiology and Health Care, University College London, UK
Jane Maddock
Affiliation:
MRC Unit for Lifelong Health and Ageing, University College London, UK
Michael J. Green
Affiliation:
MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
Ellen J. Thompson
Affiliation:
Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, UK
Eoin McElroy
Affiliation:
Department of Neuroscience, Psychology and Behaviour, University of Leicester, UK
Helena L. Davies
Affiliation:
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Jessica Mundy
Affiliation:
Social, Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
Anna J. Stevenson
Affiliation:
Centre for Genomic and Experimental Medicine, University of Edinburgh, UK
Alex S. F. Kwong
Affiliation:
Division of Psychiatry, University of Edinburgh, UK; and MRC Integrative Epidemiology Unit, University of Bristol, UK
Gareth J. Griffith
Affiliation:
MRC Integrative Epidemiology Unit, University of Bristol, UK
Srinivasa Vittal Katikireddi
Affiliation:
MRC/CSO Social & Public Health Sciences Unit, University of Glasgow, UK
Claire L. Niedzwiedz
Affiliation:
Institute of Health & Wellbeing, University of Glasgow, UK
George B. Ploubidis
Affiliation:
Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK
Emla Fitzsimons
Affiliation:
Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK
Morag Henderson
Affiliation:
Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK
Richard J. Silverwood
Affiliation:
Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK
Nish Chaturvedi
Affiliation:
MRC Unit for Lifelong Health and Ageing, University College London, UK
Gerome Breen
Affiliation:
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
Claire J. Steves
Affiliation:
Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, UK
Andrew Steptoe
Affiliation:
Institute of Epidemiology and Health Care, University College London, UK
David J. Porteous
Affiliation:
Centre for Genomic and Experimental Medicine, University of Edinburgh, UK
Praveetha Patalay*
Affiliation:
MRC Unit for Lifelong Health and Ageing, University College London, UK; and Centre for Longitudinal Studies, UCL Social Research Institute, University College London, UK
*
Correspondence: Dr Praveetha Patalay. Email: p.patalay@ucl.ac.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.

Type
Paper
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists

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Footnotes

*

Joint first authors.

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