TY - JOUR
AU - di Gessa, Giorgio
AU - Maddock, Jane
AU - Green, Michael J.
AU - Thompson, Ellen J.
AU - McElroy, Eoin
AU - Davies, Helena L.
AU - Mundy, Jessica
AU - Stevenson, Anna J.
AU - Kwong, Alex S.F.
AU - Griffith, Gareth J.
AU - Katikireddi, Srinivasa Vittal
AU - Niedzwiedz, Claire L.
AU - Ploubidis, George B.
AU - Fitzsimons, Emla
AU - Henderson, Morag
AU - Silverwood, Richard J.
AU - Chaturvedi, Nishi
AU - Breen, Gerome
AU - Steves, Claire J.
AU - Steptoe, Andrew
AU - Porteous, David J.
AU - Patalay, Praveetha
PY - 2021
DA - September
TI - Pre-pandemic mental health and disruptions to healthcare, economic and housing outcomes during the COVID-19 pandemic: evidence from 12 UK longitudinal studies
JO - British Journal of Psychiatry
DO - https://doi.org/10.1192/bjp.2021.132
AB - 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.
PB - Cambridge University Press
UR - http://eprints.gla.ac.uk/253675/
KW - Coronavirus (COVID-19)
ER