Objectives: The COVID-19 pandemic has substantially affected workers’ mental health. We investigated changes in UK workers’ mental health by industry, socioeconomic class and occupation and differential effects by UK country of residence, gender and age.

Methods: We used representative Understanding Society data from 6474 adults (41 207 observations) in paid employment who participated in pre-pandemic (2017–2020) and at least one COVID-19 survey. The outcome was General Health Questionnaire-12 (GHQ-12) caseness (score: ≥4). Exposures were industry, socioeconomic class and occupation and are examined separately. Mixed-effects logistic regression was used to estimate relative (OR) and absolute (%) increases in distress before and during pandemic. Differential effects were investigated for UK countries of residence (non-England/England), gender (male/female) and age (younger/older) using three-way interaction effects.

Results: GHQ-12 caseness increased in relative terms most for ‘professional, scientific and technical’ (OR: 3.15, 95% CI 2.17 to 4.59) industry in the pandemic versus pre-pandemic period. Absolute risk increased most in ‘hospitality’ (+11.4%). For socioeconomic class, ‘small employers/self-employed’ were most affected in relative and absolute terms (OR: 3.24, 95% CI 2.28 to 4.63; +10.3%). Across occupations, ‘sales and customer service’ (OR: 3.01, 95% CI 1.61 to 5.62; +10.7%) had the greatest increase. Analysis with three-way interactions showed considerable gender differences, while for UK country of residence and age results are mixed.

Conclusions: GHQ-12 caseness increases during the pandemic were concentrated among ‘professional and technical’ and ‘hospitality’ industries and ‘small employers/self-employed’ and ‘sales and customers service’ workers. Female workers often exhibited greater differences in risk by industry and occupation. Policies supporting these industries and groups are needed.


This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

Cite as

Kromydas, T., Green, M., Craig, P., Katikireddi, S., Leyland, A., Niedzwiedz, C., Pearce, A., Thomson, R. & Demou, E. 2022, 'Comparing population-level mental health of UK workers before and during the COVID-19 pandemic: A longitudinal study using Understanding Society', Journal of Epidemiology and Community Health, 76(6), pp. 527-536. http://dx.doi.org/10.1136/jech-2021-218561

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Last updated: 12 December 2023
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