Niedzwiedz, Claire L and Green, Michael James and Benzeval, Michaela and Campbell, Desmond and Craig, Peter and Demou, Evangelia and Leyland, Alastair and Pearce, Anna and Thomson, Rachel and Whitley, Elise and Katikireddi, Srinivasa Vittal (2021) Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study. Journal of Epidemiology & Community Health, 75, (3), pp. 224-231. doi: 10.1136/jech-2020-215060.
External website: https://jech.bmj.com/content/75/3/224.long
BACKGROUND
There are concerns that COVID-19 mitigation measures, including the 'lockdown', may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups.
METHODS
Repeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of over 27,000 adults (aged 18+) interviewed in four survey waves between 2015 and 2020. A total of 9748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity.
RESULTS
Psychological distress increased 1 month into lockdown with the prevalence rising from 19.4% (95% CI 18.7% to 20.1%) in 2017-2019 to 30.6% (95% CI 29.1% to 32.3%) in April 2020 (RR=1.3, 95% CI 1.2 to 1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI 0.6 to 1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI 1.3 to 1.5), as did binge drinking (RR=1.5, 95% CI 1.3 to 1.7).
CONCLUSIONS
Psychological distress increased 1 month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate negative impacts on health.
B Substances > Tobacco (cigarette smoking)
G Health and disease > State of health > Mental health
G Health and disease > Substance use disorder (addiction) > Alcohol use disorder
G Health and disease > Disease by cause (Aetiology) > Communicable / infectious disease > Viral disease / infection > Coronavirus (COVID-19)
VA Geographic area > International
VA Geographic area > Europe > United Kingdom
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