Publication type
Journal Article
Authors
Publication date
June 6, 2023
Summary:
Purpose:
The COVID-19 pandemic increased psychiatric distress and impacts differed by family structure. We aimed to identify mechanisms contributing to these inequalities.
Methods:
Survey data were from the UK Household Longitudinal Study. Psychiatric distress (GHQ-12) was measured in April 2020 (first UK lockdown; n = 10,516), and January 2021 (lockdown re-introduced following eased restrictions; n = 6,893). Pre-lockdown family structure comprised partner status and presence of children (< 16 years). Mediating mechanisms included: active employment, financial strain, childcare/home-schooling, caring, and loneliness. Monte Carlo g-computation simulations were used to adjust for confounding and estimate total effects and decompositions into: controlled direct effects (effects if the mediator was absent), and portions eliminated (PE; representing differential exposure and vulnerability to the mediator).
Results:
In January 2021, after adjustment, we estimated increased risk of distress among couples with children compared to couples with no children (RR: 1.48; 95% CI 1.15–1.82), largely because of childcare/home-schooling (PE RR: 1.32; 95% CI 1.00–1.64). Single respondents without children also had increased risk of distress compared to couples with no children (RR: 1.55; 95% CI 1.27–1.83), and the largest PE was for loneliness (RR: 1.16; 95% CI 1.05–1.27), though financial strain contributed (RR: 1.05; 95% CI 0.99–1.12). Single parents demonstrated the highest levels of distress, but confounder adjustment suggested uncertain effects with wide confidence intervals. Findings were similar in April 2020 and when stratified by sex.
Conclusion:
Access to childcare/schooling, financial security and social connection are important mechanisms that need addressing to avoid widening mental health inequalities during public health crises.
Published in
Annals of General Psychiatry
Volume
Volume: 22:24
DOI
https://doi.org/10.1186/s12991-023-00454-1
ISSN
1744859
Subjects
Notes
Open Access
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