scholarly journals Income-related health inequality among Chinese adults during the COVID-19 pandemic: evidence based on an online survey

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Peng Nie ◽  
Lanlin Ding ◽  
Zhuo Chen ◽  
Shiyong Liu ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Family Member ◽  
Health Inequalities ◽  
Online Survey ◽  
Mainland China ◽  
Decomposition Analysis ◽  
National Sample ◽  
Vulnerable Groups

AbstractBackgroundPartial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic.MethodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities.ResultsMost participants reported their health status as “very good” (39.0%) or “excellent” (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%),p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health).ConclusionsPer capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups.

scholarly journals The impact of sitting time and physical activity on mental health during COVID-19 lockdown

2021 ◽  
Author(s):  
Matthew Pears ◽  
Susanna Kola-Palmer ◽  
Liane Beretta De Azevedo
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Online Survey ◽  
Depression Score ◽  
Sitting Time ◽  
Multiple Stepwise Regression Analysis ◽  
Previous Diagnosis ◽  
The Uk ◽  
The Impact

Abstract Objective The primary aim of this study was to investigate the association between physical activity (PA) and sitting time on adults’ mental health (i.e., depression, anxiety and wellbeing) and the influence of mediators and confounders. Methods An online survey was disseminated in the UK between May and June 2020. A total of 284 participants (33.5 ± 12.4 years) self-reported their PA, sitting time and mental health through validated questionnaires. Results Multiple stepwise regression analysis revealed that being of younger age, female, on a lower income, with one or more comorbid health conditions, with a previous diagnosis of mood disorder and increased sitting time independently correlated with higher depression scores (F (13,219) = 12.31, p < 0.001), and explained 42% of the variance. Similar results were found for wellbeing where socio-demographic, health outcomes and sitting time influenced the subjective wellbeing (F (14,218) = 5.77, p < 0.001, 27% variance), although only socio-demographic and health outcomes contributed to the variation in anxiety score (F (13,219) = 7.84, p < 0.001, 32% variance). PA did not explain variation when sitting time was taken into account in any of the models. Combined analysis revealed that participants with lower sedentary time (< 8 h) and with both low or moderate and high PA presented a significantly lower depression score [low PA: (B = −2.7, 95% CI −4.88, −0.52); moderate and high PA (B = −2.7, −4.88, −0.52)]. Conclusion Sitting time was strongly associated with adverse mental health during COVID-19 lockdown and should be considered in future public health recommendations.

scholarly journals A Mental Health Paradox: Mental health was both a motivator and barrier to physical activity during the COVID-19 pandemic

2020 ◽  
Author(s):  
Maryam Marashi ◽  
Emma Nicholson ◽  
Michelle Ogrodnik ◽  
Barbara Fenesi ◽  
Jennifer Heisz
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Online Survey ◽  
Perceived Barriers ◽  
Physically Active ◽  
Aerobic Activity ◽  
Physical Health Outcomes ◽  
Strength Based ◽  
Barriers And Motivators

AbstractThe COVID-19 pandemic has impacted the mental health, physical activity, and sedentary behavior of citizens worldwide. Using an online survey with 1669 respondents, we sought to understand why and how by querying about perceived barriers and motivators to physical activity that changed because of the pandemic, and how those changes impacted mental health. Consistent with prior reports, our respondents were less physically active (aerobic activity, −11%, p <0.05; strength-based activity, −30%, p<0.01) and more sedentary (+11%, p<0.01) during the pandemic as compared to 6-months before. The pandemic also increased psychological stress (+22%, p <0.01) and brought on moderate symptoms of anxiety and depression. Respondents’ whose mental health deteriorated the most were also the ones who were least active (depression r = −.21, p<0.01; anxiety r = −.12, p<0.01). The majority of respondents were unmotivated to exercise because they were too anxious (+8%, p <0.01), lacked social support (+6%, p =<0.01), or had limited access to equipment (+23%, p <0.01) or space (+41%, p <0.01). The respondents who were able to stay active reported feeling less motivated by physical health outcomes such as weight loss (−7%, p<0.01) or strength (−14%, p<0.01) and instead more motivated by mental health outcomes such as anxiety relief (+14%, p <0.01). Coupled with previous work demonstrating a direct relationship between mental health and physical activity, these results highlight the potential protective effect of physical activity on mental health and point to the need for psychological support to overcome perceived barriers so that people can continue to be physically active during stressful times like the pandemic.

scholarly journals A light of hope? Inequalities in mental health before and after the peace agreement in Colombia: a decomposition analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sebastián León-Giraldo ◽  
Germán Casas ◽  
Juan Sebastián Cuervo-Sánchez ◽  
Catalina González-Uribe ◽  
Antonio Olmos ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Health Inequalities ◽  
Health Care Services ◽  
Decomposition Analysis ◽  
Mental Health Outcomes ◽  
Internal Displacement ◽  
Negative Consequences ◽  
Peace Agreement ◽  
Health Differences

Abstract Background The present study seeks to evaluate the change in mental health inequalities in the department of Meta after the signing of Colombia’s Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions (‘SRQ-20’), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences in mental health inequalities over time. Methods Our study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and changes in inequalities in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities. Results Mental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years. Conclusions The reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context.

scholarly journals Mental health risk factors during the first wave of the COVID-19 pandemic

BJPsych Open ◽  
2021 ◽  
Vol 7 (6) ◽  
Author(s):  
Henrique Prata Ribeiro ◽  
André Ponte ◽  
Miguel Raimundo ◽  
Tiago Reis Marques
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Health Outcomes ◽  
Multivariate Regression ◽  
Online Survey ◽  
Significant Proportion ◽  
Mental Health Outcomes ◽  
Vulnerable Groups ◽  
Indirect Contact ◽  
Associated Risk Factors

Background During the first wave of the COVID-19 pandemic, distancing measures were enforced to reduce virus spread, which likely had an impact on the overall mental health of the population. Aims To investigate the prevalence of mental health outcomes (depression, anxiety and insomnia), and associated risk factors, during a physical distancing period imposed in the first wave of COVID-19. Method During the first month of Portugal's state of emergency, an online survey was created and disseminated through social media channels. Sociodemographic and clinical variables were assessed via self-reported questionnaires. Univariate linear regressions were used to identify associations between the collected variables and mental health outcomes. Multivariate regression analyses were performed to identify independent risk factors for clinical outcomes, with adjustment for potential confounders. Results We analysed data from 1626 participants: a significant proportion showed depression (30.2%), anxiety (53.1%) and insomnia (36.3%) symptoms. Multivariate regression models showed that being male and working from home were protective for all mental health outcomes analysed, whereas the perception of infection, being under psychiatric care and taking medication were risk factors (P < 0.05). Days in isolation and being unemployed were risk factors for depression and insomnia (P < 0.05). Younger age and being a student were risk factors for depression, whereas being a healthcare professional was protective (P < 0.05). Indirect contact with COVID-19 was a risk factor for anxiety (P < 0.05). Conclusions COVID-19-related distancing measures were associated with high levels of adverse mental health symptoms. Several risk factors were associated with these symptoms, which highlight the importance of identifying vulnerable groups during physical distancing periods.

scholarly journals A Light of Hope? Inequalities in Mental Health and The Peace Agreement in Colombia: A Decomposition Analysis

2020 ◽  
Author(s):  
Sebastian Leon-Giraldo ◽  
Germán Casas ◽  
Juan Sebastián Cuervo-Sánchez ◽  
Catalina González-Uribe ◽  
Antonio Olmos ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Health Inequalities ◽  
Health Care Services ◽  
Decomposition Analysis ◽  
Mental Health Outcomes ◽  
Internal Displacement ◽  
Negative Consequences ◽  
Peace Agreement ◽  
Health Differences

Abstract Background: The present study seeks to evaluate the evolution of mental health inequalities in the department of Meta after the signing of Colombia's Peace Agreement in 2016 with the FARC guerrilla group. Using a validated survey instrument composed of 20 questions (‘SRQ-20’), we measure changes in mental health inequalities from 2014, before the signing of the agreement, to 2018, after the signing of the agreement. We then decompose the changes in inequalities to establish which socioeconomic factors explain differences over time.Methods: Our study uses information from the Conflicto, Salud y Paz (CONPAS) survey conducted in the department of Meta, Colombia, in 1,309 households in 2018, with retrospective information for 2014. To measure inequalities, we calculate the concentration indices for both years. Through the Oaxaca change decomposition method, we disaggregate changes in mental health inequalities into its underlying factors. This method allows us to explain the relationship between changes in mental health inequalities and reduced inequality in several sociodemographic factors. It also identifies the extent to which these factors help explain the changes in mental health inequalities. Results: Mental health inequalities in Meta were reduced almost by half from 2014 to 2018. In 2018, the population at the lower and middle socioeconomic levels had fewer chances of experiencing mental health disorders in comparison to 2014. The reduction in mental health differences is mostly attributed to reductions in the influence of certain sociodemographic variables, such as residence in rural zones and conflict-affected territories, working in the informal sector, or experiencing internal displacement. However, even though mental health inequalities have diminished, overall mental health outcomes have worsened in these years. Conclusions: The reduction in the contribution of conflict-related variables for explaining mental health inequalities could mean that the negative consequences of conflict on mental health have started to diminish in the short run after the peace agreement. Nevertheless, conflict and the presence of other socioeconomic inequalities still contribute to persistent adverse mental health outcomes in the overall population. Thus, public policy should be oriented towards improving mental health care services in these territories, given the post-accord context.

scholarly journals A mental health paradox: Mental health was both a motivator and barrier to physical activity during the COVID-19 pandemic

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0239244
Author(s):  
Maryam Yvonne Marashi ◽  
Emma Nicholson ◽  
Michelle Ogrodnik ◽  
Barbara Fenesi ◽  
Jennifer J. Heisz
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Health Outcomes ◽  
Sedentary Behavior ◽  
Online Survey ◽  
Health Belief ◽  
Perceived Barriers ◽  
Physically Active ◽  
Aerobic Activity ◽  
Barriers And Motivators

The COVID-19 pandemic has impacted the mental health, physical activity, and sedentary behavior of people worldwide. According to the Health Belief Model (HBM), health-related behavior is determined by perceived barriers and motivators. Using an online survey with 1669 respondents, we sought to understand why and how physical activity and sedentary behavior has changed by querying about perceived barriers and motivators to physical activity that changed because of the pandemic, and how those changes impacted mental health. The following results were statistically significant at p < .05. Consistent with prior reports, our respondents were less physically active (aerobic activity, -11%; strength-based activity, -30%) and more sedentary (+11%) during the pandemic as compared to 6-months before. The pandemic also increased psychological stress (+22%) and brought on moderate symptoms of anxiety and depression. Respondents’ whose mental health deteriorated the most were also the ones who were least active (depression r = -.21, anxiety r = -.12). The majority of respondents were unmotivated to exercise because they were too anxious (+8%,), lacked social support (+6%), or had limited access to equipment (+23%) or space (+41%). The respondents who were able to stay active reported feeling less motivated by physical health outcomes such as weight loss (-7%) or strength (-14%) and instead more motivated by mental health outcomes such as anxiety relief (+14%). Coupled with previous work demonstrating a direct relationship between mental health and physical activity, these results highlight the potential protective effect of physical activity on mental health and point to the need for psychological support to overcome perceived barriers so that people can continue to be physically active during stressful times like the pandemic.

Mental distress and its associations with behavioral outcomes during the COVID-19: A national survey of Chinese adults (Preprint)

2020 ◽  
Author(s):  
Lu Ma ◽  
Liwang Gao ◽  
Joseph Tak-Fai Lau ◽  
Rahman Atif ◽  
Blair T. Johnson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Body Weight ◽  
Educational Attainment ◽  
Structural Equation ◽  
Online Survey ◽  
Mental Distress ◽  
Structural Equation Models ◽  
Behavioral Outcomes ◽  
National Sample ◽  
Negative Consequences

BACKGROUND This study primarily aimed to evaluate the associations between mental distress and COVID-19-related changes in behavioral outcomes, and potential modifiers (age, gender, and educational attainment) of such associations. OBJECTIVE The COVID -19 pandemic has led to elevated levels of mental distress attributed to prolonged lockdowns, business closures, and social isolation. Its impact on behavioral outcomes is however less known. This study is designed to primarily evaluate the associations between mental distress and COVID-19-related changes in drinking, smoking, physical activity and body weight, and potential modifiers of such associations including age, gender, and educational attainment. METHODS An online survey using anonymous network sampling was conducted in China during April-May, 2020 using a 74-item questionnaire distributed through social media. A national sample of 10,545 adults in 31 provinces provided data on socio-demographic characteristics, COVID-19-related mental distress, and changes in behavioral outcomes. Structural equation models were used for data analyses. RESULTS About 13% of adults reported experiencing at least one symptom of mental distress. After adjusting for age, education, gender, ethnicity, marital status, residence, and number of chronic conditions, greater mental distress was associated with increased smoking and alcohol consumption (among current smokers and drinkers) and with both increased and decreased physical activity. Underweight adults were more likely to lose body weight (≥1 kg) whereas overweight adults were more likely to gain weight by the same amount. The association between mental distress and change in physical activity was stronger in adults aged 40 and above and those with high education. Mental distress was significantly associated with an increase in smoking in males but not females. CONCLUSIONS Mental distress was associated with increased smoking in males but not females. These findings inform the design of tailored public health interventions aimed to mitigate long-term negative consequences of mental distress on outcomes.

scholarly journals How is the COVID-19 lockdown impacting the mental health of parents of school-age children in the UK? A cross-sectional online survey

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e043397
Author(s):  
Austen El-Osta ◽  
Aos Alaa ◽  
Iman Webber ◽  
Eva Riboli Sasco ◽  
Emmanouil Bagkeris ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Social Isolation ◽  
Online Survey ◽  
Female Gender ◽  
School Age Children ◽  
School Age ◽  
Cross Sectional ◽  
The Uk ◽  
The Impact

ObjectiveInvestigate the impact of the COVID-19 lockdown on feelings of loneliness and social isolation in parents of school-age children.DesignCross-sectional online survey of parents of primary and secondary school-age children.SettingCommunity setting.Participants1214 parents of school-age children in the UK.MethodsAn online survey explored the impact of lockdown on the mental health of parents with school-age children, and in particular about feelings of social isolation and loneliness. Associations between the UCLA Three-Item Loneliness Scale (UCLATILS), the Direct Measure of Loneliness (DMOL) and the characteristics of the study participants were assessed using ordinal logistic regression models.Main outcome measuresSelf-reported measures of social isolation and loneliness using UCLATILS and DMOL.ResultsHalf of respondents felt they lacked companionship, 45% had feelings of being left out, 58% felt isolated and 46% felt lonely during the first 100 days of lockdown. The factors that were associated with higher levels of loneliness on UCLATILS were female gender, parenting a child with special needs, lack of a dedicated space for distance learning, disruption of sleep patterns and low levels of physical activity during the lockdown. Factors associated with a higher DMOL were female gender, single parenting, parenting a child with special needs, unemployment, low physical activity, lack of a dedicated study space and disruption of sleep patterns during the lockdown.ConclusionsThe COVID-19 lockdown has increased feelings of social isolation and loneliness among parents of school-age children. The sustained adoption of two modifiable health-seeking lifestyle behaviours (increased levels of physical activity and the maintenance of good sleep hygiene practices) wmay help reduce feelings of social isolation and loneliness during lockdown.

scholarly journals Physical activity and mental well-being under COVID-19 lockdown: a cross-sectional multination study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Costas I. Karageorghis ◽  
Jonathan M. Bird ◽  
Jasmin C. Hutchinson ◽  
Mark Hamer ◽  
Yvonne N. Delevoye-Turrell ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Young Adults ◽  
Sedentary Behavior ◽  
Online Survey ◽  
Electronic Device ◽  
Well Being ◽  
Middle Aged ◽  
Steps Per Day ◽  
Western Nations

Abstract Background COVID-19 lockdowns have reduced opportunities for physical activity (PA) and encouraged more sedentary lifestyles. A concomitant of sedentariness is compromised mental health. We investigated the effects of COVID-19 lockdown on PA, sedentary behavior, and mental health across four Western nations (USA, UK, France, and Australia). Methods An online survey was administered in the second quarter of 2020 (N = 2541). We measured planned and unplanned dimensions of PA using the Brunel Lifestyle Physical Activity Questionnaire and mental health using the 12-item General Health Questionnaire. Steps per day were recorded only from participants who used an electronic device for this purpose, and sedentary behavior was reported in hours per day (sitting and screen time). Results In the USA and Australia samples, there was a significant decline in planned PA from pre- to during lockdown. Among young adults, Australians exhibited the lowest planned PA scores, while in middle-aged groups, the UK recorded the highest. Young adults exhibited the largest reduction in unplanned PA. Across nations, there was a reduction of ~ 2000 steps per day. Large increases in sedentary behavior emerged during lockdown, which were most acute in young adults. Lockdown was associated with a decline in mental health that was more pronounced in women. Conclusions The findings illustrate the deleterious effects of lockdown on PA, sedentary behavior, and mental health across four Western nations. Australian young and lower middle-aged adults appeared to fare particularly badly in terms of planned PA. The reduction in steps per day is equivalent to the non-expenditure of ~ 100 kcal. Declines in mental health show how harmful lockdowns can be for women in particular.

scholarly journals Factors Related to Mental Health During the COVID-19 Lockdown in Spain

2021 ◽  
Vol 12 ◽  
Author(s):  
Ruth Pinedo ◽  
Isabel Vicario-Molina ◽  
Eva González Ortega ◽  
Andrés Palacios Picos
Keyword(s):  
Mental Health ◽  
Latent Variables ◽  
Structural Equation ◽  
Online Survey ◽  
Psychological Impact ◽  
Well Being ◽  
Vulnerable Groups ◽  
Equation Modeling ◽  
Healthy Habits ◽  
And Gender

The COVID-19 disease has forced governments to adopt exceptional measures. The lockdown decreed in Spain in 2020 required citizens to stay confined at home, which might have affected their mental health. The objective is to identify factors that influenced adults' mental health during this period. A sample of 3,508 adults from the Spanish general population completed an online survey that collected sociodemographic data and information about daily planning and activities, healthy habits, loneliness, coping humor and mental health. Data were analyzed using Structural Equation Modeling. According to the results, the proposed model showed good fit values, and latent variables explained 30% of the variance in mental health. Loneliness, coping humor, healthy habits, age and gender had a significant weight in the prediction of mental health during lockdown. Area of residence, number of days of confinement and number of people in the household were not related to mental health. This study addresses the effect of COVID-19 and social distancing measures by identifying risk and protective factors for the development of mental health difficulties. There is a need to target specific and early interventions aimed at mitigating the psychological impact of the pandemic while increasing well-being, especially in more vulnerable groups.

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