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Bandara P, Wickrama P, Sivayokan S, Knipe D, Rajapakse T. Reflections on the trends of suicide in Sri Lanka, 1997-2022: The need for continued vigilance. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003054. [PMID: 38630779 PMCID: PMC11023397 DOI: 10.1371/journal.pgph.0003054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 03/03/2024] [Indexed: 04/19/2024]
Abstract
Despite reductions in suicide rates in Sri Lanka during the past decades, largely by introduction of national bans on highly hazardous pesticides, the country continues to record a higher than global average rate of suicide. With the changing availability of methods of suicide over time, we aimed to examine the age-standardized suicide rates in Sri Lanka by sex, age, and method between 1997 to 2022 using national police suicide data to identify trends. The rate of suicide in Sri Lanka in 2022 was 27/100,000 and 5/100,000, in males and females respectively, with an overall suicide rate of 15/100,000 population. When considering the previous decades, the overall rate of suicide has declined from 1997 until about 2015, in both sexes, driven by a drop in the numbers of suicides due to pesticide ingestion. In females the overall rates of suicide plateaued around 2015, but in males there has been an upward trend in overall suicide that started in 2016, mostly due to an increase in rates of hanging. Since 2016 rates of suicide by hanging have increased among older males, and young females (17-25 years). Whilst the current suicide rate in Sri Lanka is substantially lower than it was during the 1990s, the upward trend in hanging seen in the last few years, particularly among older men and young women, is of concern. Ongoing monitoring of suicide rates should be a priority during the next few years, to detect and respond to changes as soon as possible. There is an urgent need to address current risk factors for suicide in Sri Lanka, such as significant financial insecurity, unemployment, depression, alcohol misuse, and domestic violence, and to minimize media glamourization of hanging by suicide.
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Affiliation(s)
- Piumee Bandara
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Prabath Wickrama
- Department of Psychiatry, University of Jaffna, Jaffna, Sri Lanka
| | | | - Duleeka Knipe
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Thilini Rajapakse
- South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Psychiatry, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
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Laker B, Weisz N, Vassolo R. Countercyclical approach to enhancing health and well-being in healthcare systems: strategies for economic resilience and sustainable care. BMJ LEADER 2024:leader-2023-000873. [PMID: 38408842 DOI: 10.1136/leader-2023-000873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 02/20/2024] [Indexed: 02/28/2024]
Affiliation(s)
| | - Natalia Weisz
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
| | - Roberto Vassolo
- IAE Business School, Universidad Austral, Buenos Aires, Argentina
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Talana ALE, Quensell ML, Peltzer NK, Thompson MD, Stupplebeen D, Pirkle CM, Keliikoa LB. Examining Mental Health and Economic Consequences During the COVID-19 Pandemic Among Filipino Residents in Hawai'i: May - Oct 2020. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2024; 83:16-24. [PMID: 38223464 PMCID: PMC10782392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has resulted in rapid and drastic changes to daily lives, posing a threat to residents' mental health and well-being. Filipinos are disproportionately impacted by COVID-19 and have one of the highest COVID-19 prevalence in Hawai'i. The COVID-19 pandemic has been associated with a rise in mental health concerns, yet little is known about the impact on the mental health of Filipinos in Hawai'i. Using publicly available polling data from the SMS Community Pulse Survey, this study sought to describe the mental distress experienced by Filipino residents during the COVID-19 pandemic. Data were collected from an online panel of Hawai'i residents over 4 timepoints (May 5-10; June 11-17; July 31-August 8; October 19-31, 2020). Compared to non-Filipinos, a higher proportion of Filipinos reported feeling stress and sadness during 3 of the 4 timepoints. Across all timepoints, Filipinos were more likely to respond affirmatively to mental health indicators (62.5%). Similarly, Filipinos reported food insecurity in higher proportions relative to non-Filipinos in most timepoints, particularly notable in Timepoint 4 where 33.0% of Filipino respondents reported food insecurity. These findings suggest that Filipinos would benefit from social policy and community-supported initiatives to address social determinants of health, reduce chronic stress, and prevent further mental health disparities.
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Affiliation(s)
- Angel Lynn E. Talana
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Michelle L. Quensell
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Nicole K. Peltzer
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Mika D. Thompson
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - David Stupplebeen
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - Catherine M. Pirkle
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
| | - L. Brooke Keliikoa
- Office of Public Health Studies, Thompson School of Social Work and Public Health, University of Hawai‘i at Mānoa, Honolulu, HI
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Di Quirico R. Uncertainty, Anxiety and the Post-Pandemic Economic Environment. CLINICAL NEUROPSYCHIATRY 2023; 20:227-232. [PMID: 37791078 PMCID: PMC10544235 DOI: 10.36131/cnfioritieditore20230401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
There is ample evidence from medical and social sciences that economic crises impact on individual mental health. This makes neuro-psychiatric dynamics and individual mental health, particularly that of entrepreneurs, relevant for economic policy designers. At the same time, economic policies can have an impact on mental health, reducing or increasing economic uncertainty and, consequently, changing the level of anxiety in individuals. The COVID-19 pandemic resulted in a severe economic crisis and a drastic transformation of the European economic environment. However, the severity and impact of this crisis differ from many other economic and financial setbacks of the past, including the one resulting from the 2008 crisis. Moreover, the consequences of the pandemic on mental health will add to the long-term consequences of the 2010s crisis and the effects of the war at Europe's Eastern borders. Together, the three crises may increase economic uncertainty in the post-pandemic World and its impact on mental health. This essay examines the connections between economic uncertainty, anxiety, and mental health. It suggests considering some relevant elements to estimate the impact of economic uncertainty on individual mental health. Also, hypotheses about the consequences of the "three crises shock" on mental health in the post-pandemic World are advanced. Finally, the essay helps anticipate how the EU anti-crisis economic policies may generate needs and opportunities for mental health care in national health systems.
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Affiliation(s)
- Roberto Di Quirico
- Dipartimento di Ingegneria meccanica, chimica e dei materiali Università degli studi di Cagliari (Dept. Of Mechanical, Chemical, and Materials Engineering, University of Cagliari) via Marengo, 2 - 09123 Cagliari, Italy
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Varghese SS, Gnanaselvam NA, Joseph B. Prevalence of and Work-Related Factors Associated with Sickness Presenteeism among Nursing Care Providers in Selected Tertiary Hospitals in Bangalore City: A Cross-Sectional Study. Indian J Occup Environ Med 2023; 27:183-189. [PMID: 37600650 PMCID: PMC10434814 DOI: 10.4103/ijoem.ijoem_240_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/17/2023] [Accepted: 01/26/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Sickness presenteeism is a phenomenon where "workers go to work when ill." The objective of this study was to determine the prevalence of and work-related factors associated with presenteeism among nursing care providers in selected tertiary hospitals in Bangalore city. Methodology Participants were selected using stratified sampling followed by simple random sampling. A questionnaire was designed to capture socio-demographic information, sickness-related behavior, performance-based self-esteem (PBSE), and selected work-related characteristics. Results A total of 357 participants were enrolled in the study, 274 were staff nurses (S/N) and 83 were nursing assistants (N/A). About 75% of the participants reported presenteeism at least once in the last year, two-fifths did so in the last 4 weeks and nearly 15% were sick on the day of the interview. The mean Stanford Sickness Presenteeism Scale-6 score was 18.49 ± 3.84. The most frequent reason for presenteeism was "perceived mildness of the disease." In bivariate analysis, those who were younger, male, had children, higher qualifications, chronic ailment/s, financial commitments, lesser work experience, and higher PBSE had higher presenteeism scores. When introduced into a linear regression model, those S/N who had children [Standardized coefficient = 0.23 (0.40-1.97)], higher PBSE scores [Standardized coefficient = 0.385 (0.15-2.55)], and reported sickness absenteeism in the preceding 4 weeks [Standardized coefficient = 0.136 (0.12-1.01)] were significantly associated with higher presenteeism scores. Those N/A who had lesser work experience had higher presenteeism scores [Standardized coefficient = -0.33 (-0.02--0.004)]. Conclusion Presenteeism is a common phenomenon among nursing care providers. It is imperative that both employers and employees be educated about its ill effects on the individual, fellow staff, and patients, followed by the adoption of preventive measures.
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Affiliation(s)
- Suman S. Varghese
- Department of Community Health, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Nancy A. Gnanaselvam
- Department of Community Health, St. John’s Medical College, Bengaluru, Karnataka, India
| | - Bobby Joseph
- Department of Community Health, St. John’s Medical College, Bengaluru, Karnataka, India
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Oksa R, Mäkikangas A, Savela N, Latikka R, Oksanen A. Longitudinal development of well-being among Finnish employees during 2019-2021: Relationships with personality trait profiles. Scand J Psychol 2023; 64:179-193. [PMID: 36183236 DOI: 10.1111/sjop.12868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 06/27/2022] [Accepted: 08/16/2022] [Indexed: 11/30/2022]
Abstract
We examined well-being profiles among Finnish employees before and during the COVID-19 pandemic and their links with personality trait profiles. Longitudinal survey data were collected in 2019-2021, and 733 respondents participated in all five surveys. The data were analyzed with a person-centered approach using latent profile analysis (LPA). Measures included burnout, work engagement, psychological distress; and Big Five personality traits. Six well-being profiles: Disengaged, Declined, Engaged, Fluctuated, Stable, and Burned-out, and four personality profiles: Ordinary, Reserved, Resilient, and Overcontrolled were identified. Resilient participants typically belonged to the Engaged well-being profile and Reserved to Burned-out and Fluctuated well-being profiles. Although some separation in developmental well-being profiles existed, overall, well-being was rather stable. Personality trait profiles played a crucial role in maintaining well-being.
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Affiliation(s)
- Reetta Oksa
- Faculty of Social Sciences, Emerging Technologies Lab, Tampere University, Tampere, Finland
| | - Anne Mäkikangas
- Faculty of Social Sciences, Work Research Centre, Tampere University, Tampere, Finland
| | - Nina Savela
- Faculty of Social Sciences, Emerging Technologies Lab, Tampere University, Tampere, Finland
| | - Rita Latikka
- Faculty of Social Sciences, Emerging Technologies Lab, Tampere University, Tampere, Finland
| | - Atte Oksanen
- Faculty of Social Sciences, Emerging Technologies Lab, Tampere University, Tampere, Finland
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Fukuya Y, Nawa N, Morita A, Fujiwara T. Association of revision of Money Lending Business Act and suicide rate in Japan: An interrupted time series analysis. Suicide Life Threat Behav 2023. [PMID: 36856288 DOI: 10.1111/sltb.12950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 01/09/2023] [Accepted: 02/01/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Debt problems are associated with suicide. In Japan, the Money Lending Business (MLB) Act was revised in December 2006 and fully enforced in June 2010 to reduce multiple debt problems. This study aimed to examine the association between the full enforcement of the revised act and suicide rates. METHODS An interrupted time series analysis was used to the national registry data of death records between January 2000 and December 2016. Stratified analysis was conducted to assess the differences between gender and age groups. RESULTS The effects of the full enforcement on the suicide rate were the greatest among men aged 40-64 years; after the enforcement, there was a significant decrease of -0.3085 per 100,000 persons in the level of the suicide rate (95% confidence interval [CI] -0.529 to -0.0881) and -0.0165 per 100,000 persons (95% CI -0.0215 to -0.0115) in the trend. Among women aged 40-64 and ≥65 years, an increase in the level of the suicide rate was observed after the enforcement. CONCLUSIONS The full enforcement of the revised MLB Act was associated with decreased suicide rates, particularly among middle-aged men. Policy interventions for addressing debt problems may have the potential to prevent suicide.
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Affiliation(s)
- Yoshifumi Fukuya
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Nobutoshi Nawa
- Institute of Education, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ayako Morita
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
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Jeong H, Yim HW, Lee SY, Jung DY. Impact of the COVID-19 Pandemic on Gender Differences in Depression Based on National Representative Data. J Korean Med Sci 2023; 38:e36. [PMID: 36786083 PMCID: PMC9925330 DOI: 10.3346/jkms.2023.38.e36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/21/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Restrictions on daily life and changes in economic structure due to coronavirus disease 2019 (COVID-19) likely would have affected men and women differently. However, there is still a lack of research on the difference between men and women in the amount of change in depression during COVID-19 compared to before COVID-19. Therefore, the researchers investigated gender differences in the magnitude of increase in the prevalence of depression with its severity and individual symptoms during COVID-19 compared with pre-pandemic levels. METHODS The Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2018 were used to assess depression levels pre-pandemic and the KNHANES 2020 for pandemic depression levels. Depression was evaluated using the Patient Health Questionnaire-9 (PHQ-9). To analyze the differences between men and women in the magnitude of the mental health impact of COVID-19, the researchers analyzed the weighted differences in depression prevalence, severity, and individual symptoms during the COVID-19 pandemic compared to before COVID-19 stratified by gender. RESULTS In men, there were significant increases in weighted prevalence for depression (1.2% percentage point; 95% confidence interval [CI], 0.0-2.3) and severe symptoms of depression (2.6-fold; 95% CI, 1.2-5.7). Among the individual symptoms of depression, significant increases during the pandemic compared to before were: little interest or pleasure in doing things, 1.26-fold; feeling tired or having little energy, 2.2-fold; and suicidal thoughts, 1.7-fold. However, there was no significant difference in prevalence, symptoms severity, and any symptom before and during COVID-19 in women. CONCLUSIONS Because the pandemic is likely to increase mental problems of the affected over time due to such problems as financial stress and joblessness or post-infection health issues, the researchers anticipate an increase in the prevalence of some mental illnesses. In particular, since the suicide rate of men is higher than that of women, from a public health perspective, active interventions are needed to prevent an increase in the suicide rate due to COVID-19. It is also necessary to establish national policies to overcome the psychological, social, and economic losses resulting from COVID-19.
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Affiliation(s)
- Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Seung-Yup Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Da Young Jung
- Clinical Research Coordinating Center, Catholic Medical Center, Seoul, Korea
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Liczbińska G, Brabec M, Piontek J, Malina RM. Age at menarche, environmental stress, and social inequality: Evidence from Poland in the 1930s-1950s. Am J Hum Biol 2023; 35:e23817. [PMID: 36219696 DOI: 10.1002/ajhb.23817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 08/02/2022] [Accepted: 09/23/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To address the relationship between socioeconomic factors and age of menarche among Polish women born and reared in periods that varied considerably in environmental stresses: the Great Depression of the 1930s, the interval of World War II, and the interval of communist rule following World War II through the 1950s. METHODS The data set included information on age at menarche and socioeconomic status (SES) of 718 women born during the Great Depression (n = 182), WWII (n = 189), and post-WWII through the 1950s (n = 347). A structured semi-parametric statistical model (generalized additive model [GAM] class) was used for analysis. An ANOVA-like linear model was used to test for marginal effects of SES-related factors and their interactions together with nonparametric seasonal effect. RESULTS The influence of period of birth, month of birth, region of early childhood, and father's education, and the interaction between period of birth and father's education on age at menarche were statistically significant. During the economic crisis and the interval of WWII, differences in ages at menarche between the extreme categories of father's education were marked. The differences in ages at menarche between women from the lowest and highest social groups were markedly reduced among women born during the post-war interval. In addition, women born in February-March attained menarche earlier than women born in September-October. CONCLUSIONS Unpredictable conditions associated with the economic crisis and war conditions had a stronger impact on age at menarche among women from families of lower SES compared to women from better economic circumstances. Individuals born and reared in low SES conditions likely suffered more severe deterioration across the spectrum of the standard of living and quality of life compared to those with a higher SES.
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Affiliation(s)
- Grażyna Liczbińska
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland
| | - Marek Brabec
- Department of Statistical Modelling, Institute of Computer Science, The Czech Academy of Sciences, Prague, Czech Republic.,Department of Biostatistics, National Institute of Public Health, Prague, Czech Republic
| | - Janusz Piontek
- Institute of Human Biology and Evolution, Faculty of Biology, Adam Mickiewicz University, Poznań, Poland
| | - Robert M Malina
- Department of Kinesiology and Health Education, University of Texas, Austin, Texas, USA
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de la Fuente-Roldán IN, Corchado-Castillo AI, Dorado-Barbé A. Mental Health and Homelessness in the Community of Madrid (Spain): The Impact of Discrimination and Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2034. [PMID: 36767398 PMCID: PMC9915538 DOI: 10.3390/ijerph20032034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to analyze the impact of experiences of violence and discrimination on mental health among people in situations of homelessness (PSH). For this purpose, a quantitative, descriptive, and correlational investigation was conducted by conducting a survey with 603 PSH living in the Community of Madrid (Spain). The results show high levels of mental health impairment, as well as approximately half of the participants having experienced discrimination and violence in the course of their homelessness. Perceived experiences of discrimination are associated with higher levels of mental health impairment (OR = 0.458; p = < 0.001; 95% IC 0.31-0.68). This deterioration is also related to a negative self-assessment of the general state of health among participants (OR = 0.262; p = < 0.001; 95% IC 0.12-0.57). However, impaired mental health is not associated with experiences of violence. The findings also indicate that there are intersections in terms of being female, young, and foreign that result in greater psychological impairment and a higher risk of experiencing violence and discrimination. This study provides an insight into the PSH experiences in relation to mental health, violence, and discrimination and the need to implement actions aimed at improving their psychosocial wellbeing from the perspective of respect for citizens' rights.
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Affiliation(s)
- Iria Noa de la Fuente-Roldán
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
- Institute for Research in Development and Cooperation (IUDC-UCM), Complutense University of Madrid, 28015 Madrid, Spain
| | - Ana Isabel Corchado-Castillo
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
| | - Ana Dorado-Barbé
- Department of Social Work and Social Services (Faculty of Social Work), Complutense University of Madrid, 28223 Madrid, Spain
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Sacco PL, Valle F, De Domenico M. Proactive vs. reactive country responses to the COVID-19 pandemic shock. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001345. [PMID: 36962977 PMCID: PMC10021818 DOI: 10.1371/journal.pgph.0001345] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 12/08/2022] [Indexed: 01/25/2023]
Abstract
The infection caused by SARS-CoV-2, responsible for the COVID-19 pandemic, is characterized by an infectious period with either asymptomatic or pre-symptomatic phases, leading to a rapid surge of mild and severe cases putting national health systems under serious stress. To avoid their collapse, and in the absence of pharmacological treatments, during the early pandemic phase countries worldwide were forced to adopt strategies, from elimination to mitigation, based on non-pharmacological interventions which, in turn, overloaded social, educational and economic systems. To date, the heterogeneity and incompleteness of data sources does not allow to quantify the multifaceted impact of the pandemic at country level and, consequently, to compare the effectiveness of country responses. Here, we tackle this challenge from a complex systems perspective, proposing a model to evaluate the impact of systemic failures in response to the pandemic shock. We use health, behavioral and economic indicators for 44 countries to build a shock index quantifying responses in terms of robustness and resilience, highlighting the crucial advantage of proactive policy and decision making styles over reactive ones, which can be game-changing during the emerging of a new variant of concern.
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Affiliation(s)
- Pier Luigi Sacco
- DiSFiPEQ, University of Chieti-Pescara, Pescara, Italy
- metaLAB (at) Harvard, Cambridge, Massachusetts, United States of America
| | | | - Manlio De Domenico
- Department of Physics and Astronomy "Galileo Galilei", University of Padova, Padova, Italy
- Padua Center for Network Medicine, Padova, Italy
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12
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Shevlin M, Redican E, Hyland P, Butter S, McBride O, Hartman TK, Murphy J, Vallières F, Bentall RP. Perceived manageability of debt and mental health during the COVID-19 pandemic: A UK population analysis. PLoS One 2022; 17:e0274052. [PMID: 36129896 PMCID: PMC9491596 DOI: 10.1371/journal.pone.0274052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/21/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives This study examined the association between perceived manageability of debt and risk of depression, anxiety, and mental health help-seeking among a nationally representative sample of adults living in the United Kingdom (UK). Methods Data was derived from the COVID-19 Psychological Research Consortium (C19PRC) Study Wave 6 (August/September 2021) which examined the psychological, social, and economic effects of the COVID-19 pandemic on the UK adult population. Bivariate and logistic regression analyses were conducted to determine the association between different levels of perceived debt manageability (i.e., “easily manageable”, “some problems”, “quite serious problems”, “very serious problems”, “cannot manage at all”) and mental health related outcomes. Results Almost a quarter of the sample (24%, n = 494) reported debt management problems, and debt manageability associated with higher levels of anxiety, depression, and mental health help-seeking. After adjusting for demographic variables (e.g. income, receipt of benefits), logistic regression analysis demonstrated a dose-response association between increasing levels of debt manageability problems and mental health outcomes. Specifically, adjusted odds ratios for anxiety ranged from 2.28 (‘some problems’) to 11.18 (‘very serious problems’), for depression ranged from 2.80 (‘some problems’) to 16.21 (‘cannot manage at all’), and for mental health help-seeking ranged from 1.69 (‘some problems’) to 3.18 (‘quite serious problems’, ‘very serious problems’). Conclusion This study highlights that debt manageability problems represent a robust predictor of depression, anxiety, and mental-health help seeking.
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Affiliation(s)
- Mark Shevlin
- Department of Psychology, Ulster University, Londonderry, Northern Ireland, United Kingdom
- * E-mail:
| | - Enya Redican
- Department of Psychology, Ulster University, Londonderry, Northern Ireland, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sarah Butter
- Department of Psychology, Ulster University, Londonderry, Northern Ireland, United Kingdom
| | - Orla McBride
- Department of Psychology, Ulster University, Londonderry, Northern Ireland, United Kingdom
| | - Todd K. Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Jamie Murphy
- Department of Psychology, Ulster University, Londonderry, Northern Ireland, United Kingdom
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Fountoulakis KN, Fountoulakis NK, Theodorakis PN, Souliotis K. Overall mortality trends in Greece during the first period of austerity and the economic crisis (2009-2015). Hippokratia 2022; 26:98-104. [PMID: 37324039 PMCID: PMC10266329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVES The economic crisis and the resulting austerity in Greece led to a drastic reduction in healthcare spending, which has been assumed to have impacted people's health. This paper discusses official standardized mortality rates in Greece between 2000 and 2015. METHODS This study was designed to analyze population-level data and collected data from the World Bank, the Organisation for Economic Co-operation and Development, Eurostat, and the Hellenic Statistics Authority. Separate linear regression models were developed for the periods before and after the crisis and were compared. RESULTS Standardized mortality rates do not support a previously reported assumption of a specific and direct negative effect of austerity on global mortality. Standardized rates continued to decrease linearly, and their correlation to economic variables changed after 2009. Total infant mortality rates show an overall rising trend since 2009, but the interpretation is unclear because of the reduction in the absolute number of deliveries. CONCLUSIONS The mortality data from the first six years of the financial crisis in Greece and the decade that preceded do not support the assumption that budget cuts in health are related to the dramatic worsening of the overall health of the Greek people. Still, data suggest an increase in specific causes of death and the burden on a dysfunctional and unprepared health system that is working in an overstretched manner trying to meet needs. The dramatic acceleration of the aging of the population constitutes a specific challenge for the health system. HIPPOKRATIA 2022, 26 (3):98-104.
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Affiliation(s)
- K N Fountoulakis
- 3rd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | | | | | - K Souliotis
- Faculty of Social and Political Sciences, University of Peloponnese, Greece
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14
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Lancaster MR, Callaghan P. The effect of exercise on resilience, its mediators and moderators, in a general population during the UK COVID-19 pandemic in 2020: a cross-sectional online study. BMC Public Health 2022; 22:827. [PMID: 35468747 PMCID: PMC9037056 DOI: 10.1186/s12889-022-13070-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/22/2022] [Indexed: 01/04/2023] Open
Abstract
Background Resilience is central to positive mental health and well-being especially when faced with adverse events. Factors such as exercise, location, sleep, mental health, and personality are moderators and mediators of resilience. However, the impact of these factors on resilience during severe adverse events are unknown. The present study examined how the COVID-19 pandemic affected resilience and its moderators and mediators by investigating whether there was a difference in resilience and quality of life between people with varying levels of exercise, including those who changed their exercise levels pre and during a COVID-19-related lockdown, and whether location affected the relationship between levels of exercise and resilience and quality of life. Methods Following ethical approval, a cross-sectional online survey capturing data on self-reported key moderators and mediators of resilience before and during the COVID-19 lockdown imposed on the 23rd March 2020 in the UK was distributed via social media and completed over a three week time period during July 2020 via a self-selecting sample of the general population (N = 85). The key moderators and mediators of resilience the survey assessed were exercise, location, life-orientation, mental health, and sleep quality. All data were self-reported. Results Participants’ exercise intensity level increased as resilience increased (F(2,82) = 4.22, p = .003: Wilks’ lambda = .82, partial n2 = 0.09). The relationship between exercise, and resilience and quality of life was independent of sleep and mental health status pre-lockdown (p = .013, p = .027 respectively). In the face of the COVID-19 pandemic, this relationship was dependent on mental health but not sleep quality (p = <.001 for resilience p = .010 for quality of life). There were no statistically significant differences between participants living in urban or rural locations. Conclusion Exercise is strongly correlated to resilience and during a pandemic such as COVID-19 it becomes a mechanism in which to moderate resilience. The relationship between exercise and resilience is supported by this study. The influence that a pandemic had on mental health is mediated by its effect on quality of life.
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Affiliation(s)
- Molly Rose Lancaster
- Conducted research at London Southbank University, 103 Borough Road, London, SE1 0AA, UK.
| | - Patrick Callaghan
- Professor of Mental Health Science and Associate Pro Vice-Chancellor Research, London Southbank University, 103 Borough Road, London, SE1 0AA, UK
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15
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Jarroch R, Tajik B, Tuomainen TP, Kauhanen J. Economic Recession and the Long Term Risk of Psychiatric Disorders and Alcohol Related Diseases-A Cohort Study From Eastern Finland. Front Psychiatry 2022; 13:794888. [PMID: 35250662 PMCID: PMC8891480 DOI: 10.3389/fpsyt.2022.794888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 01/25/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long-term development of psychiatric disorders and alcohol-related diseases after economic recessions is insufficiently studied. We investigated the overall impact of the economic recession between 1991 and 1994 in Finland on the long-term incidence of psychiatric and alcohol-related diseases. METHODS A population-based sample of 1,774 women and men aged 53-73 years were examined between 1998 and 2001 from the Kuopio Ischemic Heart Disease Risk Factor Study (KIHD). Participants completed comprehensive questionnaires on the possible impact of the 1990s recession in Finland on their lives. They were followed-up until 2018. Cox proportional hazards regression was used to estimate hazard ratios (HR) of new incident psychiatric and alcohol-related disorders during the 20-years follow-up after linkage to the National Hospital Registry. Logistic regression was used to estimate odds ratios (OR) of psychiatric disorders at baseline. RESULTS At baseline, 93 participants had psychiatric disorders. During 20-years follow-up, 138 new psychiatric disorders and 45 alcohol-related diseases were developed. The covariate-adjusted risk of psychiatric disorders was over twice higher among men who experienced recession-induced hardships compared to those who did not (HR = 2.20, 95%CI = 1.04-4.70, p = 0.04). The risk of alcohol-related diseases was more than four times higher among men with hardships (HR = 4.44, 95%CI = 1.04-18.90, p = 0.04). No such associations were observed among women. No association was observed between recession-induced hardships and having psychiatric disorders at baseline in both genders (multivariate-adjusted p = 0.63 for women, multivariate-adjusted p = 0.36 for men). CONCLUSION Long-term risk of psychiatric disorders and alcohol-related diseases was increased after the 1990s economic recession in Finland, but only among middle-age and older men.
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Affiliation(s)
- Rand Jarroch
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Behnam Tajik
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
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16
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Buajitti E, Rosella LC, Bryan K, Giesinger I, Goel V. Downstream health impacts of employment losses during the COVID-19 pandemic. Canadian Journal of Public Health 2021; 113:135-146. [PMID: 34874548 PMCID: PMC8650522 DOI: 10.17269/s41997-021-00588-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/15/2021] [Indexed: 11/17/2022]
Abstract
Objectives
The Canadian workforce has experienced significant employment losses during the COVID-19 pandemic, in part as a result of non-pharmaceutical interventions to slow COVID-19 transmission. Health consequences are likely to result from these job losses, but without historical precedent for the current economic shutdown they are challenging to plan for. Our study aimed to use population risk models to quantify potential downstream health impacts of the COVID-19 pandemic and inform public health planning to minimize future health burden. Methods The impact of COVID-19 job losses on future premature mortality and high-resource health care utilization (HRU) was estimated using an economic model of Canadian COVID-19 lockdowns and validated population risk models. Five-year excess premature mortality and HRU were estimated by age and sex to describe employment-related health consequences of COVID-19 lockdowns in the Canadian population. Results With federal income supplementation like the Canadian Emergency Response Benefit, we estimate that each month of economic lockdown will result in 5.6 new high-resource health care system users (HRUs), and 4.1 excess premature deaths, per 100,000, over the next 5 years. These effects were concentrated in ages 45–64, and among males 18–34. Without income supplementation, the health consequences were approximately twice as great in terms of both HRUs and premature deaths. Conclusion Employment losses associated with COVID-19 countermeasures may have downstream implications for health. Public health responses should consider financially vulnerable populations at high risk of downstream health outcomes. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-021-00588-3.
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Affiliation(s)
- Emmalin Buajitti
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Laura C Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute for Better Health, Trillium Health Partners, Mississauga, ON, Canada
| | - Kevin Bryan
- Rotman School of Management, University of Toronto, Toronto, ON, Canada
| | - Ingrid Giesinger
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Vivek Goel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
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17
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Oksanen A, Oksa R, Savela N, Mantere E, Savolainen I, Kaakinen M. COVID-19 crisis and digital stressors at work: A longitudinal study on the Finnish working population. COMPUTERS IN HUMAN BEHAVIOR 2021; 122:106853. [PMID: 34754137 PMCID: PMC8569509 DOI: 10.1016/j.chb.2021.106853] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 04/27/2021] [Accepted: 05/01/2021] [Indexed: 11/28/2022]
Abstract
The global crisis caused by the outbreak of a novel coronavirus and the associated disease (COVID-19) has changed working conditions due to social-distancing policies. Many workers started to use new technologies at work, including social media applications. In this longitudinal study, we investigated the potential stress effects of social media communication (SMC) at work. Based on our integrative theoretical model, we expected that SMC at work would burden some workers, but those who were accustomed to SMC at work would be better off when the crisis started. We collected a nationally representative sample of Finnish workers before (N = 1308) and during (N = 1081) the COVID-19 crisis. Outcome measures included technostress and work exhaustion. Multilevel linear mixed-effects regression models investigated formal and informal SMC at work. Covariates included cyberbullying at work, social media usage, personality, occupational status, and sociodemographic factors. Results showed that formal SMC increased and predicted higher technostress. However, technostress and work exhaustion decreased among workers already accustomed to using SMC at work before the crisis. The results indicate a disparity in workers' resilience during remote work and highlight a need for organizational level support.
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Affiliation(s)
- Atte Oksanen
- Faculty of Social Sciences, Tampere University, Finland
| | - Reetta Oksa
- Faculty of Social Sciences, Tampere University, Finland
| | - Nina Savela
- Faculty of Social Sciences, Tampere University, Finland
| | - Eerik Mantere
- Faculty of Social Sciences, Tampere University, Finland.,Faculty of Sociology, University of Bordeaux, France
| | | | - Markus Kaakinen
- Institute of Criminology and Legal Policy, University of Helsinki, Finland
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18
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Psychological distress during the COVID-19 epidemic in Chile: The role of economic uncertainty. PLoS One 2021; 16:e0251683. [PMID: 34731175 PMCID: PMC8565721 DOI: 10.1371/journal.pone.0251683] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 05/01/2021] [Indexed: 12/30/2022] Open
Abstract
Previous research has shown that the COVID-19 outbreak, social distancing, and lockdown can affect people’s psychological well-being. The aims of this study were (1) to estimate the extent to which perceptions and expectations regarding the social, economic, and domestic effects of the COVID-19 outbreak are associated with psychological distress and (2) to identify some demographic, psychosocial, and economic factors associated with increased vulnerability to psychological distress during the COVID-19 outbreak in Chile. 1078 people participated in a telephone survey between May 30 and June 10, 2020. The sample is representative of the Chilean adult population. Psychological distress was assessed through a questionnaire of anxious and depressive symptoms (Patient Health Questionnaire-4). We analyzed the data set using ordinary least-squares regression models, first estimating models for the entire sample, and then stratifying the sample into different groups to explore differences by gender and age. 19.2% of participants displayed significant psychological distress (PHQ-4 ≥ 6), with moderate to severe anxiety-depression symptoms being more prevalent in women than in men (23.9% vs 14.1%, χ2 16.78, p<0.001). The results of this study suggest that being a woman, feeling lonely and isolated, living in the areas hit hardest by the pandemic and lockdown, expecting a lack of income due to having to stop working as a consequence of the pandemic, and having a history of diagnosed mental disorders are significantly associated with psychological distress (p<0.05). The results of this study highlight the need to implement psychosocial programs to guard people’s psychological well-being and social policies to address economic uncertainty during the current COVID-19 outbreak in Chile.
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19
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Irarrazaval M, Norambuena P, Montenegro C, Toro-Devia O, Vargas B, Caqueo-Urízar A. Public Policy Responses to Address the Mental Health Consequences of the COVID-19 Pandemic: Evidence From Chile. Front Public Health 2021; 9:590335. [PMID: 34660500 PMCID: PMC8511669 DOI: 10.3389/fpubh.2021.590335] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 08/30/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: This paper reviews the mental health policies that have been implemented in Chile in response to the COVID-19 pandemic and the international context of countries' responses. Even before the start of the pandemic, there were significant barriers to access mental health services in Chile, coupled with a scenario of nationwide social unrest and protests that questioned the legitimacy of public institutions; now the rapidly worsening outbreaks of COVID-19 are exacerbating the pre-existing mental health crisis. Methods: We conducted a bibliometric and content analysis of the Chilean mental health public policies implemented during the COVID-19 pandemic and then compared these policies with international experiences and emerging scientific evidence on the mental health impact of pandemics. Results: Our analysis of the policies identifies five crucial points of action developed in Chile: (i) an established framework to address mental health in emergency and disaster situations; (ii) a timely COVID-19 Mental Health Action Plan; (iii) inclusion of mental health in the public health agenda; (iv) development of a presidential strategy during the pandemic for comprehensive mental health and well-being; and (v) emerging research assessing the mental health implications of COVID-19. Conclusions: In Chile, the public policy responses to address the mental health consequences of the COVID-19 pandemic has been characterized by the coordinated implementation of mental health plans, ranging from a health sectoral initiative to inter-agency and intersectoral efforts. However, it is imperative that increased funding is allocated to mental health, and efforts should be made to promote the participation of people with lived experiences and communities in the design and implementation of the proposed actions. This aspect could be of key importance to social peace and community recovery after the pandemic.
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Affiliation(s)
- Matias Irarrazaval
- Department of Mental Health, Ministry of Health, Santiago, Chile.,Millenium Institute for Research in Depression and Personality, Santiago, Chile
| | - Pablo Norambuena
- Department of Mental Health, Ministry of Health, Santiago, Chile.,School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Cristian Montenegro
- Millenium Institute for Research in Depression and Personality, Santiago, Chile.,Wellcome Centre for Cultures and Environments of Health, University of Exeter, Exeter, United Kingdom
| | - Olga Toro-Devia
- School of Public Health, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Belen Vargas
- Department of Mental Health, Ministry of Health, Santiago, Chile
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20
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Long-Term Impact of Economic Downturn and Loneliness on Psychological Distress: Triple Crises of COVID-19 Pandemic. J Clin Med 2021; 10:jcm10194596. [PMID: 34640614 PMCID: PMC8509467 DOI: 10.3390/jcm10194596] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 12/15/2022] Open
Abstract
Background: The COVID-19 crisis poses global mental health and global economy challenges. However, there is a lack of longitudinal research investigating whether financial instability and social disruption may increase the risk of developing mental health problems over time that may potentially outlast the pandemic. Methods: We conducted an online survey for members of the general population (n = 2703) in Germany during the twelve months spanning from April 2020 to March 2021. We investigated the development of COVID-19 related psychological distress, the number of unemployed people, federal government debt, income distribution, and loneliness over the time period. Results: Over a period of twelve months, 53.6% of respondents in Germany reported experiencing psychological distress, varying from mild levels, 34.2%, to severe levels, 19.4%, of distress. High federal government debt, high incident COVID-19 cases, low incomes, and the prevalence of loneliness were found to be associated with increased long-term mental health problems. Psychological distress scores were most strongly increased in female and young respondents as well as those who reported fewer years of education, low income, and higher loneliness. Conclusions: Our study highlights factors that have a long-term impact on mental health amid the COVID-19 pandemic. We suggest that specific mental-health services could be offered to support high-risk groups experiencing financial fragility and loneliness. For purposes of safeguarding their mental health there is a need to monitor and track such risk factors in real time.
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21
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Kamekis A, Rachiotis G, Markaki A, Samara V, Symvoulakis EK. Employment and suicidal rates during economic recession: A country-targeted integrative review. Int J Soc Psychiatry 2021; 67:801-815. [PMID: 33135535 DOI: 10.1177/0020764020969740] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The economic crisis' effects on suicide rates for countries undergoing or exiting austerity measures have been widely debated. This integrative review aimed to identify, appraise, and synthesize available evidence of employment status effect on suicide mortality rates in Greece during the recent economic recession period. METHODS A literature review of studies evaluating suicides in the general Greek population, as well as across age and gender groups, in relation to employment during the economic crisis period was performed. PubMed electronic database was searched for relevant articles published in English or Greek language from 2009 up to February 2020. Appraisal was carried out based on the Hierarchy of Evidence Rating System and the GRADE guidelines. RESULTS A total of 24 articles met all inclusion criteria with 20 of them at level IV, 2 at level VII, and 2 at level VIII. A total of 18 studies reported increase of suicide rates during the economic recession period. About 12 studies examined the co-relation between unemployment and suicide rate, with ten studies showing a positive correlation. Moreover, thirteen studies reported data on the effect of gender and age variables on suicide rates. CONCLUSION Evidence shows that suicide mortality rates in Greece increased after the eruption of economic recession, particularly after the implementation of radical austerity measures (2011-2014). This increase was positively correlated with unemployment and was more prominent among males of working age. Further in depth epidemiological research of regional variations in terms of profile and contributing or enabling factors of suicidal behavior is needed.
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Affiliation(s)
| | - George Rachiotis
- Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Biopolis, Larissa, Greece
| | - Adelais Markaki
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Vasiliki Samara
- Department of Educational and Social policy, University of Makedonia, Thessaloniki, Central Macedonia, Greece
| | - Emmanouil K Symvoulakis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
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22
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Blanuša J, Barzut V, Knežević J. Intolerance of Uncertainty and Fear of COVID-19 Moderating Role in Relationship Between Job Insecurity and Work-Related Distress in the Republic of Serbia. Front Psychol 2021; 12:647972. [PMID: 34177703 PMCID: PMC8226083 DOI: 10.3389/fpsyg.2021.647972] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/12/2021] [Indexed: 01/01/2023] Open
Abstract
The COVID-19 outbreak in Serbia was followed by strict restrictions that negatively affected the economy, particularly small size companies. The complete lockdown and the prohibition of certain services have led to an unstable employment situation. Only several studies investigated the job insecurity and its consequences during COVID-19 pandemic, and some of them highlight the fear of COVID-19 as a significant moderator of mental health. Other studies emphasize the huge effect that intolerance of uncertainty could have in explaining distress, especially during pandemic. In addition, intolerance of uncertainty was considered as a possible moderator of the relationship between the objective and subjective job threat, as well their consequences for mental health. This study aimed to examine the presence of job insecurity and work related distress in Serbia during the first wave of COVID-19. We wanted to measure the effect of the job insecurity on experienced work distress, as well the moderation potential of the intolerance of uncertainty as an individual-level and the fear of coronavirus as a situation-dependent variable. Five hundred and twenty five employed participants took part in an online study during the first wave of coronavirus infection in Serbia. To measure job insecurity, we used Perception of job insecurity scale (PJIS), while distress was assessed with Distress scale from 4DSQ. Fear of COVID-19 was measured on three items. The intolerance of uncertainty was measured by the IUS-11 scale. The results showed that 30.4% of the participants consider their employment as moderately or highly insecure, and 15.1% thought they can lose their jobs. 63.4% of participants expressed increased levels of distress. The moderation analysis revealed that the effect of job insecurity on distress can be moderated by interaction of intolerance of uncertainty and COVID-related fear. In general, distress scores were increasing with increasing job insecurity, intolerance of uncertainty and fear of COVID-19. This pattern is not observed only when fear and intolerance of uncertainty were both low, when job instability could not influence distress. This study also showed that emotional appraisal of the job threat had higher impact on distress than the perceived threat, that shed the light on the importance of considering general resilience capabilities as a protective factor in the work environment in the time of crisis.
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Affiliation(s)
- Jelena Blanuša
- Department of Educational Sciences, College for Vocational Education of Preschool Teachers and Sports Trainers, Subotica, Serbia
| | - Vesna Barzut
- Faculty of Sport and Tourism, Educons University, Novi Sad, Serbia
| | - Jasmina Knežević
- Department of Educational Sciences, College for Vocational Education of Preschool Teachers and Sports Trainers, Subotica, Serbia
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23
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The Association of Energy Poverty with Health and Wellbeing in Children in a Mediterranean City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115961. [PMID: 34199387 PMCID: PMC8199602 DOI: 10.3390/ijerph18115961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/27/2021] [Accepted: 05/30/2021] [Indexed: 11/29/2022]
Abstract
Children have been identified as being particularly vulnerable to energy poverty (EP), but little empirical research has addressed the effect of EP on children’s health and wellbeing, especially in southern Europe. In this work we aimed to provide an in-depth description of the distribution of EP by sociodemographic, socioeconomic and housing characteristics, as well as to analyse the association between EP and health and wellbeing in children in Barcelona. We performed a cross-sectional study using data from the Barcelona Health Survey for 2016 (n = 481 children under 15 years). We analysed the association between EP and health outcomes through prevalence differences and prevalence ratios (PR) and their 95% confidence interval (CI), using Poisson regression models with robust variance. In Barcelona, 10.6% of children were living in EP and large inequalities were found by sociodemographic, socioeconomic and housing characteristics. EP was strongly associated with poor health in children (PR (95% CI): 7.70 (2.86, 20.72)). Living in EP was also associated with poor mental health (PR (95% CI): 2.46 (1.21, 4.99)) and with more cases of asthma (PR (95% CI): 4.19 (1.47, 11.90)) and overweight (PR (95% CI): 1.50 (1.05, 2.15)) in children. It is urgent to develop specific measures to avoid such serious and unfair health effects on children.
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24
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Kola L, Kohrt BA, Hanlon C, Naslund JA, Sikander S, Balaji M, Benjet C, Cheung EYL, Eaton J, Gonsalves P, Hailemariam M, Luitel NP, Machado DB, Misganaw E, Omigbodun O, Roberts T, Salisbury TT, Shidhaye R, Sunkel C, Ugo V, van Rensburg AJ, Gureje O, Pathare S, Saxena S, Thornicroft G, Patel V. COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. Lancet Psychiatry 2021; 8:535-550. [PMID: 33639109 PMCID: PMC9764935 DOI: 10.1016/s2215-0366(21)00025-0] [Citation(s) in RCA: 346] [Impact Index Per Article: 115.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/11/2021] [Accepted: 01/14/2021] [Indexed: 12/30/2022]
Abstract
Most of the global population live in low-income and middle-income countries (LMICs), which have historically received a small fraction of global resources for mental health. The COVID-19 pandemic has spread rapidly in many of these countries. This Review examines the mental health implications of the COVID-19 pandemic in LMICs in four parts. First, we review the emerging literature on the impact of the pandemic on mental health, which shows high rates of psychological distress and early warning signs of an increase in mental health disorders. Second, we assess the responses in different countries, noting the swift and diverse responses to address mental health in some countries, particularly through the development of national COVID-19 response plans for mental health services, implementation of WHO guidance, and deployment of digital platforms, signifying a welcome recognition of the salience of mental health. Third, we consider the opportunity that the pandemic presents to reimagine global mental health, especially through shifting the balance of power from high-income countries to LMICs and from narrow biomedical approaches to community-oriented psychosocial perspectives, in setting priorities for interventions and research. Finally, we present a vision for the concept of building back better the mental health systems in LMICs with a focus on key strategies; notably, fully integrating mental health in plans for universal health coverage, enhancing access to psychosocial interventions through task sharing, leveraging digital technologies for various mental health tasks, eliminating coercion in mental health care, and addressing the needs of neglected populations, such as children and people with substance use disorders. Our recommendations are relevant for the mental health of populations and functioning of health systems in not only LMICs but also high-income countries impacted by the COVID-19 pandemic, with wide disparities in quality of and access to mental health care.
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Affiliation(s)
- Lola Kola
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria; BRiTE Center, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA.
| | - Brandon A Kohrt
- Division of Global Mental Health, Department of Psychiatry, George Washington University, Washington, DC, USA
| | - Charlotte Hanlon
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, WHO Collaborating Centre for Mental Health Research and Capacity-Building, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - Siham Sikander
- Global Health Department, Health Services Academy, Islamabad, Pakistan; Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | | | - Corina Benjet
- Division of Epidemiology and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Eliza Yee Lai Cheung
- The Reference Centre for Psychosocial Support, International Federation of the Red Cross and Red Crescent, Hong Kong Special Administrative Region, China; The Red Cross of the Hong Kong Special Administrative Region of China, Hong Kong Special Administrative Region, China
| | - Julian Eaton
- CBM Global and Centre for Global Mental Health, London, UK
| | - Pattie Gonsalves
- Wellcome-DBT India Alliance, Sangath, New Delhi, India; School of Psychology, University of Sussex, Brighton, UK
| | - Maji Hailemariam
- Department of Obstetrics, Gynecology and Reproductive Biology, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | | | - Daiane B Machado
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Centre for Data and Knowledge Integration for Health, CIDACS-FIOCRUZ, Bahia, Brazil
| | - Eleni Misganaw
- Mental Health Service Users Association Ethiopia, Addis Ababa, Ethiopia; Global Mental Health Peer Network, Pretoria, South Africa
| | - Olayinka Omigbodun
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria; Centre for Child and Adolescent Mental Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Tessa Roberts
- Centre for Society and Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tatiana Taylor Salisbury
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; WHO Collaborating Centre for Research and Training in Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Charlene Sunkel
- Global Mental Health Peer Network, Johannesburg, South Africa
| | - Victor Ugo
- Mentally Aware Nigeria Initiative, Lagos, Nigeria; United for Global Mental Health, London, UK
| | - André Janse van Rensburg
- Centre for Rural Health, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa; Centre for Health Systems Research and Development, Faculty of Humanities, University of the Free State, Bloemfontein, South Africa
| | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Soumitra Pathare
- Centre for Mental Health Law and Policy, Indian Law Society, Pune, India
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Graham Thornicroft
- Centre for Global Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Centre for Implementation Science, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA; Wellcome-DBT India Alliance, Sangath, New Delhi, India
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Hall J, Goranitis I, Kigozi J, Guariglia A. New evidence on the impact of the Great Recession on health-compromising behaviours. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100980. [PMID: 33571870 DOI: 10.1016/j.ehb.2021.100980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
Using data from the English Longitudinal Study of Ageing over the period 2004-2017, this paper explores the effects of the Great Recession and its aftermath upon health-compromising behaviours in adults aged 50 and over. We introduce new techniques into this area of research, namely dynamic random-effects logit estimators which control for initial conditions and correlated individual effects. We observe a lack of crisis effect upon the probabilities of smoking and being physically inactive, as well as of transitioning in and out of these behaviours. In line with other recent literature, this suggests that the relationship between economic recessions and smoking and physical inactivity may have broken down. Alternatively, the over 50s may have been protected from the crisis and subsequent austerity measures. Nonetheless, both the crisis and post-crisis period were associated with a lower probability of drinking frequently.
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Affiliation(s)
- James Hall
- Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Newcastle-under-Lyme, ST5 5BG, United Kingdom.
| | - Ilias Goranitis
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Jesse Kigozi
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Alessandra Guariglia
- Department of Economics, University of Birmingham, University House, Edgbaston, Birmingham, B15 2TY, United Kingdom.
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26
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Zilidis C, Angelopoulos NV. The impact of economic crisis on mortality due to mental health illnesses. J Public Health (Oxf) 2021; 44:92-99. [PMID: 33912955 DOI: 10.1093/pubmed/fdab129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 02/15/2021] [Accepted: 04/10/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The financial crisis affected several aspects of health. The aim of this study is to explore the impact of the crisis on mortality of mental illnesses in Greece and the socioeconomic determinants of mortality trends. METHODS Mortality data of 2000-16 were analyzed and sex-and-age-standardized death rates (SDRs) were calculated. The Average Annual Percent Change (AAPC) before and after the time point of slope change was computed. The crisis impact on SDRs was explored with interrupted time series analyses and standardized rate ratios (SRRs). The correlation of mortality with socioeconomic and healthcare-related variables was investigated with correlation and regression analyses. RESULTS A significant change in SDR trend was observed after 2012. The AAPC reversed from -2.9% to 94.5%, while the SRR was calculated at 6.1 (5.5-6.7). Income reduction, unemployment rise and health budget cuts were found to be significantly correlated with mortality rise. CONCLUSIONS Financial crisis had a significant impact on mortality due to mental illnesses, especially in females and elderly. The findings indicate that mortality increase is more driven by socioeconomic and healthcare-related factors that affect access to appropriate healthcare than by morbidity trends. The findings have implications in planning interventions to provide appropriate healthcare to patients living with mental illness.
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Affiliation(s)
- C Zilidis
- General Department, University of Thessaly, Larissa, Greece
| | - N V Angelopoulos
- Department of Psychiatry, Faculty of Medicine, University of Thessaly, Larissa, Greece
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McDaid D. Viewpoint: Investing in strategies to support mental health recovery from the COVID-19 pandemic. Eur Psychiatry 2021; 64:e32. [PMID: 33971992 PMCID: PMC8134893 DOI: 10.1192/j.eurpsy.2021.28] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, United Kingdom
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28
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Bauer A, Garman E, McDaid D, Avendano M, Hessel P, Díaz Y, Araya R, Lund C, Malvasi P, Matijasevich A, Park AL, Paula CS, Ziebold C, Zimmerman A, Evans-Lacko S. Integrating youth mental health into cash transfer programmes in response to the COVID-19 crisis in low-income and middle-income countries. Lancet Psychiatry 2021; 8:340-346. [PMID: 33549174 PMCID: PMC9215313 DOI: 10.1016/s2215-0366(20)30382-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 11/28/2022]
Abstract
Social protection measures can play an important part in securing livelihoods and in mitigating short-term and long-term economic, social, and mental health impacts of the COVID-19 pandemic. In particular, cash transfer programmes are currently being adapted or expanded in various low-income and middle-income countries to support individuals and families during the pandemic. We argue that the current crisis offers an opportunity for these programmes to focus on susceptible young people (aged 15-24 years), including those with mental health conditions. Young people living in poverty and with mental health problems are at particular risk of experiencing adverse health, wellbeing, and employment outcomes with long-term consequences. They are also at risk of developing mental health conditions during this pandemic. To support this population, cash transfer programmes should not only address urgent needs around food security and survival but expand their focus to address longer-term mental health impacts of pandemics and economic crises. Such an approach could help support young people's future life chances and break the vicious cycle between mental illness and poverty that spirals many young people into both socioeconomic and mental health disadvantage.
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Affiliation(s)
- Annette Bauer
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK.
| | - Emily Garman
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Mauricio Avendano
- Department of Global Health & Social Medicine, King's College London, London, UK; Department of Social and Behavioural Sciences, Harvard School of Public Health Boston, Massachusetts, MA, USA
| | - Philipp Hessel
- Escuela de Gobierno Alberto Lleras Camargo, Universidad de Los Andes, Bogotá, Colombia
| | - Yadira Díaz
- Escuela de Gobierno Alberto Lleras Camargo, Universidad de Los Andes, Bogotá, Colombia
| | - Ricardo Araya
- Centre for Global Mental Health, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; Centre for Global Mental Health, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Paulo Malvasi
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, Department of Public Health, São Paulo, Brasil
| | - Alicia Matijasevich
- Faculdade de Medicina FMUSP, Departamento de Medicina Preventiva, Universidade de São Paulo, São Paulo, Brasil
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cristiane Silvestre Paula
- Programa de Pós-graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, Brasil
| | - Carolina Ziebold
- Programa de Pós-graduação em Distúrbios do Desenvolvimento, Universidade Presbiteriana Mackenzie, São Paulo, Brasil
| | - Annie Zimmerman
- Department of Global Health & Social Medicine, King's College London, London, UK; Centre for Global Mental Health, Health Service & Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sara Evans-Lacko
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
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Abstract
The worldwide economic crisis of the last decade, and still unresolved, led to a great recession involving all major economies. Since economic factors may influence mental wellbeing, not surprisingly a rise in poor mental health was observed in different countries, while representing a great challenge to psychiatric interventions. This paper aims at reviewing the available English literature focusing on the impact of the current economic crisis on mental health, with a special focus on depression and suicide. Available studies indicate that consequences of economic crisis, such as unemployment, increased workload or work reorganization, and reduced staff and wages, may constitute important stressing factors with a negative impact on mental health. Although data are not easily comparable in different countries, depression seems to be the most common psychiatric disorders especially in middle-aged men. Even suicide rates seem to be increased in men, mainly in countries with no public welfare or poor family relationships. All these findings require a careful attention from both governments that cut resources on public health instead of investing in it, and psychiatric associations that should implement appropriate strategies to face and to manage this sort of depression epidemic driven by economic crisis. Again, as available data suggest that the impact of the crisis might have been attenuated in countries with higher spending in social protection, they clearly urge policy makers to take into account possible health externalities associated to inadequate social protection systems.
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30
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Clark AE, D'Ambrosio C, Barazzetta M. Childhood circumstances and young adulthood outcomes: The role of mothers' financial problems. HEALTH ECONOMICS 2021; 30:342-357. [PMID: 33226156 DOI: 10.1002/hec.4194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 06/11/2023]
Abstract
We here consider the cognitive and noncognitive consequences on young adults of growing up with a mother who reported experiencing major financial problems. We use UK data from the Avon Longitudinal Study of Parents and Children to show that early childhood financial problems are associated with worse adolescent cognitive and noncognitive outcomes, controlling for both income and a set of standard variables, and in value-added models controlling for children's earlier age-5 outcomes. The estimated effect of financial problems is almost always larger in size than that of income. Around one-quarter to one-half of the effect of financial problems on the noncognitive outcomes seems to transit through mother's mental health.
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31
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Banks A, Fields L. Correlates of Incarceration of Fathers, Socioeconomic Influences, and Mental Illness. SOCIAL WORK IN PUBLIC HEALTH 2021; 36:26-37. [PMID: 33252019 DOI: 10.1080/19371918.2020.1851842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The United States leads globally in incarceration. Incarceration can disrupt families in both immediate and long-term ways, including finances and mental illness. We examined the relationship between father incarceration during adolescence and the development of mental illness in adulthood as well as the relationship of household assets and debts in relation to the mental illness outcomes. Wave IV data of the National Longitudinal Study of Adolescent to Adult Health were used with a final analytic sample of 2129 participants. Data were analyzed using MANOVA in Stata 13.1. The findings indicated that biological father incarceration correlates with more adolescent mental illness. Enhanced model residuals were also significant for father incarceration, household assets, and household debts. Incarceration of biological fathers correlates with poorer mental health outcomes. Household assets and debts correlate with changes in adolescent outcomes as well, giving us more target areas for intervention development and testing. Clinically, assessing for adolescent experiences with father incarceration may be useful in supporting improved mental health over the life course. Policy work should give more attention to promotion of health and well-being of adolescents via reduction of the negative experience of fathers serving and/or having served time in prison. More discussion on family-level assets and debts is warranted to promote health and well-being for adolescents and adults.
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Affiliation(s)
- Andrae Banks
- Department of Social Work, North Carolina Central University, Durham, United States
| | - LaShawnda Fields
- Brown School of Social Work, Washington University in St. Louis, St Louis, United States
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32
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García-Mayor J, Moreno-Llamas A, De la Cruz-Sánchez E. Inequalities in the long-term impact of the economic recession on preventive healthcare use and health-related lifestyle in Spain (2006-2017). HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:42-55. [PMID: 32557930 DOI: 10.1111/hsc.13067] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/07/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
Study of the long-term impact of economic recession on lifestyle according to socioeconomic groups is scarce. This study examines health-related lifestyle and preventive medical attendance in different socioeconomic groups in the Spanish adult population (18-64 years of age) before, during and after an economic recession. Data were collected from three waves of the Spanish National Health Survey (2006, 2012 and 2017). Self-perceived health, health-related lifestyle and common preventive medical attendance were evaluated by means of multivariate logistic models. The increase in good self-perceived health in 2006-2012 was 7.1%, 6.9% and 8.3% for the high, middle and low group, respectively, and 5.2%, 5.9% and 7.9% for the high, middle and low group, respectively, in 2006-2017. In 2006-2012 and 2006-2017, the gap increased between people of the high and low groups in smoking prevalence (2.8%-4.7%), physical activity (2.0%-4.0%), daily fruit (1.0%-6.3%) and vegetable intake (2.5%-6.1%). The probability of women´s gynaecological attendance increased statistically significant for cytology in three groups in 2006-2012 and 2006-2017 (OR = 1.35, 95% CI = 1.08-1.67; OR = 1.42, 95% CI = 1.18-1.7; OR = 1.34, 95% CI = 1.21-1.47 for the high, middle and low groups, respectively, in 2006-2012 and OR = 1.34, 95% CI = 1.08-1.67; OR = 1.62, 95% CI = 1.35-1.95; OR = 1.51, 95% CI = 1.37-1.66 for the high, middle and low groups, respectively, in 2006-2017), but not for mammography. This study reveals long-term socioeconomic inequalities in lifestyle behaviours after the economic recession. Health policies must be emphasised in these population subgroups and in more disadvantaged populations.
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33
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Ziebold C, de Jesus Mari J. The COVID-19 pandemic: Challenges to prevent suicide in megacities. Indian J Med Res 2021; 152:325-328. [PMID: 33380695 PMCID: PMC8061586 DOI: 10.4103/ijmr.ijmr_3992_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Carolina Ziebold
- Postgraduate Program in Developmental Disorders, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Jair de Jesus Mari
- Department of Psychiatry & Medical Psychology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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34
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Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing. PLoS One 2020; 15:e0241895. [PMID: 33175894 PMCID: PMC7657497 DOI: 10.1371/journal.pone.0241895] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/22/2020] [Indexed: 01/05/2023] Open
Abstract
Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative "Understanding America Study" (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents' own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.
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35
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Codagnone C, Bogliacino F, Gómez C, Charris R, Montealegre F, Liva G, Lupiáñez-Villanueva F, Folkvord F, Veltri GA. Assessing concerns for the economic consequence of the COVID-19 response and mental health problems associated with economic vulnerability and negative economic shock in Italy, Spain, and the United Kingdom. PLoS One 2020; 15:e0240876. [PMID: 33108374 PMCID: PMC7591048 DOI: 10.1371/journal.pone.0240876] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/05/2020] [Indexed: 12/29/2022] Open
Abstract
Many different countries have been under lockdown or extreme social distancing measures to control the spread of COVID-19. The potentially far-reaching side effects of these measures have not yet been fully understood. In this study we analyse the results of a multi-country survey conducted in Italy (N = 3,504), Spain (N = 3,524) and the United Kingdom (N = 3,523), with two separate analyses. In the first analysis, we examine the elicitation of citizens' concerns over the downplaying of the economic consequences of the lockdown during the COVID-19 pandemic. We control for Social Desirability Bias through a list experiment included in the survey. In the second analysis, we examine the data from the same survey to predict the level of stress, anxiety and depression associated with being economically vulnerable and having been affected by a negative economic shock. To accomplish this, we have used a prediction algorithm based on machine learning techniques. To quantify the size of this affected population, we compare its magnitude with the number of people affected by COVID-19 using measures of susceptibility, vulnerability and behavioural change collected in the same questionnaire. We find that the concern for the economy and for "the way out" of the lockdown is diffuse and there is evidence of minor underreporting. Additionally, we estimate that around 42.8% of the populations in the three countries are at high risk of stress, anxiety, and depression, based on their level of economic vulnerability and their exposure to a negative economic shock.
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Affiliation(s)
- Cristiano Codagnone
- Università degli studi di Milano, Milan, Italy
- Open Evidence Research, Barcelona, Spain
- Faculty of Information and Communication Science, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Francesco Bogliacino
- Universidad Nacional de Colombia, Bogotá, Colombia
- Centro de Investigaciones para el Desarrollo, Bogotá, Colombia
| | - Camilo Gómez
- Universidad Nacional de Colombia, Bogotá, Colombia
- Centro de Investigaciones para el Desarrollo, Bogotá, Colombia
| | - Rafael Charris
- Universidad Nacional de Colombia, Bogotá, Colombia
- Centro de Investigaciones para el Desarrollo, Bogotá, Colombia
| | - Felipe Montealegre
- Universidad Nacional de Colombia, Bogotá, Colombia
- Centro de Investigaciones para el Desarrollo, Bogotá, Colombia
| | | | - Francisco Lupiáñez-Villanueva
- Open Evidence Research, Barcelona, Spain
- Faculty of Information and Communication Science, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Frans Folkvord
- Open Evidence Research, Barcelona, Spain
- Centro de Investigaciones para el Desarrollo, Bogotá, Colombia
- Tillburg School of Humanities and Digital Sciences, Tilburg University, Tillburg, The Netherlands
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The impact of a Stress Control course delivered in partnership with a sports organisation on mental health outcomes in a general population. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Mental health problems have a significant impact globally in terms of social and economic costs. Increasing access to and uptake of mental health interventions (particularly by men) remains a challenge for service providers. The current study sought to examine the efficacy of a delivering a Stress Control intervention in partnership with a community sporting organisation (the Gaelic Athletic Assocaition, GAA) in ameliorating mental health difficulties in a general population. Measures of anxiety, depression and quality of life were administered before and after the delivery of the 6-week programme. A focus group was conducted afterwards to gather qualitative data on participants’ experiences of the intervention. Statistically significant decreases in depression scores were found following attendance at the course: t (94) = 3.14, p = .002, with a large effect size (0.5) (n = 95). There was an increase in the number of male attendees compared with clinic-based courses. Thematic analysis of the focus group data revealed a number of key themes including increased accessibility in terms of the scale and context of the delivery of the course. Delivering large-scale psychoeducational courses like Stress Control in partnership with the GAA represents a promising avenue for increasing access (for males in particular) to an effective intervention for improving mental health outcomes
Key learning aims
(1)
To gain an understanding of the impact of delivering a large-scale psychological intervention in partnership with a community sports organisation on accessibility and stigma reduction for participants.
(2)
To become aware of the potential benefits of considering non-clinic-based locations in running public mental health interventions.
(3)
To understand the key role of the normalisation of the experience of common mental health problems and the impact on intervention uptake.
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Testing the Mechanism of Action of Computerized Cognitive Training in Young Adults with Depression: Protocol for a Blinded, Randomized, Controlled Treatment Trial. ACTA ACUST UNITED AC 2020; 5. [PMID: 32743079 PMCID: PMC7394311 DOI: 10.20900/jpbs.20200014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Depression is associated with a broad range of cognitive deficits, including processing speed (PS) and executive functioning (EF). Cognitive symptoms commonly persist with the resolution of affective symptoms and increase risk of relapse and recurrence. The cognitive control network is comprised of brain areas implicated in EF and mood regulatory functions. Prior research has demonstrated the effectiveness of computerized cognitive training (CCT) focused on PS and EF in mitigating both cognitive and affective symptoms of depression. Methods: Ninety participants aged 18–29 with a current diagnosis of major depressive disorder or persistent depressive disorder, or a Hamilton Depression Rating Scale score ≥12, will be randomized to either PS/EF CCT, verbal CCT, or waitlist control. Participants in the active groups will complete 15 min of training 5 days/week for 8 weeks. Clinical and neuropsychological assessments will be completed at baseline, week 4, week 8, and 3-month follow-up. Structural and functional magnetic resonance imaging (fMRI) will be completed at baseline and week 8. We will compare changes in mood, cognition, daily functioning, and fMRI data. We will explore cognitive control network functioning using resting-state and task-based fMRI. Results: Recruitment began in October 2019; we expect to finish recruitment by April 2022 and subsequently begin data analysis. Conclusions: This study is innovative in that it will include both active and waitlist control conditions and will explore changes in neural activation. Identifying the neural networks associated with improvements following CCT will allow for the development of more precise and effective interventions. Trial Registration: ClinicalTrials.govNCT03869463; https://clinicaltrials.gov/ct2/show/NCT03869463.
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Jemberie WB, Stewart Williams J, Eriksson M, Grönlund AS, Ng N, Blom Nilsson M, Padyab M, Priest KC, Sandlund M, Snellman F, McCarty D, Lundgren LM. Substance Use Disorders and COVID-19: Multi-Faceted Problems Which Require Multi-Pronged Solutions. Front Psychiatry 2020; 11:714. [PMID: 32848907 PMCID: PMC7396653 DOI: 10.3389/fpsyt.2020.00714] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/07/2020] [Indexed: 12/21/2022] Open
Abstract
COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.
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Affiliation(s)
- Wossenseged Birhane Jemberie
- Department of Social Work, Umeå University, Umeå, Sweden
- Centre for Demography and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- The Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Jennifer Stewart Williams
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
- Research Centre for Generational Health and Ageing, Faculty of Health, University of Newcastle, Callaghan, NSW, Australia
| | - Malin Eriksson
- Department of Social Work, Umeå University, Umeå, Sweden
| | | | - Nawi Ng
- Department of Epidemiology and Global Health, Faculty of Medicine, Umeå University, Umeå, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | - Mojgan Padyab
- Department of Social Work, Umeå University, Umeå, Sweden
- Centre for Demography and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | - Kelsey Caroline Priest
- MD/PhD Program, School of Medicine, Oregon Health & Science University, Portland, OR, United States
| | - Mikael Sandlund
- Psychiatry Unit, Department of Clinical Science, Umeå University, Umeå, Sweden
| | | | - Dennis McCarty
- Oregon Health & Science University- Portland State University, School of Public Health, Portland, OR, United States
| | - Lena M. Lundgren
- Department of Social Work, Umeå University, Umeå, Sweden
- Cross-National Behavioral Health Laboratory, Graduate School of Social Work, University of Denver, Denver, CO, United States
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Mental Health and Work Attitudes among People Resuming Work during the COVID-19 Pandemic: A Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145059. [PMID: 32674361 PMCID: PMC7400483 DOI: 10.3390/ijerph17145059] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/09/2020] [Accepted: 07/11/2020] [Indexed: 12/16/2022]
Abstract
The unprecedented outbreak of the Coronavirus Disease 2019 (COVID-19) caused an economic downturn and increased the unemployment rate in China. In this context, employees face health and social economic stressors. To assess their mental health (i.e., anxiety, depression, insomnia and somatization) and work attitudes (i.e., work engagement, job satisfaction and turnover intention) as well as the associated factors, we conducted a cross-sectional study among people who resumed work after the Spring Festival holiday during the COVID-19 pandemic. The results show that the prevalence of anxiety, depression, insomnia and somatization among these people was 12.7%, 13.5%, 20.7% and 6.6%, respectively. The major risk factor for mental health was worrying about unemployment, and the main protective factors were psychological strengths (i.e., resilience and optimism). Regarding work attitudes, the percentage of people who felt more satisfied with their job (43.8%) was larger than that of those who felt less satisfied (26.9%), while the percentage of people who thought about quitting their job more frequently (15.7%) was smaller than that of those who considered it less frequently (63.2%). However, work engagement was lower than usual. Similar to the factors associated with mental health, the major risk factor for work attitudes was also worrying about unemployment, and the main protective factors were resilience and optimism. In addition, the nature of the organization, job status, age, position and income changes were also related to these work attitudes. Our findings shed light on the need for organization administrators to be aware of the status of and factors associated with employees’ mental health and work attitudes during the COVID-19 pandemic. Policies or interventions could be developed based on our findings.
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van Agteren J, Bartholomaeus J, Fassnacht DB, Iasiello M, Ali K, Lo L, Kyrios M. Using Internet-Based Psychological Measurement to Capture the Deteriorating Community Mental Health Profile During COVID-19: Observational Study. JMIR Ment Health 2020; 7:e20696. [PMID: 32490845 PMCID: PMC7294997 DOI: 10.2196/20696] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/02/2020] [Accepted: 06/03/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The coronavirus disease (COVID-19) is expected to have widespread and pervasive implications for mental health in terms of deteriorating outcomes and increased health service use, leading to calls for empirical research on mental health during the pandemic. Internet-based psychological measurement can play an important role in collecting imperative data, assisting to guide evidence-based decision making in practice and policy, and subsequently facilitating immediate reporting of measurement results to participants. OBJECTIVE The aim of this study is to use an internet-based mental health measurement platform to compare the mental health profile of community members during COVID-19 with community members assessed before the pandemic. METHODS This study uses an internet-based self-assessment tool to collect data on psychological distress, mental well-being, and resilience in community cohorts during (n=673) and prior to the pandemic (two cohorts, n=1264 and n=340). RESULTS Our findings demonstrate significantly worse outcomes on all mental health measures for participants measured during COVID-19 compared to those measured before (P<.001 for all outcomes, effect sizes ranging between Cohen d=0.32 to Cohen d=0.81. Participants who demonstrated problematic scores for at least one of the mental health outcomes increased from 58% (n=197/340) before COVID-19 to 79% (n=532/673) during COVID-19, leading to only 21% (n=141) of measured participants displaying good mental health during the pandemic. CONCLUSIONS The results clearly demonstrate deterioration in mental health outcomes during COVID-19. Although further research is needed, our findings support the serious mental health implications of the pandemic and highlight the utility of internet-based data collection tools in providing evidence to innovate and strengthen practice and policy during and after the pandemic.
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Affiliation(s)
- Joep van Agteren
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Adelaide, Australia
| | - Jonathan Bartholomaeus
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Daniel B Fassnacht
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Adelaide, Australia
| | - Matthew Iasiello
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- College of Nursing and Health Science, Flinders University, Adelaide, Australia
| | - Kathina Ali
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Adelaide, Australia
| | - Laura Lo
- Wellbeing and Resilience Centre, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Michael Kyrios
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
- Órama Institute for Mental Health and Wellbeing, Adelaide, Australia
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Stoyanova A, Pinilla J. The Evolution of Mental Health in the Context of Transitory Economic Changes. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2020; 18:203-221. [PMID: 31761976 DOI: 10.1007/s40258-019-00537-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Mental health disorders are highly prevalent across countries. They increase over time and impose a severe burden on individuals and societies. OBJECTIVE This paper examines the evolution of mental health over a period of 15 years, paying special attention on the impact of the most recent economic downturn and subsequent recovery, in Spain. METHOD We use data coming from the National Health Surveys of 2006/2007, 2011/2012 and 2016/2017. Mental health is proxied by two measures, doctor-diagnosed mental disorder and psychological distress (based on the 12-item General Health Questionnaire). To account for the relationship between the two mental health indicators, we estimate a bivariate probit model. The potential endogeneity of unemployment status is considered. RESULTS We observe different patterns of the two mental health indicators over time. Psychological distress in men increased during recession years, but slightly decreased among women. Diagnosed mental disorders declined during the peak years of the crisis. Unemployment is a major risk factor for mental distress. Irrespective of the economic conditions, belonging to a higher social class acts as a buffer against psychological distress for women, but not for men. The remaining determinants acted as expected. Women declared worse psychological health than men, and were also more often diagnosed with mental disorders. Having a partner had a protective impact, while providing intensive care to a dependent relative exerted the opposite effect. Education acted as buffer against the onset of psychological distress in women. CONCLUSION Even though the need for mental healthcare increased during the recession, the fact that fewer people were diagnosed suggests that barriers to accessing mental healthcare may be aggravated during the crisis. Policies aiming to tackle the challenges posed by the high prevalence of mental disorders have to be particularly attentive to changes in individuals' socioeconomic situation, including education, unemployment and social class.
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Affiliation(s)
- Alexandrina Stoyanova
- Department of Economics, Faculty of Economics and Business Administration, Universitat de Barcelona, BEAT and CAEPS, 08034, Barcelona, Spain.
| | - Jaime Pinilla
- Department of Quantitative Methods in Economics, Universidad de Las Palmas de Gran Canaria, 35017, Las Palmas de Gran Canaria, Spain
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Purtle J, Nelson KL, Counts NZ, Yudell M. Population-Based Approaches to Mental Health: History, Strategies, and Evidence. Annu Rev Public Health 2020; 41:201-221. [PMID: 31905323 PMCID: PMC8896325 DOI: 10.1146/annurev-publhealth-040119-094247] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is growing recognition in the fields of public health and mental health services research that the provision of clinical services to individuals is not a viable approach to meeting the mental health needs of a population. Despite enthusiasm for the notion of population-based approaches to mental health, concrete guidance about what such approaches entail is lacking, and evidence of their effectiveness has not been integrated. Drawing from research and scholarship across multiple disciplines, this review provides a concrete definition of population-based approaches to mental health, situates these approaches within their historical context in the United States, and summarizes the nature of these approaches and their evidence. These approaches span three domains: (a) social, economic, and environmental policy interventions that can be implemented by legislators and public agency directors, (b) public health practice interventions that can be implemented by public health department officials, and (c) health care system interventions that can be implemented by hospital and health care system leaders.
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Affiliation(s)
- Jonathan Purtle
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA;
| | - Katherine L Nelson
- Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA;
| | | | - Michael Yudell
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania 19104, USA
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Antunes A, Frasquilho D, Zózimo JR, Silva M, Cardoso G, Ferrão J, Caldas-de-Almeida JM. Solutions to tackle the mental health consequences of the economic recession: A qualitative study integrating primary health care users and professionals' perspectives. Health Policy 2019; 123:1267-1274. [PMID: 31672248 DOI: 10.1016/j.healthpol.2019.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 08/01/2019] [Accepted: 10/08/2019] [Indexed: 11/19/2022]
Abstract
This qualitative study explores solutions proposed by primary health care users and professionals to address the consequences of the economic recession and austerity measures on populations' mental health and delivery of care in Portugal. Qualitative data were collected in three primary health care centres in the Lisbon Metropolitan Area. Five focus groups with 26 users and semistructured interviews with 27 health professionals were conducted. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis. Solutions proposed by users focused on improvements in accessibility and management of services, socioeconomic and living conditions, human resources for health, and investment in mental health. Health professionals focused on improvements in integration and articulation of services, infrastructure and structural barriers to primary care, recruitment and retention of human resources, and socioeconomic and living conditions. The themes from both groups were integrated and organized into three axes for action: 1) increasing investment and reversing austerity measures in health and social sectors; 2) coordination and integration of mental health care; and 3) tackling the social determinants of mental health. The findings provide an assessment of the needs and priorities set by primary health care users and professionals, reflecting their contextspecific experiences. These complementary perspectives highlight the need for inter-sectoral efforts in policy-making to improve delivery of care and to mitigate social inequalities in health across the Portuguese population.
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Affiliation(s)
- Ana Antunes
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Portugal; Lisbon Institute of Global Mental Health, Portugal.
| | - Diana Frasquilho
- Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Portugal
| | - Joana R Zózimo
- Lisbon Institute of Global Mental Health, Portugal; Chronic Diseases Research Center (CEDOC), Nova Medical School, Nova University of Lisbon, Portugal
| | - Manuela Silva
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Portugal; Lisbon Institute of Global Mental Health, Portugal
| | - Graça Cardoso
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Portugal; Lisbon Institute of Global Mental Health, Portugal
| | - João Ferrão
- Institute of Social Sciences, University of Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Comprehensive Health Research Centre (CHRC), Nova Medical School, Nova University of Lisbon, Portugal; Lisbon Institute of Global Mental Health, Portugal
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Economou M, Peppou LE, Souliotis K, Lazaratou H, Kontoangelos K, Nikolaidi S, Palli A, Stefanis CN. Attitudes to depression and psychiatric medication amid the enduring financial crisis in Attica: Comparison between 2009 and 2014. Int J Soc Psychiatry 2019; 65:479-487. [PMID: 31250687 DOI: 10.1177/0020764019858653] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Only a handful of studies have explored the effect of the financial crisis on public attitudes to mental illness. AIMS This study examines changes in lay attitudes to depression and psychiatric medication between 2009 and 2014 in Attica region. Furthermore, it explored a potential interaction with employment status. METHODS Data were drawn from two surveys conducted in 2009 and 2014 using the same sampling procedure, interview mode, and survey instrument. Specifically, a random and representative sample of 586 people was recruited in 2009 and of 604 in 2014. Attitudes to depression were measured by the Personal Stigma subscale of the Depression Stigma Scale and attitudes to psychiatric medication by a self-constructed scale with good psychometric properties. Data collection occurred via telephone. RESULTS There has been no overall change in lay attitudes to depression. Nonetheless, a positive change was recorded with regard to the belief that depression is a sign of personal weakness and a negative change with respect to people with depression being dangerous. Attitudes to psychiatric medication have worsened during the study period. Employment status was not found to interact with the survey year. CONCLUSION Anti-stigma efforts should be tailored on counteracting the dangerousness stereotype, while they should prioritize targeting attitudes to psychiatric medication.
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Affiliation(s)
- Marina Economou
- 1 University Mental Health Research Institute, Athens, Greece
- 2 First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Kyriakos Souliotis
- 3 Faculty of Social and Political Sciences, University of Peloponnese, Corinth, Greece
| | - Helen Lazaratou
- 2 First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Kontoangelos
- 1 University Mental Health Research Institute, Athens, Greece
- 2 First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sofia Nikolaidi
- 1 University Mental Health Research Institute, Athens, Greece
| | - Alexandra Palli
- 1 University Mental Health Research Institute, Athens, Greece
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Kyriopoulos I, Nikoloski Z, Mossialos E. Does economic recession impact newborn health? Evidence from Greece. Soc Sci Med 2019; 237:112451. [PMID: 31377499 DOI: 10.1016/j.socscimed.2019.112451] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/12/2019] [Accepted: 07/26/2019] [Indexed: 01/01/2023]
Abstract
This study examines the impact of the Greek recession on newborn health. Using a large administrative dataset of 838,700 births from 2008 to 2015, our analysis shows that birth weight (BW) and pregnancy length are generally procyclical with respect to prenatal economic climate, while the risk of low birth weight and preterm birth are both countercyclical. We report heterogeneity in the relationship between business cycle fluctuations during pregnancy and newborn health across socioeconomic groups. Birth outcomes of children born to low socioeconomic status (SES) families are sensitive to economic fluctuations during the first and third trimesters of the pregnancy, whereas those of high-SES newborns respond to economic volatility only in the first trimester. These results are robust, even after using different measures of economic climate and uncertainty. After accounting for potential selection into pregnancy, we find that in utero exposure to economic crisis is linked with a BW loss, which is driven by the low-SES children. Our findings have social policy implications. The impact of economic crisis on birth indicators is more detrimental for the low-SES children, resulting in a widening of the BW gap between children of low- and high-SES families. This could, in turn, exacerbate long-term socioeconomic and health inequalities and hinder social mobility.
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Affiliation(s)
- Ilias Kyriopoulos
- Department of Health Policy, London School of Economics and Political Science (LSE), London WC2A 2AE, UK.
| | - Zlatko Nikoloski
- Department of Health Policy, London School of Economics and Political Science (LSE), London WC2A 2AE, UK.
| | - Elias Mossialos
- Department of Health Policy, London School of Economics and Political Science (LSE), London WC2A 2AE, UK.
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Loureiro A, Santana P, Nunes C, Almendra R. The Role of Individual and Neighborhood Characteristics on Mental Health after a Period of Economic Crisis in the Lisbon Region (Portugal): A Multilevel Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152647. [PMID: 31344971 PMCID: PMC6696374 DOI: 10.3390/ijerph16152647] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/28/2022]
Abstract
Mental health is an intrinsic dimension of health influenced by individual and contextual factors. This cross-sectional study analyzes the association between the individual, neighborhood characteristics, and one’s self-assessed mental health status in the Lisbon region after an economic crisis. Via the application of multilevel regression models, the study assesses the link between one’s neighborhood environment—deprivation, low self-assessed social capital, and low self-assessed satisfaction with the area of residence—and mental health regardless of one’s individual characteristics. Constraints related to the economic crisis play an important role in the explanation of poor mental health.
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Affiliation(s)
- Adriana Loureiro
- Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal.
| | - Paula Santana
- Centre of Studies on Geography and Spatial Planning (CEGOT) and Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
| | - Carla Nunes
- Centre for Research in Public Health and National School of Public Health, Nova University of Lisbon, Avenida Padre Cruz, 1600-560 Lisbon, Portugal
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530 Coimbra, Portugal
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López V, Paladines B, Vaca S, Cacho R, Fernández-Montalvo J, Ruisoto P. Psychometric properties and factor structure of an Ecuadorian version of the Alcohol Use Disorders Identification Test (AUDIT) in college students. PLoS One 2019; 14:e0219618. [PMID: 31291363 PMCID: PMC6619822 DOI: 10.1371/journal.pone.0219618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 06/27/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Alcohol Use Disorders Identification Test (AUDIT) is the gold standard in assessing harmful alcohol intake, which is responsible for substantial morbidity and mortality. OBJECTIVE The goal of this study is to evaluate the psychometric properties and factor structure of an Ecuadorian adaptation of a Spanish translation of the AUDIT in a large sample of college students in Ecuador. METHODS A total of 7905 students, including 46.26% males, and 53.75% females, from 11 universities in Ecuador, were surveyed. The questionnaire was tested for two- and three-factor structures, reliability, and correlations with other health related measures. RESULTS The Kaiser-Meyer-Olkin test for sampling adequacy was satisfactory (.0885), and Bartlett´s test for sphericity was significant (p < .001). Although both models showed a good fit to the data, the two-factor model was preferred based on the high correlations between the factors 2 and 3 within the three-factor model (.86 for the total sample, .77 for females, and .91 for males). The reliability for the two-factor model was good, as indicated by Cronbach´s α = .806 (factor I) and .716 (factor II) for the total sample, .808 (factor I) and .667 (factor II) for females, and .787 (factor I) and .728 (factor II) for males. Additionally, the AUDIT scores positively correlated with several health-related measures: stress, psychological inflexibility, loneliness and depression/anxiety symptomatology. CONCLUSION The Ecuadorian adaptation of the Spanish version of the AUDIT has good reliability, and internal consistency and correlates with other health related measures, proving to be a reliable tool that can be used by researchers and clinicians to screen hazardous alcohol intake in college students.
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Affiliation(s)
- Víctor López
- Department of Psychology, Technical Particular University of Loja, Loja, Ecuador
| | - Belén Paladines
- Department of Psychology, Technical Particular University of Loja, Loja, Ecuador
| | - Silvia Vaca
- Department of Psychology, Technical Particular University of Loja, Loja, Ecuador
| | - Raúl Cacho
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | | | - Pablo Ruisoto
- Faculty of Psychology, University of Salamanca, Salamanca, Spain
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Abstract
OBJECTIVE Subjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008. METHODS Cross-sectional data from the biennial European Social Survey (2002-2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers. RESULTS Data were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00-1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas. CONCLUSIONS Subjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.
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Antunes A, Frasquilho D, Zózimo JR, Silva M, Cardoso G, Ferrão J, Caldas-de-Almeida JM. Exploring socioeconomic and mental health trajectories during times of economic recession: a qualitative study with primary health care users and professionals. J Ment Health 2019; 29:597-604. [PMID: 30862202 DOI: 10.1080/09638237.2019.1581343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: The 2008 economic recession has been shown to affect populations' mental health due to deterioration of socioeconomic and living conditions. Concurrently, mental health problems may have constituted a vulnerability to wider social inequalities during this period.Aims: To explore perceptions and experiences of primary health care users and professionals regarding the relationship between mental health and socioeconomic position during the economic recession in Portugal.Method: Data were collected in three primary health care centres in Lisbon Metropolitan Area. Focus groups and semi-structured interviews were conducted with users and professionals, respectively. Interviews were audio-recorded, transcribed verbatim and underwent thematic analysis.Results: Two themes were obtained. The first comprised the relationship between changes in socioeconomic conditions (unemployment, precarious work conditions and financial hardship) and poor mental health. The second involved the consequences of experiencing mental health problems during the recession, namely disability, need of sick leave and early retirement.Conclusions: This study provided a comprehensive overview of the bidirectional relationship between socioeconomic conditions and mental health, emphasizing the need to develop policies to address the drivers of poor mental health during times of economic downturn and tackle the barriers faced by people with mental disorders to promote their full social inclusion.
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Affiliation(s)
- Ana Antunes
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal
| | - Diana Frasquilho
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal
| | - Joana Rocha Zózimo
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal.,CSG - Research in Social Sciences and Management, University of Lisbon, Lisbon, Portugal
| | - Manuela Silva
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal
| | - Graça Cardoso
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal
| | - João Ferrão
- Institute of Social Sciences, University of Lisbon, Lisbon, Portugal
| | - José Miguel Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC), Nova Medical School
- Faculdade de Ciências Médicas, Nova University of Lisbon, Lisbon, Portugal
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Bubonya M, Cobb-Clark DA, Christensen D, Johnson SE, Zubrick SR. The Great Recession and Children's Mental Health in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040537. [PMID: 30781815 PMCID: PMC6406973 DOI: 10.3390/ijerph16040537] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/30/2019] [Accepted: 02/11/2019] [Indexed: 11/23/2022]
Abstract
This paper analyzes the effects of “shocks” to community-level unemployment expectations, induced by the onset of the Great Recession, on children’s mental well-being. The Australian experience of the Great Recession represents a unique case study as despite little change in actual unemployment rates, levels of economic uncertainty grew. This affords us the ability to examine the effects of shocks to economic expectations independent of any actual changes to economic conditions. We draw on and link data from multiple sources, including several waves of the Longitudinal Study of Australian Children (2004–2010), a consumer sentiment survey, and data on local economic conditions. Using our purpose-built data set, we estimate difference-in-differences models to identify plausibly causal effects. We find, for boys, there is no detectable effect of community-level unemployment expectations shocks on mental health. For girls, however, there are modest increases in mental health problems and externalizing behaviors, as measured by the Strengths and Difficulties Questionnaire (SDQ). We additionally find no discernible change in mother’s psychological distress as a result of expectations shocks. These results are stable after controlling for actual labor market conditions.
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Affiliation(s)
- Melisa Bubonya
- School of Economics, Level 5, Social Sciences Building, University of Sydney, NSW 2006, Australia.
- ARC Centre of Excellence for Families and Children over the Life Course, University of Queensland, Level 2, Cycad Building (1018), 80 Meiers Rd, Indooroophilly, QLD 4068, Australia.
| | - Deborah A Cobb-Clark
- School of Economics, Level 5, Social Sciences Building, University of Sydney, NSW 2006, Australia.
- ARC Centre of Excellence for Families and Children over the Life Course, University of Queensland, Level 2, Cycad Building (1018), 80 Meiers Rd, Indooroophilly, QLD 4068, Australia.
- Institute for the Study of Labor (IZA), Schaumburg-Lippe-Straße 5-9, 53113 Bonn, Germany.
| | - Daniel Christensen
- ARC Centre of Excellence for Families and Children over the Life Course, University of Queensland, Level 2, Cycad Building (1018), 80 Meiers Rd, Indooroophilly, QLD 4068, Australia.
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009, Australia.
| | - Sarah E Johnson
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009, Australia.
| | - Stephen R Zubrick
- ARC Centre of Excellence for Families and Children over the Life Course, University of Queensland, Level 2, Cycad Building (1018), 80 Meiers Rd, Indooroophilly, QLD 4068, Australia.
- Telethon Kids Institute, Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands, WA 6009, Australia.
- Centre for Child Health Research, University of Western Australia, Nedlands, WA 6009, Australia.
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