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Drydakis N. Health inequalities among people experiencing food insecurity. An intersectional approach. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:867-886. [PMID: 38141013 DOI: 10.1111/1467-9566.13745] [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: 10/31/2022] [Accepted: 12/05/2023] [Indexed: 12/24/2023]
Abstract
The study examines the socioeconomic determinants of physical health among populations experiencing food insecurity and receiving free meals in soup kitchens in the Prefecture of Attica, Greece. Data were collected from the same six soup kitchens in 2012, 2017 and 2021, resulting in a dataset of 1533 observations. The study revealed that periods characterised by an economic recession are associated with deteriorated physical health of food-insecure people. Moreover, the study found that physical health deteriorations among food-insecure people are associated with older age, female gender, immigration status, disability and/or long-term health conditions, LGBT status, unemployment, economic inactivity, homelessness, living below the poverty threshold, long-term food dependency, illicit drug consumption and residing in lower- and middle-class areas. The study proposes the Intersectional Model of Health Inequalities, which integrates multiple factors involved in shaping the health inequalities of people experiencing food insecurity, from macro-level factors such as a country's economic performance to individual-level factors like education, employment status and demographic characteristics. The model emphasises that low-income populations should not be treated as a homogeneous entity. Its goal is to inform policymakers about the diverse health inequalities experienced by people with low incomes.
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Affiliation(s)
- Nick Drydakis
- School of Economics, Finance and Law, Centre for Inclusive Societies and Economies, Faculty of Business and Law, Anglia Ruskin University, Cambridge, UK
- Pembroke College, University of Cambridge, Cambridge, UK
- Centre for Science and Policy, University of Cambridge, Cambridge, UK
- Global Labor Organization, Essen, Germany
- Institute of Labor Economics, Bonn, Germany
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Yeboah Asiamah-Asare BK, Peprah P, Adu C, Ahinkorah BO, Addo IY. Associations of nuptiality perceptions, financial difficulties, and socio-demographic factors with mental health status in Australian adults: Analysis of the Household, Income and Labour Dynamics in Australia (HILDA) survey. PLoS One 2024; 19:e0296941. [PMID: 38354107 PMCID: PMC10866460 DOI: 10.1371/journal.pone.0296941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE This study examined the association of nuptial/relationship factors, financial difficulties, and socio-demographic factors with the mental health status of Australian adults. DESIGN Cross-sectional quantitative study design. SETTINGS, PARTICIPANTS, AND INTERVENTIONS Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey wave 19, 6846 adults were included in the analysis. Mental health was measured using the mental component summary (MCS) subscale of the Short-Form Health Survey SF-36. Hierarchical multiple linear regressions were used to examine the predictors of mental health status. RESULTS Overall, 7.1% of the participants reported poor mental health status. Individual financial difficulty factors explained 3.2% (p<0.001) of the variance in mental health scores. In addition, financial difficulties were negatively associated with mental health status. Nuptiality and relationship factors accounted for 9.8% (p<0.001) of the variance in mental health status. CONCLUSION The study suggests negative marital or relationship perceptions and financial difficulties are significant factors accounting for poor mental health. This finding suggests the need for more policy attention toward the social determinants of poor mental health especially nuptiality or relationship perceptions which have received less policy and research attention in Australia.
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Affiliation(s)
- Bernard Kwadwo Yeboah Asiamah-Asare
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
- Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Prince Peprah
- Social Policy Research Centre, UNSW, Sydney, Australia
- Centre for Primary Health Care and Equity, UNSW, Sydney, Australia
| | - Collins Adu
- Department of Health Promotion, Education and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- Centre for Social Research in Health; UNSW Sydney, Sydney, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, University of Technology Sydney, Sydney, Australia
- School of Clinical Medicine, UNSW Sydney, Sydney, Australia
| | - Isaac Yeboah Addo
- Centre for Social Research in Health; UNSW Sydney, Sydney, Australia
- Concord Clinical School, University of Sydney, Sydney, Australia
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Wind K, Poland B, HakemZadeh F, Jackson S, Tomlinson G, Jadad A. Using self-reported health as a social determinants of health outcome: a scoping review of reviews. Health Promot Int 2023; 38:daad165. [PMID: 38041807 DOI: 10.1093/heapro/daad165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023] Open
Abstract
Reducing disease prevalence rather than promoting health has long been the objective of significant population health initiatives, such as the social determinants of health (SDH) framework. However, empirical evidence suggests that people with diagnosed diseases often answer the self-reported health (SRH) question positively. In pursuit of a better proxy to understand, measure and improve health, this scoping review of reviews examines the potential of SRH to be used as an outcome of interest in population health policies. Following PRISMA-ScR guidelines, it synthesizes findings from 77 review papers (published until 11 May 2022) and reports a robust association between SDH and SRH. It also investigates inconsistencies within and between reviews to reveal how variation in population health can be explained by studying the impact of contextual factors, such as cultural, social, economic and political elements, on structural determinants such as socioeconomic situation, gender and ethnicity. These insights provide informed hypotheses for deeper explorations of the role of SDH in improving SRH. The review detects several gaps in the literature. Notably, more evidence syntheses are required, in general, on the pathway from contextual elements to population SRH and, in particular, on the social determinants of adolescents' SRH. This study reports a disease-oriented mindset in collecting, analysing and reporting SRH across the included reviews. Future studies should utilize the capability of SRH in interconnecting social, psychological and biological dimensions of health to actualize its full potential as a central public health measure.
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Affiliation(s)
- Keiwan Wind
- DeGroote School of Business, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4M4, Canada
| | - Blake Poland
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Farimah HakemZadeh
- Faculty of Liberal Arts and Professional Studies, School of Human Resources Management, York University, 4700 Keele Street, Toronto, Ontario M3J 1P3, Canada
| | - Suzanne Jackson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - George Tomlinson
- Dalla Lana School of Public Health, University of Toronto, 155 College St Room 500, Toronto, Ontario M5T 3M7, Canada
| | - Alejandro Jadad
- Centre for Digital Therapeutics, R. Fraser Elliott Building, 4th Floor, 190 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada
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Nagar A, Chaklader B, Ray S, Rathod H, Srivastava K, Banerjee A. Community's perception of lockdown ascribed to the COVID-19 pandemic. Ind Psychiatry J 2023; 32:S220-S224. [PMID: 38370929 PMCID: PMC10871399 DOI: 10.4103/ipj.ipj_226_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 04/18/2023] [Accepted: 08/08/2023] [Indexed: 02/20/2024] Open
Abstract
Background The COVID-19 pandemic caused a mandatory nationwide lockdown from March 24, 2020. In this difficult and unprecedented time, the requirement to adapt to lockdown and a forced stay-at-home had an impact on people's lives. Aim Community's perception of lockdown ascribed to COVID-19 pandemic. Materials and Methods A cross-sectional study was done on individuals aged 18 and above across India, to assess their perception regarding lockdown due to the COVID-19 pandemic. The study was carried out using a semi-structured questionnaire, where the data were collected via Google Forms and analyzed via Epi info 7. The questionnaire comprised of how individuals perceived the lockdown, and how COVID-19 news circulating on various social media platforms and news channels affected their mental health. Results The study included a total of 552 individuals. The study found that the lockdown was supported by 47% of respondents. 69.9% participants acknowledged that during lockdown, a huge amount of COVID-19 news was being disseminated, while 67.2% of individuals were overly preoccupied with thinking about preventative measures. As a result of being confined indoors, 59% of respondents thought their screen time had increased. Conclusion Respondents perceived that the lockdown had its benefits and drawbacks. They were impacted by the flood of information from various social media platforms as well and there was an increase in screen time.
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Affiliation(s)
- Akash Nagar
- Department of Community Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Biswajit Chaklader
- Project Officer, National Tuberculosis Elimination Programme (NTEP), World Health Organization (WHO), Dehradun, Uttarakhand, India
| | - Suman Ray
- Department of Community Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Hetal Rathod
- Department of Community Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Kajal Srivastava
- Department of Community Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
| | - Amitav Banerjee
- Department of Community Medicine, Dr. D. Y. Patil Medical College Hospital and Research Centre, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India
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Kokorikou DS, Sarigiannidis I, Fiore VG, Parkin B, Hopkins A, El-Deredy W, Dilley L, Moutoussis M. Testing hypotheses about the harm that capitalism causes to the mind and brain: a theoretical framework for neuroscience research. FRONTIERS IN SOCIOLOGY 2023; 8:1030115. [PMID: 37404338 PMCID: PMC10315660 DOI: 10.3389/fsoc.2023.1030115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023]
Abstract
In this paper, we will attempt to outline the key ideas of a theoretical framework for neuroscience research that reflects critically on the neoliberal capitalist context. We argue that neuroscience can and should illuminate the effects of neoliberal capitalism on the brains and minds of the population living under such socioeconomic systems. Firstly, we review the available empirical research indicating that the socio-economic environment is harmful to minds and brains. We, then, describe the effects of the capitalist context on neuroscience itself by presenting how it has been influenced historically. In order to set out a theoretical framework that can generate neuroscientific hypotheses with regards to the effects of the capitalist context on brains and minds, we suggest a categorization of the effects, namely deprivation, isolation and intersectional effects. We also argue in favor of a neurodiversity perspective [as opposed to the dominant model of conceptualizing neural (mal-)functioning] and for a perspective that takes into account brain plasticity and potential for change and adaptation. Lastly, we discuss the specific needs for future research as well as a frame for post-capitalist research.
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Affiliation(s)
- Danae S. Kokorikou
- Psychoanalysis Unit, Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Ioannis Sarigiannidis
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - Vincenzo G. Fiore
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Beth Parkin
- Department of Psychology, School of Social Sciences, University of Westminster, London, United Kingdom
| | - Alexandra Hopkins
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
| | - Wael El-Deredy
- Centro de Investigación y Desarrollo en Ingeniería en Salud, Universidad de Valparaíso, Valparaíso, Chile
| | - Laura Dilley
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing, MI, United States
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, London, United Kingdom
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Maietti E, Sanmarchi F, Toth F, de Pietro C, Fantini MP, Golinelli D. Changes in private health service utilisation and access to the Italian National Health Service between 2006 and 2019: a cross-sectional comparative study. BMJ Open 2023; 13:e070975. [PMID: 37247961 DOI: 10.1136/bmjopen-2022-070975] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
OBJECTIVES Previous research highlighted that in the early 2000s a significant share of the Italian population used and paid out of pocket for private healthcare services even when they could potentially have received the same treatments from the National Health Service (NHS). The decrease in public investments in healthcare and the increase in health needs due to the population ageing may have modified the use of private health services and equity of access to the Italian NHS. This study aims to investigate the change in the prevalence of individuals who have fully paid out of pocket for accessing healthcare services in Italy between 2006 and 2019 and the main reasons behind this choice. DESIGN Cross-sectional comparative study. PARTICIPANTS AND COMPARISON Two representative samples of the Italian population were collected in 2006 and 2019. OUTCOME MEASURES Prevalence of access to fully paid out-of-pocket private health services; type of service of the last fully paid out-of-pocket access; main reasons for the last fully paid out-of-pocket access. RESULTS We found an increase in the prevalence of people who declared having fully paid out of pocket at least one access to health services during their lifetime from 79.0% in 2006 to 91.9% in 2019 (adjusted OR 2.66; 95% CI 1.98 to 3.58). 'To avoid waiting times' was the main reason and it was significantly more frequent in 2019 compared with 2006 (adjusted OR 1.75; 95% CI 1.45 to 2.11). CONCLUSIONS This comparative study, conducted the year before the outbreak of the COVID-19 pandemic, highlighted an increase in the prevalence of Italian residents who have fully paid out of pocket for access to health services to overcome long waiting times. Our findings may indicate a reduced access and possible worsening of the equity of access to the public and universalistic Italian NHS between 2006 and 2019.
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Affiliation(s)
- Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Federico Toth
- Department of Political and Social Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Carlo de Pietro
- Department of Business Economics, Health and Social Affairs, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
| | - Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum Università di Bologna, Bologna, Italy
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
- Health Services Research, Evaluation and Policy Unit, Local Health Authority of Romagna, Ravenna, Italy
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Riedel-Heller SG, Reininghaus U, Schomerus G. [Public mental health: Core component or side issue of public health?]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:356-362. [PMID: 36867193 PMCID: PMC9983529 DOI: 10.1007/s00103-023-03670-y] [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: 10/04/2022] [Accepted: 02/01/2023] [Indexed: 03/04/2023]
Abstract
This article provides an overview of the self-conception, research, and fields of action of public mental health. It is becoming clear that mental health is a central element of public health and that a relevant knowledge base exists on this topic. In addition, lines of development of this field, which is gaining in importance in Germany, are shown. Although there are important current initiatives in the field of public mental health, such as the establishment of a Mental Health Surveillance (MHS) and the Mental Health Offensive, the positioning in the field does not correspond to the relevance of mental illness in population medicine.
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Affiliation(s)
- Steffi G. Riedel-Heller
- grid.9647.c0000 0004 7669 9786Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig, Philipp-Rosenthal-Str. 55, 04103 Leipzig, Deutschland
| | - Ulrich Reininghaus
- grid.7700.00000 0001 2190 4373Abteilung Public Mental Health, Zentralinstitut für Seelische Gesundheit, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland ,grid.13097.3c0000 0001 2322 6764Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, Großbritannien ,grid.13097.3c0000 0001 2322 6764ESRC Centre for Society and Mental Health, King’s College London, London, Großbritannien
| | - Georg Schomerus
- grid.9647.c0000 0004 7669 9786Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universität Leipzig, Leipzig, Deutschland
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Pinna Pintor M, Suhrcke M, Hamelmann C. The impact of economic sanctions on health and health systems in low-income and middle-income countries: a systematic review and narrative synthesis. BMJ Glob Health 2023; 8:bmjgh-2022-010968. [PMID: 36759018 PMCID: PMC9923316 DOI: 10.1136/bmjgh-2022-010968] [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: 10/13/2022] [Accepted: 12/30/2022] [Indexed: 02/11/2023] Open
Abstract
INTRODUCTION Economic sanctions restrict customary commercial and financial ties between states to induce change in political constitution or conduct of the targeted country. Although the stated goals of sanctions often include humanitarian objectives, prospective procedures for health risk assessment are not regularly incorporated in their implementation. Moreover, past experience suggests that the burden of economic isolation may fall on the civilian population. We present key findings from a WHO-sponsored evidence review on the impact of economic sanctions on health and health systems in low-income and middle-income countries, aiming at comprehensive coverage and explicit consideration of issues of causality and mechanisms. METHODS Broad searches of PubMed and Google Scholar (1970-2021) were designed to retrieve published and grey English-language literature expected to cut across disciplines, terminology and research methods. Studies providing an impact estimate were rated by a structured assessment based on ROBINS-I risk of bias domains, synthesised via vote counting and contextualised into the broader literature through a thematic synthesis. RESULTS Included studies (185) were mostly peer-reviewed, mostly single-country, largely coming from medicine and public health, and chiefly concerned with three important target countries-Iraq, Haiti and Iran. Among studies providing impact estimates (31), most raised multiple risk-of-bias concerns. Excluding those with data integrity issues, a significant proportion (21/27) reported consistently adverse effects of sanctions across examined outcomes, with no apparent association to assessed quality, focus on early episodes or publication period. The thematic synthesis highlights the complexity of sanctions, their multidimensionality and the possible mechanisms of impact. CONCLUSION Future research should draw on qualitative knowledge to collect domain-relevant data, combining it with better estimation techniques and study design. However, only the adoption of a risk assessment framework based on prospective data collection and monitoring can certify claims that civilians are adequately protected.
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Affiliation(s)
- Matteo Pinna Pintor
- Living Conditions, Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, Luxembourg
| | - Marc Suhrcke
- Living Conditions, Luxembourg Institute of Socio-Economic Research, Esch-sur-Alzette, Luxembourg,University of York Centre for Health Economics, York, UK
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Bartoll-Roca X, Marí-Dell'Olmo M, Gotsens M, Palència L, Pérez K, Díez E, Borrell C. Neighbourhood income inequalities in mental health in Barcelona 2001-2016: a Bayesian smoothed estimate. GACETA SANITARIA 2022; 36:534-539. [PMID: 35644735 DOI: 10.1016/j.gaceta.2022.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Obtaining reliable health estimates at the small area level (such as neighbourhoods) using survey data usually poses the problem of small sample sizes. To overcome this limitation, we explored smoothing techniques in order to estimate poor mental health prevalence at the neighbourhood level and analyse its profile by income in Barcelona city (Spain). METHOD A Bayesian smoothing model with a logit-normal transformation was applied to four repeated cross-sectional waves of the Barcelona health survey for 2001, 2006, 2011 and 2016. Mental health status was identified from the 12-item General Health Questionnaire. Income inequalities were analysed with neighbourhood income in quantiles for each year and trends in the pooled analysis. RESULTS The prevalence of poor mental health ranged from 14.6% in 2001 to 18.9% in 2016. The yearly difference between neighbourhoods was 12.4% in 2001, 16.7% in 2006, 14.2% in 2011, and 20.0% in 2016. The odds ratio and 95% credible interval (95%CI) of experiencing poor mental health was 1.40 times higher (95%CI: 1.02-1.91) in less advantaged neighbourhoods than in more advantaged neighbourhoods in 2001, 1.61 times higher (95%CI: 1.01-2.59) in 2006 and 2.31 times higher (95%CI: 1.57-3.40) in 2016. CONCLUSIONS This study shows that the Bayesian smoothed techniques allows detection of inequalities in health in neighbourhoods and monitoring of interventions against them. In Barcelona, mental health problems are more prevalent in low-income neighbourhoods and raised in 2016.
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Affiliation(s)
- Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain.
| | - Marc Marí-Dell'Olmo
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mercè Gotsens
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain
| | - Laia Palència
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Elia Díez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Spain; Institut d'Investigació Biomèdica Sant Pau (IIB-Sant Pau), Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Departament de Ciències Experimentals i de la Salut, Facultat de Ciències de la Salut i de la Vida, Universitat Pompeu Fabra, Barcelona, Spain
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Asper M, Osika W, Dalman C, Pöllänen E, Simonsson O, Flodin P, Sidorchuk A, Marchetti L, Awil F, Castro R, Niemi ME. Effects of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health: systematic review. BJPsych Open 2022; 8:e181. [PMID: 36214114 PMCID: PMC9551492 DOI: 10.1192/bjo.2022.587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A rise in mental illness is expected to follow the COVID-19 pandemic, which has also been projected to lead to a deep global economic recession, further adding to risk factors. AIMS The aim of this review was to assess the impact of the COVID-19 pandemic and previous pandemics, epidemics and economic crises on mental health. METHOD Searches were conducted in PubMed, Web of Science, PsycINFO and Sociological Abstracts. We included studies of all populations exposed to the COVID-19 pandemic, and other similar pandemics/epidemics and economic crises, compared with non-exposed time periods or regions. The outcome was mental health. RESULTS The 174 included studies assessed mental health impacts of the COVID-19 pandemic (87 studies), 2008 economic crisis (84 studies) and severe acute respiratory syndrome (SARS) epidemic (three studies). Outcomes were divided into affective disorders, suicides, mental healthcare utilisation and other mental health. COVID-19 pandemic studies were of lesser quality than those for the economic crisis or SARS epidemic. Most studies for all exposures showed increases in affective disorders and other mental health problems. For economic crisis exposure, increases in mental healthcare utilisation and suicides were also found, but these findings were mixed for COVID-19 pandemic exposure. This is probably because of quarantine measures affecting help-seeking and shorter follow-ups of studies of COVID-19 pandemic exposure. CONCLUSIONS Our findings highlight the importance of available, accessible and sustainable mental health services. Also, socioeconomically disadvantaged populations should be particular targets of policy interventions during the COVID-19 pandemic.
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Affiliation(s)
- Michaela Asper
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Walter Osika
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Elin Pöllänen
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Otto Simonsson
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
| | - Pär Flodin
- Department of Global Public Health, Karolinska Institutet, Sweden
| | - Anna Sidorchuk
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Sweden; and Stockholm Health Care Services, Region Stockholm, Sweden
| | | | | | - Rosa Castro
- Federation of European Academies of Medicine, Belgium
| | - Maria E Niemi
- Department of Global Public Health, Karolinska Institutet, Sweden
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Rahimi-Ardabili H, Feng X, Nguyen PY, Astell-Burt T. Have Deaths of Despair Risen during the COVID-19 Pandemic? A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12835. [PMID: 36232135 PMCID: PMC9564909 DOI: 10.3390/ijerph191912835] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
This systematic review synthesized literature on potential impacts of protracted isolation and other disruptions during the COVID-19 pandemic on deaths of despair (suicide, overdoses, and drug-related liver diseases). Five electronic databases were searched yielding 70 eligible articles. Extant evidence mostly from high-income countries indicates COVID-19-related disruption may not have influenced suicide rates so far, but there have been reports of increased drug-related and liver disease mortality. Minority groups and women were more vulnerable, indicating the need for stronger equity focus on pandemic recovery and resilience strategies. Further high-quality studies with longer-term follow-up, especially from low-income countries, will inform these strategies.
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Affiliation(s)
- Hania Rahimi-Ardabili
- Centre for Health Informatics, Australian Institute of Health Innovation, Macquarie University, Sydney 2109, Australia
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong 2522, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia
| | - Xiaoqi Feng
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong 2522, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong 2522, Australia
| | - Phi-Yen Nguyen
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong 2522, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney 2052, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne 3800, Australia
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), Wollongong 2522, Australia
- School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong 2522, Australia
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12
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Sifaki-Pistolla D, Mechili EA, Melidoniotis E, Argyriadis A, Patelarou E, Chatzea VE. Participatory Action Research for Tackling Distress and Burnout in Young Medical Researchers: Normative Beliefs before and during the Greek Financial Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710467. [PMID: 36078181 PMCID: PMC9517749 DOI: 10.3390/ijerph191710467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 05/06/2023]
Abstract
(1) Background: We aimed to explore Young medical researchers (YMR) normative beliefs and perceived causes of distress and burnout, prior and during the financial crisis in Greece, and to assess their views on Participatory Action Research (PAR) interventions towards tackling these disorders. (2) Methods: A Participatory Learning and Action (PLA) methodology was performed in two time periods (prior crisis: December 2008; during crisis: February-March 2017). In both time periods, three different groups (Group 1: females, Group 2: males, Group 3: mixed) of 5-7 participants and two sessions (≈1 h/session) per group took place in each site. Overall, 204 sessions with 1036 YMR were include in the study. (3) Results: Several socio-demographic characteristics of YMR altered during the crisis (lower income, higher smoking/alcohol consumption, etc.). The majority of YMR conceived distress and burnout as serious syndromes requiring professional support. Feeling very susceptible and the necessity for establishing PAR interventions were frequently reported during the crisis. Numerous (a) barriers and (b) cues to action were mentioned: (a) lack of time, money and support from friends/family/colleagues (b) being extensively informed about the intervention, participation of their collaborators, and raising awareness events. (4) Conclusions: The changing pattern of Greek YMR's beliefs and needs during the crisis stresses the necessity of interventions to tackle distress and burnout. Effectiveness of these interventions could be enhanced by the suggested cues to action that emerged from this study.
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Affiliation(s)
- Dimitra Sifaki-Pistolla
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Crete, Greece
- School of Health Sciences, Frederick University, Nicosia 3080, Cyprus
- Department of Healthcare, Faculty of Health, University of Vlora, 9401 Vlora, Albania
- Correspondence: ; Tel.: +30-2810-394613
| | - Enkeleint A. Mechili
- Clinic of Social and Family Medicine, School of Medicine, University of Crete, 71003 Heraklion, Crete, Greece
- Department of Healthcare, Faculty of Health, University of Vlora, 9401 Vlora, Albania
| | | | | | - Evridiki Patelarou
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71004 Heraklion, Crete, Greece
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13
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Sánchez-Recio R, Alonso JP, Gil-Lacruz A, Aguilar-Palacio I. Inequities in hospitalisation in a South European country: Lessons learned from the last European recession. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1170-e1182. [PMID: 34309102 DOI: 10.1111/hsc.13524] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 06/07/2021] [Accepted: 07/11/2021] [Indexed: 06/13/2023]
Abstract
In Spain, regional health systems (universal access) depend on each Autonomous Communities (ACs). The management of the 2008 economic crisis has been different in the ACs, which may have led to an increase in inequities in the use of health services. The objective of this study was to analyse the impact of individual and regional characteristics on public hospitalisation inequities in Spain for the period 2003-2017. We developed a repeated cross-sectional study through Spanish National Health Surveys (2003, 2006, 2011 and 2017) and the Spanish European Health Survey (2014; n = 118,499 subjects). Multilevel and Oaxaca decomposition analyses were conducted to analyse the effect of individual and regional factors in hospitalisation inequities. The results showed that the prevalence of hospitalisation was higher for women (2003: 11.2%; 2017: 9.0%) than for men (2003: 10.7%; 2017: 8.8%) and it decreased with time. Multilevel analyses showed that, after adjustment for variables related to healthcare demand, there were inequities in the probability of hospitalisation, mainly in women. The decomposition analyses showed a higher effect of the number of hospital beds available on hospitalisation in men than in women. There is a direct relationship between the number of hospital beds and the probability of hospitalisation in both sexes. In conclusion, a progressive decrease in hospitalisation use was observed in Spain in the context of the economic recession. Individual-level and regional-level factors were associated with hospitalisation inequities. It is necessary to guarantee equitable access to health services according to the need even in recession times.
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Affiliation(s)
- Raquel Sánchez-Recio
- Departamento de Fisiatría y Enfermería, Facultad de Ciencias de la Salud, Universidad de Zaragoza, Zaragoza, Spain
- Grupo de investigación de Servicios Sanitarios en Aragón (GRISSA), Zaragoza, Spain
| | - Juan Pablo Alonso
- Grupo de investigación de Servicios Sanitarios en Aragón (GRISSA), Zaragoza, Spain
- Servicio de Vigilancia epidemiológica del Departamento de Sanidad, Gobierno de Aragón, Zaragoza, Spain
| | - Ana Gil-Lacruz
- Departamento de Dirección y Organización de Empresas, Escuela de Ingeniería y Arquitectura, Universidad de Zaragoza, Zaragoza, Spain
| | - Isabel Aguilar-Palacio
- Grupo de investigación de Servicios Sanitarios en Aragón (GRISSA), Zaragoza, Spain
- Departamento de Medicina Preventiva, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
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14
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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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15
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Davis LL, Mumba MN, Toscano R, Pilkinton P, Blansett CM, McCall K, MacVicar D, Bartolucci A. A Randomized Controlled Trial Evaluating the Effectiveness of Supported Employment Integrated in Primary Care. Psychiatr Serv 2022; 73:620-627. [PMID: 34521208 DOI: 10.1176/appi.ps.202000926] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mental health issues can cause serious problems in occupational functioning, including higher rates of unemployment. Individual placement and support (IPS) is an evidence-based supported employment intervention that is typically integrated within a mental health setting; however, many primary care patients view referral to a mental health clinic as stigmatizing. Thus, this study examined whether delivery of IPS in a primary care setting provides an effective treatment option and avoids unnecessary delays in obtaining competitive employment. METHODS U.S. military veterans (N=119) who had a diagnosis in a broad range of nonpsychotic psychiatric disorders and who were receiving care from Veterans Health Administration (VHA) patient-aligned care teams were prospectively randomly assigned to IPS (N=58) or standard VHA non-IPS vocational rehabilitation (VR) (N=61). The primary outcome was achievement of steady worker status, defined as holding a competitive job for ≥6 months of the 12-month follow-up. RESULTS As hypothesized, a significantly greater proportion of IPS participants achieved steady worker status (45%), compared with VR participants (25%) (p=0.02; odds ratio=2.49, 95% confidence interval=1.14-5.43). On average, the IPS participants worked significantly more weeks (p=0.003) and earned significantly more income (p=0.033) from competitive jobs, compared with VR participants. CONCLUSIONS The results provide supporting evidence for offering IPS within primary care with the aim of restoring meaningful and sustained competitive employment for veterans living with a mental disorder. Such modifications could improve veterans' vocational outcomes, moving a significantly greater number of disabled veterans back to full and productive lives in the community.
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Affiliation(s)
- Lori L Davis
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Mercy N Mumba
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Richard Toscano
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Patricia Pilkinton
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Catherine M Blansett
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Kimberly McCall
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - David MacVicar
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
| | - Al Bartolucci
- Research Service, Department of Veterans Affairs (VA) Medical Center, Tuscaloosa, Alabama (Davis, Mumba, Toscano, Pilkinton, Blansett, McCall, MacVicar); Department of Psychiatry and Behavioral Neurobiology, University of Alabama School of Medicine, Birmingham (Davis); Capstone College of Nursing, University of Alabama, Tuscaloosa (Mumba); Department of Psychiatry and Behavioral Medicine, University of Alabama College of Community Health Sciences, Tuscaloosa (Pilkinton); Department of Biostatistics, University of Alabama at Birmingham, Birmingham (Bartolucci)
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16
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Ioannidis JPA. The end of the COVID-19 pandemic. Eur J Clin Invest 2022; 52:e13782. [PMID: 35342941 PMCID: PMC9111437 DOI: 10.1111/eci.13782] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/24/2022] [Accepted: 03/26/2022] [Indexed: 12/15/2022]
Abstract
There are no widely accepted, quantitative definitions for the end of a pandemic such as COVID-19. The end of the pandemic due to a new virus and the transition to endemicity may be defined based on a high proportion of the global population having some immunity from natural infection or vaccination. Other considerations include diminished death toll, diminished pressure on health systems, reduced actual and perceived personal risk, removal of restrictive measures and diminished public attention. A threshold of 70% of the global population having being vaccinated or infected was probably already reached in the second half of 2021. Endemicity may still show major spikes of infections and seasonality, but typically less clinical burden, although some locations are still hit more than others. Death toll and ICU occupancy figures are also consistent with a transition to endemicity by end 2021/early 2022. Personal risk of the vast majority of the global population was already very small by end 2021, but perceived risk may still be grossly overestimated. Restrictive measures of high stringency have persisted in many countries by early 2022. The gargantuan attention in news media, social media and even scientific circles should be tempered. Public health officials need to declare the end of the pandemic. Mid- and long-term consequences of epidemic waves and of adopted measures on health, society, economy, civilization and democracy may perpetuate a pandemic legacy long after the pandemic itself has ended.
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Affiliation(s)
- John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA
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17
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Peña-Longobardo LM, Oliva-Moreno J, Rodríguez-Sánchez B. The Effects of Severe Acute Respiratory Syndrome Coronavirus 2 on the Reported Mental Health Symptoms of Nonprofessional Carers: An Analysis Across Europe. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2022; 25:736-743. [PMID: 35500947 PMCID: PMC8665653 DOI: 10.1016/j.jval.2021.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 07/30/2021] [Accepted: 10/21/2021] [Indexed: 05/03/2023]
Abstract
OBJECTIVES This study tries to analyze how the crisis generated by severe acute respiratory syndrome coronavirus 2 has affected the reported mental health symptoms of informal caregivers in different European countries. METHODS The Survey of Health, Ageing and Retirement in Europe-COVID-19 was used, collecting information from the beginning of June 2020 to August 2020 about individuals' state of health and the care they received. Several probit regression models were used to analyze the differences in the probability of (1) being sad or depressed, (2) being anxious or nervous, (3) having difficulty sleeping, and (4) feeling lonely, between individuals who provided informal care and individuals who did not. Several subanalyses by geographic area, mortality rates due to coronavirus disease 2019 (COVID-19), and long-term care expenditure were also performed. RESULTS Since the outbreak of COVID-19, informal caregivers have had a higher probability of being sad or depressed of 8 percentage points (p.p.), a 7.1 p.p. higher probability of being anxious or nervous, and a 5.9 p.p. higher probability of having difficulty sleeping than non-caregivers. Informal caregivers in Southern Europe have had an 8 p.p. higher probability of being sad or depressed than non-caregivers. In Eastern Europe, this difference in probability reaches 9.7 p.p. Finally, in countries with higher mortality rates due to COVID-19, there have been greater differences in terms of being sad or depressed between caregivers and non-caregivers, regardless of expenditure on long-term care. CONCLUSIONS Since the outbreak of COVID-19, informal caregivers in Europe have had a higher probability of reporting mental health symptoms than non-caregivers.
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Affiliation(s)
| | - Juan Oliva-Moreno
- Economic Analysis and Finance Department, University of Castilla-La Mancha, Toledo, Spain
| | - Beatriz Rodríguez-Sánchez
- Department of Applied, Public and Political Economics, Faculty of Law, Complutense University of Madrid, Madrid, Spain
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18
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Backhaus I, Hoven H, Di Tecco C, Iavicoli S, Conte A, Dragano N. Economic change and population health: lessons learnt from an umbrella review on the Great Recession. BMJ Open 2022; 12:e060710. [PMID: 35379647 PMCID: PMC8980730 DOI: 10.1136/bmjopen-2021-060710] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Worldwide, the COVID-19 pandemic triggered the sharpest economic downturn since the Great Recession. To prepare for future crises and to preserve public health, we conduct an overview of systematic reviews to examine the evidence on the effect of the Great Recession on population health. METHODS We searched PubMed and Scopus for systematic reviews and/or meta-analyses focusing specifically on the impact of the Great Recession on population health (eg, mental health). Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed throughout this review and critical appraisal of included systematic reviews was performed using Assessing the Methodological Quality of Systematic Reviews. RESULTS Twenty-one studies were identified and consistently showed that the Great Recession was most risky to health, the more a country's economy was affected and the longer strict austerity policies were in place. Consequently, a deterioration of health was highest in countries that had implemented strict austerity measures (eg, Greece), but not in countries that rejected austerity measures (eg, Germany). Moreover, the impact of the Great Recession fell disproportionately on the most vulnerable groups such as people in unemployment, at risk of unemployment and those living in poverty. CONCLUSIONS The experiences of the last economic crisis show that it is possible to limit the consequences for health. Prioritising mental healthcare and prevention, foregoing austerity measures in the healthcare system and protecting vulnerable groups are the most important lessons learnt. Moreover, given the further aggravating social inequalities, a health in all policies approach, based on a comprehensive Health Impact Assessment, is advised.
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Affiliation(s)
- Insa Backhaus
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Hanno Hoven
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Cristina Di Tecco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers' Compensation Authority (INAIL), Rome, Italy
| | - Sergio Iavicoli
- Directorate for Communication and International Affairs, Ministry of Health, Rome, Italy
| | - Arne Conte
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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19
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Could COVID-19′s Aftermath on Children’s Health Be Felt into the 22nd Century? CHILDREN 2022; 9:children9040482. [PMID: 35455526 PMCID: PMC9031144 DOI: 10.3390/children9040482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 11/29/2022]
Abstract
The COVID-19 pandemic has massively affected people’s health, societies, and the global economy. Our lives are no longer as they were before COVID-19, and, most likely, will never be the same again. We hypothesize that the effect of the COVID-19 pandemic on population health and the economy will last for a very long time and will still be felt in the 22nd century. Our hypothesis is based on evidence from the 1918–1919 influenza pandemic, the Dutch famine during the Second World War, and the 2007–2008 economic crisis, as well as from the rationally predicted impact of COVID-19 on human development. We expect that the COVID-19 pandemic, including the mitigation measures taken against it, will affect children’s development in multiple ways, including obesity, both while in utero and during critical and sensitive windows of development, including the early childhood years and those of puberty and adolescence. The psychosocial and biological impact of this effect will be considerable and unequally distributed. The implications will last at least a lifetime, and, through inter-generational transmission, will likely take us to future generations, into the 22nd century. We argue for the urgent need of designing and initiating comprehensive longitudinal cohort studies to closely monitor the long-term effects of COVID-19 on children conceived, born, and raised during the pandemic. Such an approach requires a close and effective collaboration between scientists, healthcare providers, policymakers, and the younger generations, and it will hopefully uncover evidence necessary to understand and mitigate the impact of the pandemic on people’s lives in the 21st and 22nd centuries.
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Trógolo MA, Moretti LS, Medrano LA. A nationwide cross-sectional study of workers' mental health during the COVID-19 pandemic: Impact of changes in working conditions, financial hardships, psychological detachment from work and work-family interface. BMC Psychol 2022; 10:73. [PMID: 35303966 PMCID: PMC8931581 DOI: 10.1186/s40359-022-00783-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 03/11/2022] [Indexed: 12/14/2022] Open
Abstract
Background The COVID-19 disease has changed people’s work and income. While recent evidence has documented the adverse impact of these changes on mental health outcomes, most research is focused on frontline healthcare workers and the reported association between income loss and mental health comes from high-income countries. In this study we examine the impact of changes in working conditions and income loss related to the COVID-19 lockdown on workers’ mental health in Argentina. We also explore the role of psychological detachment from work and work-family interaction in mental health.
Methods A total of 1049 participants aged between 18 and 65 who were working before the national lockdown in March 2020 were recruited using a national random telephone survey. Work conditions included: working at the usual workplace during the pandemic, working from home with flexible or fixed schedules, and being unemployed or unable to work due to the pandemic. Measures of financial hardship included income loss and self-reported financial problems related to the outbreak. Work-family interface included measures of work-family conflict (WFC) and family-work conflict (FWC). Mental health outcomes included burnout, life satisfaction, anxiety and depressive symptoms. Data were collected in October 2020. Results Home-based telework under fixed schedules and unemployment impact negatively on mental health. Income loss and particularly self-reported financial problems were also associated with deterioration of mental health. More than half of the participants reported financial problems, and those who became unemployed during the pandemic experienced more often financial problems. Finally, psychological detachment from work positively influenced mental health; WFC and FWC were found to negatively impact on mental health. Conclusions Countries’ policies should focus on supporting workers facing economic hardships and unemployment to ameliorate the COVID-19’ negative impact on mental health. Organisations can protect employees’ mental health by actively encouraging psychological detachment from work and by help managing work-family interface. Longitudinal studies are needed to more thoroughly assess the long-term impact of the COVID-19-related changes in work and economic turndown on mental health issues.
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Affiliation(s)
| | - Luciana Sofía Moretti
- Universidad Siglo 21, Bv. de los Latinos 8555, 5000, Córdoba, Argentina.,Pontifica Universidad Católica Madre y Maestra, Santiago De Los Caballeros, República Dominicana
| | - Leonardo Adrián Medrano
- Universidad Siglo 21, Bv. de los Latinos 8555, 5000, Córdoba, Argentina.,Pontifica Universidad Católica Madre y Maestra, Santiago De Los Caballeros, República Dominicana
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21
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The Influence of Economic Factors on the Relationship between Partnership Status and Health: A Gender Approach to the Spanish Case. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052975. [PMID: 35270668 PMCID: PMC8910377 DOI: 10.3390/ijerph19052975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 02/26/2022] [Accepted: 03/02/2022] [Indexed: 11/17/2022]
Abstract
This study explores the relevance of economic factors (e.g., a household's economic capacity and the prevailing economic context) to understand the relationship between the partnership status and the health of Spanish adult women and men (age 30-59). To do so, it draws on cross-sectional data from the Spanish sample of the European Union Statistics on Income and Living Conditions (EU-SILC) for the years 2005, 2010, and 2015 (i.e., before, during, and after the 2008-2012 economic recession). The results reveal dissimilar patterns of association between partnership status and both the health of, and the economic difficulties faced by Spanish women and men in each of the three years studied. Most notably, the partnership status of Spanish women has a greater impact on their likelihood of experiencing economic difficulties and poor health than does that of their male counterparts. Additionally, women are also more likely to experience economic difficulties during and after the economic recession. The disadvantageous situation of Spanish women in the public sphere is shown to have a negative impact on their ability to cope with the economic difficulties associated with the end of a union and a contextual recession.
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22
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Del Llano Señarís JE, Correia NN, Logusso LG, Errea Rodríguez M, Bringas Roldán C. [The indirect costs of tension type headache. A systematic literature review]. Aten Primaria 2022; 54:102238. [PMID: 35077913 PMCID: PMC8790615 DOI: 10.1016/j.aprim.2021.102238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/14/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The objective of this work was to systematically review the published literature in relation to the estimated indirect costs associated with TTH. DESIGN This systematic review followed the Preferred Reporting Items Statement for Systematic Reviews and Meta-analyzes (PRISMA). DATA SOURCES The review was performed in two main databases, PubMed and EconLit, and was completed with the gray literature search. STUDY SELECTION The basic criterion for the inclusion of studies was that they present at least one measure of indirect costs specific to TTH. DATA EXTRACTION 12 studies were finally selected for information extraction. Of all the selected articles, the characteristics of the study design, the types of costs included, as well as the measurement instrument, and the main results were synthesized. RESULTS The search yielded a total of 568 studies. Heterogeneity was found in the designs and samples/populations of the included studies. Only two studies estimated direct and indirect costs for TTH. Among the most notable results, we find an estimated moderate impact of disability due to TTH (between 0.037 and 0.15 per person, 0.06-0.09% for the population). Productivity and efficiency losses were observed and were very heterogeneous. The willingness to pay for effective treatment would range from $1.32 to $9.20 per month. Quality of life is low, between 28.2 and 28.4 points out of 100, and health-related quality of life seems to improve significantly with treatment. CONCLUSIONS Despite the high heterogeneity of the results, we can conclude that tension headache is characterized by a moderate impact on disability, on productivity and efficiency at work or school, and on the quality of life of those who suffer it.
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Garcia S, Hopfer S, Botes E, Greiff S. Associations between Coronavirus Crisis Perception, Perceived Economic Risk of Coronavirus, General Self-Efficacy, and Coronavirus Anxiety at the Start of the Pandemic: Differences by Gender and Race. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2872. [PMID: 35270567 PMCID: PMC8910045 DOI: 10.3390/ijerph19052872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/18/2022] [Accepted: 02/25/2022] [Indexed: 11/16/2022]
Abstract
The coronavirus pandemic has escalated rates of anxiety in the general U.S. population. Understanding how factors associated with coronavirus anxiety at the start of the pandemic differed among populations hardest impacted by coronavirus anxiety is key to effectively remediating negatively associated health outcomes and to better understand how to address concerns of the public at the start of a global pandemic. This study was a secondary analysis of data from a cross-sectional online survey of 1165 Prolific users between 13 and 15 March 2020. Data were collected from a stratified sample of U.S. adults aged 20 or older and currently living in the United States. The sample was stratified for age, gender, and race. Coronavirus anxiety was assessed as the dependent variable, alongside three independent variables: coronavirus crisis perception, perceived economic risk of coronavirus, and general self-efficacy. Multiple linear regression assessed the associations between the independent variables and coronavirus anxiety. Interactions between independent variables and two sociodemographic variables (i.e., gender, race) were also explored. The models were adjusted for age, gender, race, education, employment, and income. The average age of participants was 45.6 ± 15.7. The majority (76%) identified as White, approximately half identified as female and reported obtaining a bachelor's degree or higher. Coronavirus crisis perception and perceived economic risk of coronavirus were positively associated with coronavirus anxiety (β = 0.46, 95% CI = 0.41, 1.00; β = 0.14, 95% CI = 0.09, 1.00, respectively). General self-efficacy was negatively associated with coronavirus anxiety (β = -0.15, 95% CI = -1.00, -0.11). Gender and race both moderated the association between coronavirus crisis perception and anxiety. Race moderated the association between perceived economic risk and coronavirus crisis perception. These results provide a foundation to further explore cognitive factors in subgroups disproportionately affected by anxiety during the pandemic.
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Affiliation(s)
- Samantha Garcia
- Program in Public Health, Department of Health, Society & Behavior, Susan and Henry Samueli College of Health Sciences, University of California-Irvine, Irvine, CA 92697, USA;
| | - Suellen Hopfer
- Program in Public Health, Department of Health, Society & Behavior, Susan and Henry Samueli College of Health Sciences, University of California-Irvine, Irvine, CA 92697, USA;
| | - Elouise Botes
- Department of Developmental and Educational Psychology, University of Vienna, 1010 Vienna, Austria;
| | - Samuel Greiff
- Department of Behavioral and Cognitive Sciences, University of Luxembourg, 4366 Esch-sur-Alzette, Luxembourg;
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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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Babicki M, Kowalski K, Bogudzińska B, Mastalerz-Migas A. Impact of the COVID-19 Pandemic on Mental Well-Being. A Nationwide Online Survey Covering Three Pandemic Waves in Poland. Front Psychiatry 2021; 12:804123. [PMID: 34975595 PMCID: PMC8718800 DOI: 10.3389/fpsyt.2021.804123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 11/23/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has a significant impact on human life. This study aims to assess the prevalence of depressive and anxiety symptoms, and the assessment of the quality of life in different stages of the COVID-19 pandemic based on an online nationwide survey. The study was based on a voluntary, anonymous, and authors' own questionnaire. The first section assesses sociodemographic status. Then, standardized psychometric tools were used such as the Beck Depression Inventory (BDI), the Generalized Anxiety Disorder Assessment (GAD-7), and the Manchester Short Assessment of Quality of Life (MANSA). The study was conducted in three stages corresponding to the waves of the COVID-19 pandemic in Poland. The survey involved 5,790 respondents; 2,457, 1,626, and 1,707 for the first, second, and third pandemic wave, respectively. It was found that anxiety and depressive symptoms increased as the pandemic progressed. There was no significant effect on the subjective quality-of-life assessment. Moreover, there was a gradual decrease in anxiety about being infected with COVID-19 as well as reduced adherence to the Minister of Health's recommendations. As the COVID-19 pandemic progressed, depressive and anxiety symptoms increased among Poles. Women, singles, and people with prior psychiatric treatment are more likely to develop the aforementioned symptoms.
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Affiliation(s)
- Mateusz Babicki
- Department of Family Medicine, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Kowalski
- Department and Clinic of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | - Bogna Bogudzińska
- Students' Scientific Group at the Faculty of Psychiatry, Wroclaw Medical University, Wrocław, Poland
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Brülhart M, Klotzbücher V, Lalive R, Reich SK. Mental health concerns during the COVID-19 pandemic as revealed by helpline calls. Nature 2021; 600:121-126. [PMID: 34789873 PMCID: PMC9973557 DOI: 10.1038/s41586-021-04099-6] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 10/06/2021] [Indexed: 01/22/2023]
Abstract
Mental health is an important component of public health, especially in times of crisis. However, monitoring public mental health is difficult because data are often patchy and low-frequency1-3. Here we complement established approaches by using data from helplines, which offer a real-time measure of 'revealed' distress and mental health concerns across a range of topics4-9. We collected data on 8 million calls from 19 countries, focusing on the COVID-19 crisis. Call volumes peaked six weeks after the initial outbreak, at 35% above pre-pandemic levels. The increase was driven mainly by fear (including fear of infection), loneliness and, later in the pandemic, concerns about physical health. Relationship issues, economic problems, violence and suicidal ideation, however, were less prevalent than before the pandemic. This pattern was apparent both during the first wave and during subsequent COVID-19 waves. Issues linked directly to the pandemic therefore seem to have replaced rather than exacerbated underlying anxieties. Conditional on infection rates, suicide-related calls increased when containment policies became more stringent and decreased when income support was extended. This implies that financial relief can allay the distress triggered by lockdown measures and illustrates the insights that can be gleaned from the statistical analysis of helpline data.
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Affiliation(s)
- Marius Brülhart
- University of Lausanne, Lausanne, Switzerland. .,Centre for Economic Policy Research, London, UK.
| | | | - Rafael Lalive
- University of Lausanne, Lausanne, Switzerland,CEPR, London, United Kingdom
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McPeake J, Shaw M, MacTavish P, Blyth KG, Devine H, Fleming G, Griffin J, Gemmell L, Grose P, Henderson M, Henderson P, Hogg L, King K, McInnes I, O'Brien P, Puxty K, Rainey C, Sharma V, Sim M, Strachan L, Siebert S, Quasim T. Long-term outcomes following severe COVID-19 infection: a propensity matched cohort study. BMJ Open Respir Res 2021; 8:e001080. [PMID: 34887318 PMCID: PMC8663070 DOI: 10.1136/bmjresp-2021-001080] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There are limited data describing the long-term outcomes of severe COVID-19. We aimed to evaluate the long-term psychosocial and physical consequences of severe COVID-19 for patients. METHODS We conducted a multicentre observational cohort study; between 3 and 7 months posthospital discharge, patients who had been admitted to critical care due to severe COVID-19 were invited to an established recovery service. Standardised questionnaires concerning emotional, physical and social recovery, including information on employment, were completed by patients. Using propensity score matching, we explored outcomes between patients admitted to critical care with and without COVID-19, using data from the same recovery programme. RESULTS Between July 2020 and December 2020, 93 patients who had been admitted to critical with COVID-19 participated. Emotional dysfunction was common: 46.2% of patients had symptoms of anxiety and 34.4% symptoms of depression. At follow-up 53.7% of previously employed patients had returned to employment; there was a significant difference in return to employment across the socio-economic gradient, with lower numbers of patients from the most deprived areas returning to employment (p=0.03). 91 (97.8%) COVID-19 patients were matched with 91 non-COVID-19 patients. There were no significant differences in any measured outcomes between the two cohorts. INTERPRETATION Emotional and social problems are common in survivors of severe COVID-19 infection. Coordinated rehabilitation is required to ensure patients make an optimal recovery.
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Affiliation(s)
- Joanne McPeake
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | - Martin Shaw
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Kevin G Blyth
- NHS Greater Glasgow and Clyde, Glasgow, UK
- Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | | | - Philip Henderson
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | | | - Iain McInnes
- University of Glasgow, College of Medical, Veterinary and Life Science, Glasgow, UK
| | | | - Kathryn Puxty
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | | | - Malcolm Sim
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
| | | | - Stefan Siebert
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Tara Quasim
- NHS Greater Glasgow and Clyde, Glasgow, UK
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
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Fell M, Russell C, Medina J, Gillgrass T, Chummun S, Cobb ARM, Sandy J, Wren Y, Wills A, Lewis SJ. The impact of changing cigarette smoking habits and smoke-free legislation on orofacial cleft incidence in the United Kingdom: Evidence from two time-series studies. PLoS One 2021; 16:e0259820. [PMID: 34818369 PMCID: PMC8612573 DOI: 10.1371/journal.pone.0259820] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 10/26/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Both active and passive cigarette smoking have previously been associated with orofacial cleft aetiology. We aimed to analyse the impact of declining active smoking prevalence and the implementation of smoke-free legislation on the incidence of children born with a cleft lip and/or palate within the United Kingdom. METHODS AND FINDINGS We conducted regression analysis using national administrative data in the United Kingdom between 2000-2018. The main outcome measure was orofacial cleft incidence, reported annually for England, Wales and Northern Ireland and separately for Scotland. First, we conducted an ecological study with longitudinal time-series analysis using smoking prevalence data for females over 16 years of age. Second, we used a natural experiment design with interrupted time-series analysis to assess the impact of smoke-free legislation. Over the study period, the annual incidence of orofacial cleft per 10,000 live births ranged from 14.2-16.2 in England, Wales and Northern Ireland and 13.4-18.8 in Scotland. The proportion of active smokers amongst females in the United Kingdom declined by 37% during the study period. Adjusted regression analysis did not show a correlation between the proportion of active smokers and orofacial cleft incidence in either dataset, although we were unable to exclude a modest effect of the magnitude seen in individual-level observational studies. The data in England, Wales and Northern Ireland suggested an 8% reduction in orofacial cleft incidence (RR 0.92, 95%CI 0.85 to 0.99; P = 0.024) following the implementation of smoke-free legislation. In Scotland, there was weak evidence for an increase in orofacial cleft incidence following smoke-free legislation (RR 1.16, 95%CI 0.94 to 1.44; P = 0.173). CONCLUSIONS These two ecological studies offer a novel insight into the influence of smoking in orofacial cleft aetiology, adding to the evidence base from individual-level studies. Our results suggest that smoke-free legislation may have reduced orofacial cleft incidence in England, Wales and Northern Ireland.
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Affiliation(s)
- Matthew Fell
- Cleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Craig Russell
- Scottish Cleft Service, Royal Hospital for Children, Glasgow, United Kingdom
| | - Jibby Medina
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, United Kingdom
| | - Toby Gillgrass
- Scottish Cleft Service, Royal Hospital for Children, Glasgow, United Kingdom
| | - Shaheel Chummun
- South West Cleft Service, University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom
| | - Alistair R. M. Cobb
- South West Cleft Service, University Hospitals Bristol and Weston NHS Trust, Bristol, United Kingdom
| | - Jonathan Sandy
- Cleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Yvonne Wren
- Cleft Collective, Bristol Dental School, University of Bristol, Bristol, United Kingdom
| | - Andrew Wills
- Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Sarah J. Lewis
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
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Ojokoh BA, Olaku OA, Sarumi OA, Olotu SI. Predictive analytics for economic crisis triggered depression risk level identification among some adults in Nigeria. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e01056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Pulido J, Hoyos J, Martínez-Ruiz V, Sordo L, Fernández-Navarro P, Barrio G, Regidor E. Long-term impact of the 2008 economic crisis in Spain on road traffic collisions mortality by socioeconomic position. Health Place 2021; 71:102666. [PMID: 34507036 DOI: 10.1016/j.healthplace.2021.102666] [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: 01/15/2021] [Revised: 06/24/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
We aimed to assess the effect of the 2008 crisis on road traffic collision (RTC) mortality in Spain, by socioeconomic position (SEP) and type of road use. This prospective, country-wide study covered all adults living in Spain and aged ≥30 years in November 2001. The long-term effect of the crisis was assessed by measuring the monthly percentage change (MPC) in RTC mortality between the pre-crisis (2002-2007) and crisis period (2008-2011). During the recession, RTC mortality fell more in people with low compared to high SEP, so MPCs difference between periods were of a higher magnitude in the low compared to high SEP groups, especially among men motorcyclists. RTC mortality trends were favorable following the 2008 crisis, particularly among low-SEP groups. In men motorcyclists, the upward trend of the pre-crisis period reversed course.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - J Hoyos
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain.
| | - V Martínez-Ruiz
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Avda. de La Investigación 11. 18016, Granada, Spain
| | - L Sordo
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - P Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - G Barrio
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; National School of Public Health. Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Calle Del Profesor Martín Lagos. 28040, Madrid, Spain
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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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Socioeconomic Inequalities in Chronic Liver Diseases and Cirrhosis Mortality in European Urban Areas before and after the Onset of the 2008 Economic Recession. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168801. [PMID: 34444557 PMCID: PMC8391471 DOI: 10.3390/ijerph18168801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 01/16/2023]
Abstract
Objective: To analyse the trends in chronic liver diseases and cirrhosis mortality, and the associated socioeconomic inequalities, in nine European cities and urban areas before and after the onset of the 2008 financial crisis. Methods: This is an ecological study of trends in three periods of time: two before (2000–2003 and 2004–2008), and one after (2009–2014) the onset of the economic crisis. The units of analysis were the geographical areas of nine cities or urban areas in Europe. We analysed chronic liver diseases and cirrhosis standardised mortality ratios, smoothing them with a hierarchical Bayesian model by each city, area, and sex. An ecological regression model was fitted to analyse the trends in socioeconomic inequalities, and included the socioeconomic deprivation index, the period, and their interaction. Results: In general, chronic liver diseases and cirrhosis mortality rates were higher in men than in women. These rates decreased in all cities during the financial crisis, except among men in Athens (rates increased from 8.50 per 100,000 inhabitants during the second period to 9.42 during the third). Socioeconomic inequalities in chronic liver diseases and cirrhosis mortality were found in six cities/metropolitan areas among men, and in four among women. Finally, in the periods studied, such inequalities did not significantly change. However, among men they increased in Turin and Barcelona and among women, several cities had lower inequalities in the third period. Conclusions: There are geographical socioeconomic inequalities in chronic liver diseases and cirrhosis mortality, mainly among men, that did not change during the 2008 financial crisis. These results should be monitored in the long term.
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The 2008 Financial Crisis and Changes in Lifestyle-Related Behaviors in Italy, Greece, Spain, and Portugal: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168734. [PMID: 34444482 PMCID: PMC8392284 DOI: 10.3390/ijerph18168734] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 12/17/2022]
Abstract
Italy, Greece, Spain, and Portugal have all been strongly affected by the 2008 financial crisis, which has had a negative impact on health. We systematically evaluated the effects of the crisis on lifestyle and socioeconomic inequalities. We conducted a literature search using MEDLINE, Embase, the Cochrane Library, and health economics databases for studies reporting quantitative comparisons before and after (or during) the crisis on the following risk behaviors: alcohol consumption, smoking habit, healthy diet, physical activity, and psychotropic drugs and substance abuse, without setting any age restrictions. We selected 34 original articles published between 2011 and 2020. During/after the crisis, alcohol consumption and substance abuse decreased, while psychotropic drug use increased. We also observed a deterioration in healthy eating behavior, with a reduction in fruit and vegetable consumption. Smoking habit and physical activity showed a more complex, controversial trend. Socioeconomic inequalities were affected by the recession, and the negative effects on unhealthy lifestyle tended to be more pronounced among the disadvantaged. These results suggest the need to implement health policies and interventions aimed at monitoring risk behaviors, with special regard to disadvantaged people, and considering the potential additional impact of the COVID-19 pandemic.
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Cherrie M, Curtis S, Baranyi G, Cunningham N, Dibben C, Bambra C, Pearce J. A data linkage study of the effects of the Great Recession and austerity on antidepressant prescription usage. Eur J Public Health 2021; 31:297-303. [PMID: 33550373 DOI: 10.1093/eurpub/ckaa253] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND International literature shows unemployment and income loss during the Great Recession worsened population mental health. This individual-level longitudinal study examines how regional economic trends and austerity related to depression using administrative prescription data for a large and representative population sample. METHODS Records from a sample of the Scottish Longitudinal Study (N=86 500) were linked to monthly primary care antidepressant prescriptions (2009-15). Regional economic trends were characterized by annual full-time employment data (2004-14). Economic impact of austerity was measured via annual income lost per working age adult due to welfare reforms (2010-15). Sequence analysis identified new cases of antidepressant use, and group-based trajectory modelling classified regions into similar economic trajectories. Multi-level logistic regression examined relationships between regional economic trends and new antidepressant prescriptions. Structural equation mediation analysis assessed the contributory role of welfare reforms. RESULTS Employed individuals living in regions not recovering post-recession had the highest risk of beginning a new course of antidepressants (AOR 1.23; 95% CI 1.08-1.38). Individuals living in areas with better recovery trajectories had the lowest risk. Mediation analyses showed that 50% (95% CI 7-61%) of this association was explained by the impact of welfare benefit reforms on average incomes. CONCLUSIONS Following the Great Recession, local labour market decline and austerity measures were associated with growing antidepressant usage, increasing regional inequalities in mental health. The study evidences the impact of austerity on health inequalities and suggests that economic conditions and welfare policies impact on population health. Reducing the burden of mental ill-health primarily requires action on the social determinants.
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Affiliation(s)
- Mark Cherrie
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Sarah Curtis
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK.,School of Geography, Durham University, Durham, UK
| | - Gergő Baranyi
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
| | - Niall Cunningham
- School of Geography Politics and Sociology, Newcastle University, Newcastle, UK
| | - Chris Dibben
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK.,ESRC Administrative Data Research Centre, University of Edinburgh, Newcastle, UK
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, UK
| | - Jamie Pearce
- Centre for Research on Environment, Society and Health, School of GeoSciences, University of Edinburgh, Edinburgh, UK
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Jónsdóttir U, Þórðardóttir EB, Aspelund T, Jónmundsson Þ, Einarsdóttir K. The effect of the 2008 recession on well-being and employment status of people with and without mental health problems. Eur J Public Health 2021; 30:761-766. [PMID: 31800030 DOI: 10.1093/eurpub/ckz192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The world was hit hard by the 2008 recession which led to increased unemployment and financial strain. However, how the recession affected people with pre-existing mental health problems has been understudied. This study investigates the effect of the 2008 recession in Iceland on stress, well-being and employment status of people with regard to whether they are suffering from mental health problems. METHODS The study cohort included participants (18-69 years old) of the 'Health and Wellbeing of Icelanders', a 3-wave survey conducted before (in 2007) and after (in 2009 and 2012) the recession in 2008. Self-assessed well-being was measured with the Short Warwick-Edinburgh Mental Well-being Scale and the 4-item Perceived Stress Scale. Logistic regression was used to assess the effect of the 2008 recession on self-assessed well-being and employment status in 2009 and 2012, using 2007 as a reference year. RESULTS Participants with no pre-recession mental health problems were at increased risk of both poor well-being, (with adjusted odds ratio at 1.66, in 2009 and 1.64 in 2012) and higher perceived stress, (with adjusted odds ratio at 1.48 in 2009 and 1.53 in 2012), after the recession. Interestingly, no significant change in well-being and perceived stress was observed among participants suffering from pre-recession mental health problems. Both groups had increased risk of unemployment after the recession. CONCLUSION Results indicate that after recessions, the risk of stress and poor well-being increases only among those who do not suffer from pre-recession mental health problems.
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Affiliation(s)
- Unnur Jónsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Edda Björk Þórðardóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Thor Aspelund
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Þórarinn Jónmundsson
- School of Engineering and Natural Sciences, Faculty of Physical Sciences, University of Iceland, Reykjavik, Iceland
| | - Kristjana Einarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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36
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The economic crisis impact on the body mass index of children living in distinct urban environments. Public Health 2021; 196:29-34. [PMID: 34139606 DOI: 10.1016/j.puhe.2021.04.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/05/2021] [Accepted: 04/30/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Little is known about the impact of the 2008 global economic recession on childhood obesity in Portugal. Thus, this study's goals were to compare weight status of children during and after the economic crisis according to their neighbourhood environment features and to assess changes in specific dietary habits during the economic crisis. STUDY DESIGN Cross-sectional study. METHODS Data including weight, height, residence address to allow its geocoding and dietary habits changes during the crisis from children living in Lisbon municipality were collected in 2009 (N = 929) and in 2016 (N = 1751). A multidimensional environment index, with data of both built and socioeconomic nature collected at the statistical section level (areas comprised 300 dwellers) in the 2011 census, was used to characterize neighbourhoods. RESULTS Overall, the proportion of children who are overweight or obese living in the socioeconomically vulnerable areas decreased in 2016. Families living in the latter areas stopped buying some food items, started to buy cheaper food items, cooked more meals at home and ate less in restaurants. In 2016, the risk for overweight and obesity increased in children who lived in the least advantageous areas. Living in areas with high socioeconomic status or most advantageous areas no longer represented a decreased risk of being overweight or obese in children in 2016 as it did in 2009. CONCLUSIONS This study suggests that the economic crisis enhanced the social inequalities regarding childhood obesity. These results aid the development of evidence-based strategies to lessen the social inequities in health outcomes created by the crisis.
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Ruengorn C, Awiphan R, Wongpakaran N, Wongpakaran T, Nochaiwong S. Association of job loss, income loss, and financial burden with adverse mental health outcomes during coronavirus disease 2019 pandemic in Thailand: A nationwide cross-sectional study. Depress Anxiety 2021; 38:648-660. [PMID: 33793028 PMCID: PMC8251094 DOI: 10.1002/da.23155] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/09/2021] [Accepted: 03/16/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Economic crises during the coronavirus disease (COVID-19) pandemic severely impacted mental health outcomes. However, there is limited evidence on this issue in Thailand. We aimed to evaluate the association of economic burden during the first phase of the pandemic and the risk of adverse mental health outcomes in the Thai population. METHODS We recruited 2,303 participants aged 18 years or above with employment/full-time jobs before the national lockdown in April-May 2020. The measures of economic burden were job loss, income loss, and financial problems related to the outbreak. The outcomes included depressive symptoms, anxiety, and perceived stress. The association between economic burden and adverse mental health outcomes was evaluated using multivariable logistic regression models. RESULTS Individuals who lost their jobs during the COVID-19 pandemic had a higher risk of perceived stress compared to those who maintained their job (adjusted odds ratio [OR], 2.40; 95% confidence interval [CI], 1.28-4.51; p = .006). A higher risk of anxiety was observed in individuals with a monthly income loss of 50% (adjusted OR, 1.42; 95% CI, 1.03-1.99; p = .035; individuals without income loss, reference group) or over. Self-reported financial problems were significantly associated with adverse mental health outcomes (nonexperienced financial problems, reference group): Adjusted ORs of 1.84 (95% CI, 1.34-2.51; p < .001) for depressive symptoms, 2.00 (95% CI, 1.48-2.71; p < .001) for anxiety, and 2.12 (95% CI, 1.51-2.95; p < .001) for perceived stress. CONCLUSIONS Economic burden, especially self-reported financial problems, was associated with adverse mental health outcomes. However, long-term studies are needed to address the mental health consequences of COVID-19 and economic downturns.
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Affiliation(s)
- Chidchanok Ruengorn
- Department of Pharmaceutical Care, Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
| | - Ratanaporn Awiphan
- Department of Pharmaceutical Care, Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
| | | | | | - Surapon Nochaiwong
- Department of Pharmaceutical Care, Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
- Pharmacoepidemiology and Statistics Research Center (PESRC), Faculty of PharmacyChiang Mai UniversityChiang MaiThailand
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38
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Maynou L, Hernández-Pizarro HM, Errea Rodríguez M. The Association of Physical (in)Activity with Mental Health. Differences between Elder and Younger Populations: A Systematic Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094771. [PMID: 33947122 PMCID: PMC8124550 DOI: 10.3390/ijerph18094771] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/19/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022]
Abstract
Background: Physical activity is associated with mental health benefits. This systematic literature review summarises extant evidence regarding this association, and explores differences observed between populations over sixty-five years and those younger than sixty-five. Methods: We reviewed articles and grey literature reporting at least one measure of physical activity and at least one mental disorder, in people of all ages. Results: From the 2263 abstracts screened, we extracted twenty-seven articles and synthesized the evidence regarding the association between physical (in)activity and one or more mental health outcome measures. We confirmed that physical activity is beneficial for mental health. However, the evidence was mostly based on self-reported physical activity and mental health measures. Only one study compared younger and elder populations, finding that increasing the level of physical activity improved mental health for middle aged and elder women (no association was observed for younger women). Studies including only the elderly found a restricted mental health improvement due to physical activity. Conclusions: We found inverse associations between levels of physical activity and mental health problems. However, more evidence regarding the effect of ageing when measuring associations between physical activity and mental health is needed. By doing so, prescription of physical activity could be more accurately targeted.
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Affiliation(s)
- Laia Maynou
- Health Policy Department, London School of Economics and Political Science, London WC2A 2AE, UK;
- Centre for Research in Health and Economics (CRES-UPF) Mercè Rodoreda Building, Universitat Pompeu Fabra, 08005 Barcelona, Spain
| | - Helena M. Hernández-Pizarro
- Centre for Research in Health and Economics (CRES-UPF) Mercè Rodoreda Building, Universitat Pompeu Fabra, 08005 Barcelona, Spain
- Tecnocampus, Universitat Pompeu Fabra, 08302 Mataró, Spain
- Correspondence: ; Tel.: +34-93-542-1556
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39
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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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Ortega-Loubon C, Ruiz López Del Prado G, Muñoz-Moreno MF, Gómez-Sánchez E, López-Herrero R, Sánchez-Quirós B, Lorenzo-Lopez M, Gómez-Pesquera E, Jorge-Monjas P, Bustamante-Munguira J, Álvarez FJ, Resino S, Tamayo E, Heredia-Rodríguez M. Impact of the Economic Crisis on Endocarditis Mortality in Spain: A Nationwide Study. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2021; 52:383-391. [PMID: 33913368 DOI: 10.1177/00207314211012357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Economic recession has dire consequences on overall health. None have explored the impact of economic crisis (EC) on infective endocarditis (IE) mortality. We conducted a retrospective, nationwide, temporal trend study analyzing mortality trends by age, sex, and adverse outcomes in patients diagnosed with IE in Spain from 1997 to 2014. Data were divided into two subperiods: pre-EC (January 1997-August 2008) and post-EC (September 2008-December 2014). A total of 25 952 patients presented with IE. The incidence increased from 301.4 to 365.1 per 10 000 000 habitants, and the mortality rate rose from 24.3% to 28.4%. Those aged >75 years experienced more adverse outcomes. Complications due to sepsis, shock, acute kidney injury requiring dialysis, and heart failure increased after the EC onset, and expenditures soared to €16 216. Expenditure per community was related to mortality (P < .001). The EC resulted as an independent predictor for mortality (hazard ratio 1.06; 95% confidence interval 1.01-1.11). Incidence and mortality rate in patients with IE after the onset of the EC have increased as a result of rising adverse outcomes despite an overall increased investment.
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Affiliation(s)
- Christian Ortega-Loubon
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | | | | | - Esther Gómez-Sánchez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Rocío López-Herrero
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Belén Sánchez-Quirós
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Mario Lorenzo-Lopez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Estefanía Gómez-Pesquera
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - Pablo Jorge-Monjas
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | | | - F Javier Álvarez
- Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain.,16782University of Valladolid, Valladolid, Spain
| | - Salvador Resino
- Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain.,38176Instituto de Salud Carlos III, Majadahonda, Madrid, Spain
| | - Eduardo Tamayo
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
| | - María Heredia-Rodríguez
- Clinic University Hospital of Valladolid, Valladolid, Spain.,Group for Biomedical Research in Critical Care Medicine (BioCritic), Valladolid, Spain
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Jenkins RH, Vamos EP, Taylor-Robinson D, Millett C, Laverty AA. Impacts of the 2008 Great Recession on dietary intake: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2021; 18:57. [PMID: 33926455 PMCID: PMC8084260 DOI: 10.1186/s12966-021-01125-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 04/19/2021] [Indexed: 03/19/2024] Open
Abstract
Background The 2008 Great Recession significantly impacted economies and individuals globally, with potential impacts on food systems and dietary intake. We systematically reviewed evidence on the impact of the Great Recession on individuals’ dietary intake globally and whether disadvantaged individuals were disproportionately affected. Methods We searched seven databases and relevant grey literature through June 2020. Longitudinal quantitative studies with the 2008 recession as the exposure and any measure of dietary intake (energy intake, dietary quality, and food/macronutrient consumption) as the outcome were eligible for inclusion. Eligibility was independently assessed by two reviewers. The Newcastle Ottawa Scale was used for quality and risk of bias assessment. We undertook a random effects meta-analysis for changes in energy intake. Harvest plots were used to display and summarise study results for other outcomes. The study was registered with PROSPERO (CRD42019135864). Results Forty-one studies including 2.6 million people met our inclusion criteria and were heterogenous in both methods and results. Ten studies reported energy intake, 11 dietary quality, 34 food intake, and 13 macronutrient consumption. The Great Recession was associated with a mean reduction of 103.0 cal per adult equivalent per day (95% Confidence Interval: − 132.1, − 73.9) in high-income countries (5 studies) and an increase of 105.5 cal per adult per day (95% Confidence Interval: 72.8, 138.2) in middle-income countries (2 studies) following random effects meta-analysis. We found reductions in fruit and vegetable intake. We also found reductions in intake of fast food, sugary products, and soft drinks. Impacts on macronutrients and dietary quality were inconclusive, though suggestive of a decrease in dietary quality. The Great Recession had greater impacts on dietary intake for disadvantaged individuals. Conclusions The 2008 recession was associated with diverse impacts on diets. Calorie intake decreased in high income countries but increased in middle income countries. Fruit and vegetable consumption reduced, especially for more disadvantaged individuals, which may negatively affect health. Fast food, sugary products, and soft drink consumption also decreased which may confer health benefits. Implementing effective policies to mitigate adverse nutritional changes and encourage positive changes during the COVID-19 pandemic and other major economic shocks should be prioritised. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01125-8.
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Affiliation(s)
- Rosemary H Jenkins
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Eszter P Vamos
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - David Taylor-Robinson
- Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Waterhouse Building Block B, 2nd Floor, Liverpool, L69 3BX, UK
| | - Christopher Millett
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
| | - Anthony A Laverty
- Public Health Policy Evaluation Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, Charing Cross Campus; The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK
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Rogers JP, Chesney E, Oliver D, Begum N, Saini A, Wang S, McGuire P, Fusar-Poli P, Lewis G, David AS. Suicide, self-harm and thoughts of suicide or self-harm in infectious disease epidemics: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2021; 30:e32. [PMID: 33902775 PMCID: PMC7610720 DOI: 10.1017/s2045796021000214] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/11/2021] [Accepted: 03/16/2021] [Indexed: 12/22/2022] Open
Abstract
AIMS Suicide accounts for 2.2% of all years of life lost worldwide. We aimed to establish whether infectious epidemics are associated with any changes in the incidence of suicide or the period prevalence of self-harm, or thoughts of suicide or self-harm, with a secondary objective of establishing the frequency of these outcomes. METHODS In this systematic review and meta-analysis, MEDLINE, Embase, PsycINFO and AMED were searched from inception to 9 September 2020. Studies of infectious epidemics reporting outcomes of (a) death by suicide, (b) self-harm or (c) thoughts of suicide or self-harm were identified. A random-effects model meta-analysis for the period prevalence of thoughts of suicide or self-harm was conducted. RESULTS In total, 1354 studies were screened with 57 meeting eligibility criteria, of which 7 described death by suicide, 9 by self-harm, and 45 thoughts of suicide or self-harm. The observation period ranged from 1910 to 2020 and included epidemics of Spanish Flu, severe acute respiratory syndrome, human monkeypox, Ebola virus disease and coronavirus disease 2019 (COVID-19). Regarding death by suicide, data with a clear longitudinal comparison group were available for only two epidemics: SARS in Hong Kong, finding an increase in suicides among the elderly, and COVID-19 in Japan, finding no change in suicides among children and adolescents. In terms of self-harm, five studies examined emergency department attendances in epidemic and non-epidemic periods, of which four found no difference and one showed a reduction during the epidemic. In studies of thoughts of suicide or self-harm, one large survey showed a substantial increase in period prevalence compared to non-epidemic periods, but smaller studies showed no difference. As a secondary objective, a meta-analysis of thoughts of suicide and self-harm found that the pooled prevalence was 8.0% overall (95% confidence interval (CI) 5.2-12.0%; 14 820 of 99 238 cases in 24 studies) over a time period of between seven days and six months. The quality assessment found 42 studies were of high quality, nine of moderate quality and six of high quality. CONCLUSIONS There is little robust evidence on the association of infectious epidemics with suicide, self-harm and thoughts of suicide or self-harm. There was an increase in suicides among the elderly in Hong Kong during SARS and no change in suicides among young people in Japan during COVID-19, but it is unclear how far these findings may be generalised. The development of up-to-date self-harm and suicide statistics to monitor the effect of the current pandemic is an urgent priority.
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Affiliation(s)
- J. P. Rogers
- Division of Psychiatry, University College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - E. Chesney
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Psychosis Studies, King's College London, London, UK
| | - D. Oliver
- Department of Psychosis Studies, King's College London, London, UK
| | - N. Begum
- GKT School of Medical Education, King's College London, London, UK
| | - A. Saini
- Medical School, University College London, London, UK
| | - S. Wang
- Department of Psychology, King's College London, London, UK
| | - P. McGuire
- Department of Psychosis Studies, King's College London, London, UK
| | - P. Fusar-Poli
- Department of Psychosis Studies, King's College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - G. Lewis
- Division of Psychiatry, University College London, London, UK
| | - A. S. David
- UCL Institute of Mental Health, University College London, London, UK
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Meagher T. COVID-19 and Mental Health: Should We Expect an Increase in Disability? J Insur Med 2021; 49:1-8. [PMID: 33784745 DOI: 10.17849/insm-49-1-1-8.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Disability due to mental health disorders has been increasing in many countries over the past years. The COVID-19 pandemic may worsen this trend because of 3 different, and at times overlapping, pathways. This article describes each pathway, and by drawing on the experience of previous coronavirus epidemics and recent recessions, attempts to estimate the likelihood that claims due to mental health disorders will increase.
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Investigating the Relationship between Stress and Self-Rated Health during the Financial Crisis and Recession in 2008: The Mediating Role of Job Satisfaction and Social Support in Spain. J Clin Med 2021; 10:jcm10071463. [PMID: 33918170 PMCID: PMC8038162 DOI: 10.3390/jcm10071463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/19/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background: the 2008 financial crisis and subsequent recession had a strong impact on employment and certain health indicators, such as mental health. Many studies carried out with diverse samples attest to the negative influence of stress on health. However, few studies focus on stress and self-rated health among the Spanish workforce, or analyse which variables can act as a buffer against the negative effects of stress on self-perceived health. Aim: to analyse the mediator role of social support and job satisfaction in the relationship between work-related stress and self-rated health among the Spanish working population between 2006 and 2017. Method: repeated cross-sectional study using Spanish Surveys from 2006 to 2017, a total of 32.105 participants (47.4% women) aged 16 years and over (M = 42.3, SD = 10.7) answered a series of questions about work-related stress (PV), self-rated health (CV), job satisfaction, and social support (mediator variables) through the National Health Survey (NHS) prevalences of work-related stress, self-rated health, job satisfaction, and social support were calculated (standardised by age). We performed mediation/moderation analysis with Macro Process for SPSS to analyse the role of social support and job satisfaction in the relationship between self-rated health and work-related stress among the Spanish working population. Results: three mediation analyses were conducted, one for each time point in the study period. The results revealed a significant direct association between stress and job satisfaction. In the 2006 model, both job satisfaction and social support acted as mediators between stress and self-rated health, while in the 2011 and 2017 models, only job satisfaction acted as a mediator. The data reveal that the working population in Spain has a good capacity for resilience, since no drop in health indicators was observed. Conclusion: following the economic recession, employment has partially recovered. However, social and employment policies are required to help the population face the recent situation triggered by the Coronavirus crisis.
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Avoidable deaths in Sweden, 1997-2018: temporal trend and the contribution to the gender gap in life expectancy. BMC Public Health 2021; 21:519. [PMID: 33731076 PMCID: PMC7968161 DOI: 10.1186/s12889-021-10567-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 03/05/2021] [Indexed: 11/29/2022] Open
Abstract
Background Avoidable mortality is considered as a potential indicator of the influences of public health policies and healthcare quality on population health. This study aimed to examine the trend in avoidable mortality and its influence on rising life expectancy (LE) and declining gender gap in LE (GGLE) in Sweden. Methods We extracted data on causes of death by age, sex, and year from national registry from 1997 to 2018. The UK Office for National Statistics definition was used to divide causes of death into five mutually exclusive categories: amenable, preventable, amenable & preventable, ischemic heart disease (IHD), and non-avoidable causes. We applied Joinpoint regression to analyse temporal trends in age-standardized mortality rates. The Arriaga method was applied to decompose changes in LE and GGLE by age group and causes of death. Results Average annual reductions in avoidable vs. non-avoidable mortality were 2.6% (95% CI:2.5, 2.7) vs. 1.4% (95% CI:1.3, 1.5) in men, and 1.6% (95% CI:1.4, 1.9) vs. 0.9% (95% CI:0.7, 1.0) in women over the study period. LE in men rose by 4.1 years between 1997 and 2018 (from 72.8 to 76.9 years), of which 2.4 years (59.3%) were attributable to reductions in avoidable mortality. Corresponding LE gain was 2.3 years in women (from 78.0 in 1997 to 80.3 in 2018) and avoidable mortality accounted for 1.0 year (45.6%) of this gain. Between 1997 and 2018, the GGLE narrowed by 1.9 years, of which 1.4 years (77.7%) were attributable to avoidable causes. Among avoidable causes, while preventable causes had the largest contribution to the GGLE, IHD had the greatest contributions to LE gains and the narrowing GGLE. Conclusions Our findings showed that avoidable causes had a substantial contribution to gain in LE with more profound gain in men than in women, resulting in narrowing the GGLE. Lower pace of reductions in preventable than amenable mortality highlights the need for improving the effectiveness of inter-sectoral health policies aimed at behavioural changes. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-10567-5.
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Zilidis C, Papagiannis D, Kyriakopoulou Z. Did Economic Crisis Affect Mortality Due to Infectious Diseases? Trends of Infectious Diseases Mortality in Greece Before and After Economic Crisis. Cureus 2021; 13:e13621. [PMID: 33816020 PMCID: PMC8010371 DOI: 10.7759/cureus.13621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Economic crisis and the restrictive policies applied in Greece and other countries raise questions about whether financial crises may affect the declining trend of infectious diseases. The aim of this study is to explore the impact of the economic crisis on mortality due to infectious diseases in Greece and its possible correlation with socio-economic variables affected by the crisis. Methods Data including all deaths due to infectious diseases in Greece during 2001-2016 were analyzed. Annual total and cause-specific standardized death rates (SDR) and age-specific mortality rates were calculated. Cumulative SDRs and standardized rate ratios of the exposed and the non-exposed to austerity periods were computed. The correlation of mortality with Gross Domestic Product (GDP), unemployment, long-term unemployment and hospital expenditure was explored. Results During the exposed-to-austerity period, the SDR of infectious diseases recorded a significant increase by 5% (2.4%-7.7%), exhibiting different trends in the various groups of diseases. The cause-specific SDR increased significantly in intestinal infections, viral diseases, pneumonia, and influenza, and declined in tuberculosis and meningitis. Overall mortality was positively correlated with GDP and unemployment, and adversely with hospital expenditure. Conclusions The mortality of infectious disease was adversely affected by economic crisis and austerity, but the effects were found disease-dependent, with significant differences between the various groups of infectious disease. Unemployment and hospital expenditure were the main socio-economic determinants of mortality. Causal mechanisms of the impact remain unclear, requiring further research.
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Affiliation(s)
- Christos Zilidis
- Epidemiology and Social Medicine, University of Thessaly, Larissa, GRC
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Serafim AP, Durães RSS, Rocca CCA, Gonçalves PD, Saffi F, Cappellozza A, Paulino M, Dumas-Diniz R, Brissos S, Brites R, Alho L, Lotufo-Neto F. Exploratory study on the psychological impact of COVID-19 on the general Brazilian population. PLoS One 2021; 16:e0245868. [PMID: 33534820 PMCID: PMC7857630 DOI: 10.1371/journal.pone.0245868] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 01/10/2021] [Indexed: 12/27/2022] Open
Abstract
The COVID-19 pandemic has become one of the main international concerns regarding its impact on mental health. The present study aims to investigate the prevalence of depression, anxiety, and stress symptoms, and behavioral aspects amidst the COVID-19 pandemic in a Brazilian population. An online survey was administered from May 22 to June 5, 2020 using a questionnaire comprising of sociodemographic information, the Depression, Anxiety, and Stress Scale (DASS-21), and the Coping Strategies Inventory. Participants comprised 3,000 people from Brazil's 26 states and the Federal District, with an average age of 39.8 years, women (83%), married (50.6%), graduates (70.1%) and employees (46.7%). Some contracted the virus (6.4%) and had dead friends or relatives (22.7%). There was more consumption of drugs, tobacco, medication, and food (40.8%). Almost half of participants expressed symptoms of depression (46.4%), anxiety (39.7%), and stress (42.2%). These were higher in women, people without children, students, patients with chronic diseases, and people who had contact with others diagnosed with COVID-19. The existence of a group more vulnerable to situations with a high stress burden requires greater attention regarding mental health during and after the pandemic. That said, it should be emphasized that these findings are preliminary and portray a moment still being faced by many people amid the pandemic and quarantine measures. Therefore, we understand that the magnitude of the impacts on mental health will only be more specific with continuous studies after total relaxation of the quarantine.
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Affiliation(s)
- Antonio P Serafim
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
- Health Psychology Program, Methodist University of São Paulo, São Paulo, Brazil
| | - Ricardo S S Durães
- Health Psychology Program, Methodist University of São Paulo, São Paulo, Brazil
| | - Cristiana C A Rocca
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Priscila D Gonçalves
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Fabiana Saffi
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Alexandre Cappellozza
- Social and Applied Sciences Center, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Mauro Paulino
- Mind, Institute of Clinical and Forensic Psychology/Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Lisbon, Portugal
| | - Rodrigo Dumas-Diniz
- Mind, Institute of Clinical and Forensic Psychology/Center for Research in Neuropsychology and Cognitive and Behavioral Intervention, Lisbon, Portugal
| | - Sofia Brissos
- National Legal Medicine Institute, Psychiatry and Clinical and Forensic Psychology, Lisbon Psychiatric Hospital, Lisbon, Portugal
| | - Rute Brites
- Department of Psychology, Autónoma University, Lisbon, Portugal
| | - Laura Alho
- Mind, Digital Human-Environment Interaction Lab, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Francisco Lotufo-Neto
- Department of Psychiatry, School of Medicine, University of São Paulo, São Paulo, Brazil
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Pardhan S, Drydakis N. Associating the Change in New COVID-19 Cases to GDP per Capita in 38 European Countries in the First Wave of the Pandemic. Front Public Health 2021; 8:582140. [PMID: 33553086 PMCID: PMC7854531 DOI: 10.3389/fpubh.2020.582140] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022] Open
Abstract
COVID-19 has affected all countries globally. We explore associations between the change in new COVID-19 registered cases per million population and various macroeconomic and well-being indicators in 38 European countries over a 2-month period (1st April-31st May 2020). A statistically significant (p = 0.002) negative association was estimated between the change in new COVID-19 cases and GDP per capita, after controlling for key health determinants including public expenditure on health, life expectancy, smoking tobacco and sanitation. The country with the highest GDP per capita in Europe (i.e., Luxemburg) was found to experience the lowest change in new COVID-19 cases within the time period whilst the opposite was found for countries with lower GDP per capita (i.e., Ukraine, Bulgaria, and Romania). The outcomes of this study indicate that, in the first wave of the pandemic in Europe, a country's GDP per capita might be associated with a lower rate of new COVID-19 cases. The study concludes by suggesting that in European regions a country's economic performance should be a critical health priority for policy makers.
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Affiliation(s)
- Shahina Pardhan
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, United Kingdom
| | - Nick Drydakis
- Centre for Pluralist Economics, Faculty of Business and Law, Anglia Ruskin University, Cambridge, United Kingdom.,Pembroke College, University of Cambridge, Cambridge, United Kingdom.,Institute of Labor Economics, Bonn, Germany.,Global Labor Organization, Essen, Germany
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Barceló MA, Saez M. Methodological limitations in studies assessing the effects of environmental and socioeconomic variables on the spread of COVID-19: a systematic review. ENVIRONMENTAL SCIENCES EUROPE 2021; 33:108. [PMID: 34522574 PMCID: PMC8432444 DOI: 10.1186/s12302-021-00550-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 09/03/2021] [Indexed: 05/08/2023]
Abstract
BACKGROUND While numerous studies have assessed the effects of environmental (meteorological variables and air pollutants) and socioeconomic variables on the spread of the COVID-19 pandemic, many of them, however, have significant methodological limitations and errors that could call their results into question. Our main objective in this paper is to assess the methodological limitations in studies that evaluated the effects of environmental and socioeconomic variables on the spread of COVID-19. MAIN BODY We carried out a systematic review by conducting searches in the online databases PubMed, Web of Science and Scopus up to December 31, 2020. We first excluded those studies that did not deal with SAR-CoV-2 or COVID-19, preprints, comments, opinion or purely narrative papers, reviews and systematic literature reviews. Among the eligible full-text articles, we then excluded articles that were purely descriptive and those that did not include any type of regression model. We evaluated the risk of bias in six domains: confounding bias, control for population, control of spatial and/or temporal dependence, control of non-linearities, measurement errors and statistical model. Of the 5631 abstracts initially identified, we were left with 132 studies on which to carry out the qualitative synthesis. Of the 132 eligible studies, we evaluated 63.64% of the studies as high risk of bias, 19.70% as moderate risk of bias and 16.67% as low risk of bias. CONCLUSIONS All the studies we have reviewed, to a greater or lesser extent, have methodological limitations. These limitations prevent conclusions being drawn concerning the effects environmental (meteorological and air pollutants) and socioeconomic variables have had on COVID-19 outcomes. However, we dare to argue that the effects of these variables, if they exist, would be indirect, based on their relationship with social contact. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s12302-021-00550-7.
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Affiliation(s)
- Maria A. Barceló
- Research Group On Statistics, Econometrics and Health (GRECS), and CIBER of Epidemiology and Public Health (CIBERESP), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, 17003 Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marc Saez
- Research Group On Statistics, Econometrics and Health (GRECS), and CIBER of Epidemiology and Public Health (CIBERESP), University of Girona, Carrer de la Universitat de Girona 10, Campus de Montilivi, 17003 Girona, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Hrzic R, Vogt T, Janssen F, Brand H. Mortality convergence in the enlarged European Union: a systematic literature review. Eur J Public Health 2020; 30:1108-1115. [PMID: 32206793 PMCID: PMC7733049 DOI: 10.1093/eurpub/ckaa038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The high mortality rates in the European Union (EU) Member States that acceded in 2004 sparked political interest in mortality convergence. Whether mortality is converging in the EU remains unclear. We reviewed the literature on mortality convergence in the post-2004 EU territory as a whole. We also explored whether the study designs influenced the results and whether any determinants of mortality convergence had been empirically examined. Methods A systematic literature review was performed. Our search included scientific databases and the websites of international governmental institutions and European demographic research institutes. Results We uncovered 94 unique records and included seven studies that reported on 36 analyses. There was marked methodological heterogeneity, including in the convergence measures (beta and sigma convergence). All of the beta convergence analyses found narrowing mortality differentials, whereas most of the sigma convergence analyses found widening mortality differentials. The results are robust to the units of analysis and mortality and dispersion measures. Our results also suggest that there is a lack of evidence on the determinants of mortality convergence in the EU. Conclusions There is general agreement that the EU regions and the Member States with high initial mortality rates improved the fastest, but this trend did not lead to overall mortality convergence in the EU. The harmonization of mortality convergence measures and research into determinants of mortality convergence are needed to support future EU cohesion policy. Policy-makers should consider supporting areas that have moderate but stagnant mortality rates, in addition to those with high mortality rates.
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Affiliation(s)
- Rok Hrzic
- Department of International Health, Maastricht University, Care and Public Health Research Institute, CAPHRI, Maastricht, The Netherlands
| | - Tobias Vogt
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Max Planck Institute for Demographic Research, Rostock, Germany
| | - Fanny Janssen
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands.,Netherlands Interdisciplinary Demographic Institute - KNAW / University of Groningen, The Hague, The Netherlands
| | - Helmut Brand
- Department of International Health, Maastricht University, Care and Public Health Research Institute, CAPHRI, Maastricht, The Netherlands.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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