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Tang Z, Yang X, Tan W, Ke Y, Kou C, Zhang M, Liu L, Zhang Y, Li X, Li W, Wang SB. Patterns of unhealthy lifestyle and their associations with depressive and anxiety symptoms among Chinese young adults: A latent class analysis. J Affect Disord 2024; 352:267-277. [PMID: 38378090 DOI: 10.1016/j.jad.2024.02.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 02/10/2024] [Accepted: 02/14/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND There is little evidence on the association between patterns of unhealthy lifestyle and mental health among young adults. METHOD This study included a total of 28,978 young adults aged 18 to 44 years old in Guangdong province in south China, which was conducted from September to December in 2022. We used latent class analysis to classify the patterns of unhealthy lifestyle among young adults and used multiple logistic regression to explore their associations with depressive and anxiety symptoms. RESULT The weighted prevalence of depressive and anxiety symptoms were 28.0 % and 19.5 %, respectively. The cumulative effect of unhealthy lifestyles on depressive and anxiety symptoms was significant. Five patterns of unhealthy lifestyle were classified. Compared to the relatively healthy lifestyle class, the class with more unhealthy lifestyles (OR = 6.54, 95 % CI: 5.70-7.51) and insufficient sleep (OR = 6.16, 95 % CI: 4.92-7.70) had higher risk for depressive and anxiety symptoms. Meaningfully, having adequate mental health literacy could reduce the risk of depressive and anxiety symptoms from unhealthy lifestyle by half. LIMITATIONS The cross-section design study limited causal inferences, and the self-report information may lead to recall bias. CONCLUSIONS Unhealthy lifestyles have a negative impact on depressive and anxiety symptoms through independent, cumulative and combined effects, and they could be interrelated. Unhealthy lifestyle patterns differed in younger population by socio-demographic characteristics and mental health literacy. Health-care professionals and policymakers may provide programs to intervene multiple unhealthy lifestyles and improve mental health literacy by integrating healthy lifestyle education to promote youngers' mental health.
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Affiliation(s)
- Zhitao Tang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Xinyan Yang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Wenyan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yunfei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Min Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Lijie Liu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Yali Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Xue Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China
| | - Wenjun Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, Jilin province, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; School of Health, Zhuhai College of Science and Technology, Zhuhai, Guangdong Province, China.
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Sidorenkov G, Vonk JM, Grzegorczyk M, Cortés-Ibañez FO, de Bock GH. Factors associated with SARS-COV-2 positive test in Lifelines. PLoS One 2023; 18:e0294556. [PMID: 38019869 PMCID: PMC10686451 DOI: 10.1371/journal.pone.0294556] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 11/03/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) can affect anyone, however, it is often mixed with other respiratory diseases. This study aimed to identify the factors associated with SARS-COV-2 positive test. METHODS Participants from the Northern Netherlands representative of the general population were included if filled in the questionnaire about well-being between June 2020-April 2021 and were tested for SARS-COV-2. The outcome was a self-reported test as measured by polymerase chain reaction. The data were collected on age, sex, household, smoking, alcohol use, physical activity, quality of life, fatigue, symptoms and medications use. Participants were matched on sex, age and the timing of their SARS-COV-2 tests maintaining a 1:4 ratio and classified into those with a positive and negative SARS-COV-2 using logistic regression. The performance of the model was compared with other machine-learning algorithms by the area under the receiving operating curve. RESULTS 2564 (20%) of 12786 participants had a positive SARS-COV-2 test. The factors associated with a higher risk of SARS-COV-2 positive test in multivariate logistic regression were: contact with someone tested positive for SARS-COV-2, ≥1 household members, typical SARS-COV-2 symptoms, male gender and fatigue. The factors associated with a lower risk of SARS-COV-2 positive test were higher quality of life, inhaler use, runny nose, lower back pain, diarrhea, pain when breathing, sore throat, pain in neck, shoulder or arm, numbness or tingling, and stomach pain. The performance of the logistic models was comparable with that of random forest, support vector machine and gradient boosting machine. CONCLUSIONS Having a contact with someone tested positive for SARS-COV-2 and living in a household with someone else are the most important factors related to a positive SARS-COV-2 test. The loss of smell or taste is the most prominent symptom associated with a positive test. Symptoms like runny nose, pain when breathing, sore throat are more likely to be indicative of other conditions.
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Affiliation(s)
- Grigory Sidorenkov
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Judith M. Vonk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marco Grzegorczyk
- Computer Science and Artificial Intelligence, University of Groningen—Bernoulli Institute for Mathematics, Groningen, Netherlands
| | - Francisco O. Cortés-Ibañez
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Geertruida H. de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Vallée A. Geoepidemiological perspective on COVID-19 pandemic review, an insight into the global impact. Front Public Health 2023; 11:1242891. [PMID: 37927887 PMCID: PMC10620809 DOI: 10.3389/fpubh.2023.1242891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
The COVID-19 pandemic showed major impacts, on societies worldwide, challenging healthcare systems, economies, and daily life of people. Geoepidemiology, an emerging field that combines geography and epidemiology, has played a vital role in understanding and combatting the spread of the virus. This interdisciplinary approach has provided insights into the spatial patterns, risk factors, and transmission dynamics of the COVID-19 pandemic at different scales, from local communities to global populations. Spatial patterns have revealed variations in incidence rates, with urban-rural divides and regional hotspots playing significant roles. Cross-border transmission has highlighted the importance of travel restrictions and coordinated public health responses. Risk factors such as age, underlying health conditions, socioeconomic factors, occupation, demographics, and behavior have influenced vulnerability and outcomes. Geoepidemiology has also provided insights into the transmissibility and spread of COVID-19, emphasizing the importance of asymptomatic and pre-symptomatic transmission, super-spreading events, and the impact of variants. Geoepidemiology should be vital in understanding and responding to evolving new viral challenges of this and future pandemics.
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Affiliation(s)
- Alexandre Vallée
- Department of Epidemiology and Public Health, Foch Hospital, Suresnes, France
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Siimsen I, Orru K, Naevestad TO, Nero K, Olson A, Kaal E, Meyer SF. Socio-economic outcomes of COVID-19 on the marginalised: Who have taken the hardest hit? INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 93:103723. [PMID: 37200561 PMCID: PMC10155468 DOI: 10.1016/j.ijdrr.2023.103723] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 04/19/2023] [Accepted: 04/25/2023] [Indexed: 05/20/2023]
Abstract
This article aims to examine the socioeconomic outcomes of COVID-19 for socially marginalised people who are clients of social care organisations (e.g. people experiencing homelessness), and the factors influencing these outcomes. We tested the role of individual and socio-structural variables in determining socioeconomic outcomes based on a cross-sectional survey with 273 participants from eight European countries and 32 interviews and five workshops with managers and staff of social care organisations in ten European countries. 39% of the respondents agreed that the pandemic has had a negative effect on their income and access to shelter and food. The most common negative socio-economic outcome of the pandemic was loss of work (65% of respondents). According to multivariate regression analysis, variables such as being of a young age, being an immigrant/asylum seeker or residing in the country without documentation, living in your own home, and having (in)formal paid work as the main source of income are related to negative socio-economic outcomes following the COVID-19 pandemic. Factors such as individual psychological resilience and receiving social benefits as the main source of income tend to "protect" respondents from negative impacts. Qualitative results indicate that care organisations have been an important source of economic and psycho-social support, particularly significant in times of a huge surge in demand for services during the long-term crises of pandemic.
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Affiliation(s)
| | | | | | | | - Alexandra Olson
- The Salvation Army European Affairs Office, Brussels, Belgium
| | - Esta Kaal
- Tallinn University, Tallinn, Estonia
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Alarcão V, Candeias P, Stefanovska-Petkovska M, Pintassilgo S, Machado FL, Virgolino A, Santos O. Mental Health and Well-Being of Migrant Populations in Portugal Two Years after the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:bs13050422. [PMID: 37232659 DOI: 10.3390/bs13050422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/12/2023] [Accepted: 05/12/2023] [Indexed: 05/27/2023] Open
Abstract
In Portugal, like in other European countries, the COVID-19 pandemic aggravated the risk of poverty and social exclusion faced by migrants. This study aimed to assess mental health and well-being, and their social determinants, among Brazilian and Cape Verdean immigrant populations two years after the COVID-19 pandemic while exploring the role of positive psychological factors such as resilience and perceived social support. We conducted a cross-sectional survey combining online and face-to-face questionnaires for data collection between February and November 2022 on dimensions of mental health considered potentially relevant to the post-pandemic context: psychological distress, anxiety, and depression. Overall, 604 immigrants were included (322 Brazilian and 282 Cape Verdean); 58.5% of those surveyed were women and 41.5% were men. The results revealed that gender (being a woman) was associated with both psychological distress and depression, higher education was associated with anxiety, and that, for the three mental health dimensions under analysis, the perception of discrimination and resilience were negative and positive predictors, respectively. Findings can inform the design and implementation of relevant public mental health promotion programs with a focus on equity targeted to the general population. Such programs would help to address the psychological and social impacts of this long-term, insidious global pandemic that has challenged governments, health care systems, health care professionals, individuals, families, and communities worldwide.
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Affiliation(s)
- Violeta Alarcão
- Centro de Investigação e Estudos de Sociologia, Iscte-Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Pedro Candeias
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
- Iscte-Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Miodraga Stefanovska-Petkovska
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Sónia Pintassilgo
- Centro de Investigação e Estudos de Sociologia, Iscte-Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Fernando Luís Machado
- Centro de Investigação e Estudos de Sociologia, Iscte-Instituto Universitário de Lisboa, Avenida das Forças Armadas, 1649-026 Lisboa, Portugal
| | - Ana Virgolino
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Osvaldo Santos
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
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Liao DD, Dong M, Ding KR, Hou CL, Tan WY, Ke YF, Jia FJ, Wang SB. Prevalence and patterns of major depressive disorder and subthreshold depressive symptoms in south China. J Affect Disord 2023; 329:131-140. [PMID: 36828143 DOI: 10.1016/j.jad.2023.02.069] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 02/09/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Information on major depressive disorder (MDD) and subthreshold depressive symptoms (SDS) is rarely reported in south China. This study examines the prevalence rates and patterns of MDD and SDS of a large representative sample of adult residents in south China. METHODS The Guangdong Mental Health Survey was conducted on adults (over 18 years) from September to December 2021. Multistage stratified cluster sampling was used and face-to-face interviews were done with a two-stage design by trained lay interviewers and psychiatrists. A total of 16,377 inhabitants were interviewed using standardized assessment tools. Data were weighted to adjust for differential probabilities of selection and differential response. RESULTS The weighted prevalence rates of MDD and SDS were 2.5 % (95%CI: 2.2 %-2.9 %) and 14.7 % (95%CI: 14.0 %-15.5 %), respectively. Multinomial logistic regression analysis revealed that female, younger age, living in urban area, higher education, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, irregular napping pattern and short sleep were positively associated with SDS. Besides, female, younger age, unmarried, irregular meal pattern, lack of physical exercise, chronic diseases, short sleep and poor mental health were positively associated with MDD. LIMITATIONS The cross-sectional nature of the study limited causal inferences. CONCLUSIONS The prevalence of MDD in Guangdong province in 2021 is higher than in mainland China in 2013. Given the higher prevalence of SDS, and high burden of depression, it also offers valuable opportunities for policymakers and health-care professionals to explore the factors affecting mental health in Guangdong province, especially during the COVID-19 epidemic.
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Affiliation(s)
- Dan-Dan Liao
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Min Dong
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Kai-Rong Ding
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Cai-Lan Hou
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China
| | - Wen-Yan Tan
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Yun-Fei Ke
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China
| | - Fu-Jun Jia
- Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong Province, China; Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China; Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China.
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong Province, China.
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Coulaud PJ, Salway T, Jesson J, Bolduc N, Ferlatte O, Bertrand K, Desgrées du Loû A, Jenkins E, Jauffret-Roustide M, Knight R. Moderation of the association between COVID-19-related income loss and depression by receipt of financial support: Repeated cross-sectional surveys of young adults in Canada and France (2020-2021). SSM Popul Health 2023; 21:101340. [PMID: 36644570 PMCID: PMC9832713 DOI: 10.1016/j.ssmph.2023.101340] [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: 10/31/2022] [Revised: 12/17/2022] [Accepted: 01/10/2023] [Indexed: 01/13/2023] Open
Abstract
Background To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments and family/friends mobilized financial support interventions (e.g., emergency aid funds) and assistance. However, little is known about how financial assistance alleviated mental health problems. This study aimed to investigate the moderating effect of financial support from the government or from family/friends on the association between income loss and depression among young adults. Methods Two online cross-sectional surveys among young adults ages 18-29 living in Canada and France were conducted in 2020 (n = 4,511) and 2021 (n = 3,329). Moderate-to-severe depressive symptoms were measured using the Patient Health Questionnaire-9 (cut-off score: ≥10). Two logistic regression models were performed for each survey with an interaction term between income loss and financial support (government or family/friends modeled separately), controlling for demographics. Results Overall, half reported depressive symptoms (2020/2021: 53.5%/45.6%), and over a third lost income (2020/2021: 10.2%/11.6% all income, 37.7%/21.6% some income). In 2020, 40.6% received government financial support (17.7% in 2021) while family/friends support was received by 12% (in both surveys). In both surveys, among those who received governmental financial support, income loss was associated with depression, whether participants lost all their income (e.g., 2020: Adjusted Odds Ratios (AOR) 1.75, 95% Confidence Interval [1.29-2.44]), or some of their income (e.g., 2020: AOR 1.45 [1.17-1.81]). However, among those who received family/friends financial support, income loss was no longer significantly associated with depression in both cycles, whether participants lost all their income (e.g., 2020: AOR 1.37 [0.78-2.40]), or some of their income (e.g., 2020: AOR 1.31 [0.86-1.99]). Conclusions Association between income loss and depression was moderated by receipt of family/friends financial support but not by receipt of government financial support. Financial support interventions may help to mitigate the negative effects of income loss on young adults mental health during periods of economic crisis.
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Affiliation(s)
- Pierre-julien Coulaud
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Corresponding author. British Columbia Centre on Substance Use, 400-1045, Howe St, Vancouver, BC V6Z 2A9, Canada.
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada,British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada,Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada
| | - Julie Jesson
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Naseeb Bolduc
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Olivier Ferlatte
- École de Santé Publique de l’Université de Montréal, Montreal, Quebec, Canada,Centre de Recherche en Santé Publique, Université de Montréal et CIUSSS du Centre-Sud-de-l’Île-de-Montréal, Montreal, Quebec, Canada
| | - Karine Bertrand
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, Québec, Canada
| | - Annabel Desgrées du Loû
- Centre Population et Développement, Université Paris Cité, Institut de Recherche pour le Développement, Inserm, Paris, France
| | - Emily Jenkins
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Marie Jauffret-Roustide
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada,Centre d'Étude des Mouvements Sociaux (EHESS/CNRS UMR8044/INSERM U1276), Paris, France,Baldy Center on Law and Social Policy, Buffalo University, NY, USA
| | - Rod Knight
- British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada,Centre for Gender and Sexual Health Equity, Vancouver, British Columbia, Canada,École de Santé Publique de l’Université de Montréal, Montreal, Quebec, Canada
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Trade-offs during the COVID-19 pandemic: A discrete choice experiment about policy preferences in Portugal. PLoS One 2022; 17:e0278526. [PMID: 36525428 PMCID: PMC9757580 DOI: 10.1371/journal.pone.0278526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
The need to control the sanitary situation during the COVID-19 pandemic has led governments to implement several restrictions with substantial social and economic impacts. We explored people's trade-offs in terms of their income, life restrictions, education, and poverty in the society, compared to their willingness to avoid deaths. We applied a web-based discrete choice experiment to elicit preferences of the Portuguese citizens for these attributes and computed the marginal rate of substitution in terms of avoided deaths. We recorded 2,191 responses that faced the possibility of having 250 COVID-19 related deaths per day as the worst possible outcome from the choice levels presented. Estimates suggested that individuals would be willing to sacrifice 30% instead of 10% of their income to avoid approximately 47 deaths per day during the first six months of 2021. For the same period, they would also accept 30% of the students' population to become educationally impaired, instead of 10%, to avoid approximately 25 deaths; a strict lockdown, instead of mild life restrictions, to avoid approximately 24 deaths; and 45% of the population to be in risk of poverty, instead of 25%, to avoid approximately 101 deaths. Our paper shows that avoiding deaths was strongly preferred to the remaining societal impacts; and that being a female, as well as working on site, led individuals to be more averse to such health hazards. Furthermore, we show how a DCE can be used to assess the societal support to decision-making during times of crisis.
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Yun JY, Sim JA, Lee S, Yun YH. Stronger association of perceived health with socio-economic inequality during COVID-19 pandemic than pre-pandemic era. BMC Public Health 2022; 22:1757. [PMID: 36114525 PMCID: PMC9479296 DOI: 10.1186/s12889-022-14176-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 09/13/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
The COVID-19 pandemic has changed peoples’ routine of daily living and posed major risks to global health and economy. Few studies have examined differential impacts of economic factors on health during pandemic compared to pre-pandemic. We aimed to compare the strength of associations between perceived health and socioeconomic position (household income, educational attainment, and employment) estimated before and during the pandemic.
Methods
Two waves of nationwide survey [on 2018(T1;n = 1200) and 2021(T2;n = 1000)] were done for 2200 community adults. A balanced distribution of confounders (demographics and socioeconomic position) were achieved across the T2 and T1 by use of the inverse probability of treatment weighting. Distributions of perceived health [= (excellent or very good)/(bad, fair, or good)] for physical-mental-social-spiritual subdomains were compared between T1 and T2. Odds of bad/fair/good health for demographics and socioeconomic position were obtained by univariate logistic regression. Adjusted odds (aOR) of bad/fair/good health in lower household income(< 3000 U.S. dollars/month) were retrieved using the multiple hierarchical logistic regression models of T1 and T2.
Results
Perceived health of excellent/very good at T2 was higher than T1 for physical(T1 = 36.05%, T2 = 39.13%; P = 0.04), but were lower for mental(T1 = 38.71%, T2 = 35.17%; P = 0.01) and social(T1 = 42.48%, T2 = 35.17%; P < 0.001) subdomains. Odds of bad/fair/good health were significantly increased at T2 than T1 for household income (physical-mental-social; all Ps < 0.001) and educational attainment (social; P = 0.04) but not for employment (all Ps > 0.05). AORs of bad/fair/good health in lower household income were stronger in T2 than T1, for mental [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.82(P < 0.001)], physical [aOR (95% CI) = 2.64(2.05–3.41) in T2, 1.50(1.18–1.90) in T1; aOR difference = 1.14(P < 0.001)] and social [aOR (95% CI) = 2.15(1.68–2.77) in T2, 1.33(1.06–1.68) in T1; aOR difference = 0.35(P = 0.049)] subdomains.
Conclusions
Risks of perceived health worsening for mental and social subdomains in people with lower monthly household income or lower educational attainment became stronger during the COVID-19 pandemic compared to pre-pandemic era. In consideration of the prolonged pandemic as of mid-2022, policies aiming not only to sustain the monthly household income and compulsory education but also to actively enhance the perceived mental-social health status have to be executed and maintained.
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