Trajectories of the socioeconomic gradient of mental health: Results from the CLSA COVID-19 Questionnaire Study

As the coronavirus disease (COVID-19) pandemic prolongs, documenting trajectories of the socioeconomic gradient of mental health is important. We describe changes in the prevalence and absolute and relative income-related inequalities of mental health between April and December 2020 in Canada. We used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study and the pre-pandemic CLSA Follow-up 1. We estimated the prevalence proportion, the concentration index (relative inequality), and the generalized concentration index (absolute inequality) for anxiety and self-reported feeling generally unwell at multiple points in April-December 2020, overall, by sex and age group, by region, and among those who reported poor or fair overall health and mental health pre-pandemic. Overall, the prevalence of anxiety remained unchanged (22.45 to 22.10%, p=0.231), but self-reported feeling generally unwell decreased (9.83 to 5.94%, p=0.004). Relative and absolute income-related inequalities were unchanged for both anxiety and self-reported feeling generally unwell, with exceptions of an increased concentration of self-reported feeling generally unwell among the poor, measured by the concentration index, overall (-0.054 to -0.115, p=0.004) and in Ontario (-0.035 to -0.123, p=0.047) and British Columbia (-0.055 to -0.141, p=0.044). The COVID-19 pandemic appeared to neither exacerbate nor ameliorate existing income-related inequalities in mental health among older adults in Canada between April and December 2020. Continued monitoring of inequalities is necessary.

Trajectories of the socioeconomic gradient of mental health: Results from the CLSA COVID-19 Questionnaire Study.

As the coronavirus disease (COVID-19) pandemic prolongs, documenting trajectories of the socioeconomic gradient of mental health is important. We describe changes in the prevalence and absolute and relative income-related inequalities of mental health between April and December 2020 in Canada. We used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study and the pre-pandemic CLSA Follow-up 1. We estimated the prevalence proportion, the concentration index (relative inequality), and the generalized concentration index (absolute inequality) for anxiety and self-reported feeling generally unwell at multiple points in April-December 2020, overall, by sex and age group, by region, and among those who reported poor or fair overall health and mental health pre-pandemic. Overall, the prevalence of anxiety remained unchanged (22.45 to 22.10%, p = 0.231), but self-reported feeling generally unwell decreased (9.83 to 5.94%, p = 0.004). Relative and absolute income-related inequalities were unchanged for both anxiety and self-reported feeling generally unwell, with exceptions of an increased concentration of self-reported feeling generally unwell among the poor, measured by the concentration index, overall (-0.054 to -0.115, p = 0.004) and in Ontario (-0.035 to -0.123, p = 0.047) and British Columbia (-0.055 to -0.141, p = 0.044). The COVID-19 pandemic appeared to neither exacerbate nor ameliorate existing income-related inequalities in mental health among older adults in Canada between April and December 2020. Continued monitoring of inequalities is necessary.

A cross-sectional analysis of the association between social capital and willingness to get COVID-19 vaccine in Ontario, Canada.

OBJECTIVE: We examine the role of social capital in intention to take the vaccine at the end of the first wave of the COVID-19 pandemic. METHODS: This study uses observational, cross-sectional data from the Ontario sample of the fall 2020 Canadian Community Health Survey (CCHS), a representative sample of the population with added questions relative to symptoms of COVID-19 and intentions to get vaccinated. Questions on social capital were asked to respondents from Ontario only, yielding a sample of 6516. Odds ratios (OR) and marginal effects at sample mean of an index of social capital (at the individual or aggregated level) on changes in intentions to get vaccinated are estimated from logistic regression models. RESULTS: Individual-level social capital is associated with greater willingness to get vaccinated against COVID-19 (OR 1.09). Associations with aggregated-level social capital are less precisely estimated. Associations are the same for both males and females but vary across age categories: individual-level social capital is associated with higher willingness to get vaccinated among working-age respondents, but aggregate-level social capital is associated with higher willingness to get vaccinated among older adults. CONCLUSION: Vaccine hesitancy is not a random phenomenon, nor is it explained by individual characteristics such as education or income only. It also reflects the state of the social environment in which individuals live and public health messaging should take this into account if it is to be successful.

RéSUMé: OBJECTIF: Nous étudions le rôle du capital social dans les intentions de se faire vacciner à la fin de la première vague de la pandémie de COVID-19. MéTHODES: Ce travail utilise des données observationnelles transversales tirées de l'échantillon pour l'Ontario de la vague d'automne 2020 de l'Enquête sur la santé dans les collectivités canadiennes (ESCC), un échantillon représentatif de la population, en particulier des questions supplémentaires sur les symptômes de COVID-19 et les intentions de se faire vacciner. Les questions sur le capital social n'ont été posées qu'aux répondants vivant en Ontario, nous donnant un échantillon de taille N = 6 516. Les rapports de chances (RC) et les effets marginaux au point moyen de l'échantillon de l'indice de capital social (individuel ou agrégé) sur les changements de la santé mentale auto-déclarée ainsi que sur l'intention de se faire vacciner sont estimés à partir d'une régression logistique. RéSULTATS: Le capital social mesuré au niveau individuel est associé à des intentions plus élevées de se faire vacciner (RC de 1,09). L'association du capital social mesuré au niveau agrégé est moins précisément estimée et nous ne trouvons une association significativement différente de 0 qu'au seuil de 10 % seulement. Les associations sont les mêmes pour les hommes et les femmes mais varient selon la classe d'âge : le capital social individuel est associé à une intention élevée de se faire vacciner parmi les enquêtés en âge de travailler, mais le capital social agrégé est associé à une intention élevée de se faire vacciner parmi les enquêtés plus âgés. CONCLUSION: La réticence devant le vaccin n'est pas distribuée au hasard et n'est pas non plus expliquée seulement par les caractéristiques individuelles comme l'éducation ou le revenu. Elle reflète aussi l'état de l'environnement social dans lequel les individus vivent et les messages de santé publique doivent en tenir compte pour être efficaces.