Suicidal ideation among young adults in Canada during the COVID-19 pandemic: evidence from a population-based cross-sectional study. / Idées suicidaires chez les jeunes adultes au Canada pendant la pandémie de COVID-19 : données tirées d'une enquête populationnelle transversale.

Using data from the 2020 and 2021 cycles of the Survey on COVID-19 and Mental Health,we examined suicidal ideation among adults in Canada aged 18 to 34 years. The prevalence of suicidal ideation among adults aged 18 to 34 years was 4.2% in fall 2020 and 8.0% in spring 2021. The subgroup of adults aged 18 to 24 years had the highest prevalence of suicidal ideation, 10.7%, in spring 2021. Prevalence varied by sociodemographic characteristics and tended to be higher among people living in materially deprived areas. Suicidal ideation was strongly associated with pandemic-related stressors respondents experienced.

In spring 2021, the prevalence of suicidal ideation among young adults aged 18 to 34 years was 8.0%. At 10.7%, the prevalence of suicidal ideation was highest in the subgroup of young adults aged 18 to 24 years, in spring 2021. The odds of suicidal ideation were higher among young adults who were White versus racialized, born in Canada versus immigrated to Canada, living with low or middle income, with high school education or less, or living in a materially deprived area. Pandemic-related experiences, stressful events and mental illness were strongly associated with suicidal ideation.

La prévalence des idées suicidaires chez les jeunes adultes de 18 à 34 ans était de 8,0 % au printemps 2021. La prévalence la plus élevée d'idées suicidaires, soit 10,7 %, correspond au sous-groupe des jeunes adultes de 18 à 24 ans au printemps 2021. Les probabilités d'idées suicidaires étaient plus élevées chez les jeunes adultes qui étaient d'origine blanche (par opposition aux membres d'un groupe « racisé ¼), ceux nés au Canada (par opposition à ceux ayant immigré au Canada), ceux vivant avec un revenu faible ou moyen, ceux ayant fait des études de niveau secondaire ou moins et ceux vivant dans un milieu défavorisé sur le plan matériel. Les expériences liées à la pandémie, les événements stressants et la maladie mentale étaient fortement associés aux idées suicidaires.

Healthcare inequalities and emergency medicine.

In France, the health care system is based on universality principle and macroscopic indicators are satisfying. However, inequalities in health linger and especially affect vulnerable populations. This article explores the interactions between healthcare inequalities and emergency medicine. Vulnerable populations may experience financial, institutional or cognitive barriers that hinder their access to care and contribute to the deterioration of their health status. Emergency medicine is a medical field that is also concerned by those issues since emergency departments (EDs) play an important role in protecting universal access to care and face higher rates and worse outcomes for urgent pathologies in vulnerable populations while providing them with suboptimal care or differential pathways once emergency care is completed. This paper first aims at defining what is a vulnerable population. Than it describes the specificities of their provision of care in the emergency setting. At last, it explains how barriers in access to care could lead some vulnerable individuals to forgo ambulatory care and how it impacts their use of emergency care. Finally, the example of the Sars-Cov2 pandemic highlights the many interactions between vulnerability and health care state. At last, the issues of the territorial organization of the outpatient care services upstream of the EDs and the reality of their accessibility for all are major matters. These issues should also mobilize emergency medicine professionals and compell them to challenge stakeholders into taking actions.Copyright © SFMU et Lavoisier SAS 2020.

Midnight in Paris on heritage and nostalgia

Heritage tourism has attracted attention academically and in the industry. We study how preference for heritage tourism is motivated by individuals' need to belong, which varies as a result of differential impacts of the COVID-19 pandemic. In two studies, we measure this natural manipulation of need to belong and study its impact in a quasi-experimental manner. We find that need to belong affects preference for heritage tourism through its effect on nostalgic feeling. Individuals with higher need to belong have higher state nostalgia and prefer heritage tourism that may help satisfy their nostalgic yearning. In addition, we identify the moderating role of trait nostalgia proneness. Individuals who are more nostalgia-prone are more susceptible to this need-to-belong effect. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Restricted by Measures Against the Coronavirus? Difficulties at the Transition from School to Work in Times of a Pandemic

The paper begins with the prerequisite assumption that social deprivation is a fragile and porous category. Thus, our hypothesis is, that how people are affected by the restrictions against the spreading of the coronavirus is often discussed in far too general and simplistic terms. It is often taken as a given, that the virus and the restriction measures not only have caused severe difficulties for us all (due to social distancing, fear, affected health, etc.), but that the measures have exacerbated already previously existing forms of social deprivation. Therefore, it is assumed that marginalized groups are particularly affected by these effects of the pandemic. Two major German studies show the alleged effects of the relevant measures on adolescents and emerging adults (COPSY and FIBS) against the backdrop of social and economic deprivation;their results confirmed that social deprivation entails a higher degree of being affected by the pandemic. However, this picture becomes thwarted by considering the results of 10 narrative interviews, that were conducted by us with emerging adults in a German vocational training institute between April and August 2021 and showed variegated forms of experiencing issues related to the pandemic. In our analysis, we used the method of objective hermeneutics. In this paper, we present our considerations by outlining two contrastive experiences with the Covid-19 pandemic, in order to highlight the divergent ways in which the pandemic has been experienced even among individuals who previously had been affected by social deprivation – at least at first glance – in similar ways. The conceptual lens through which we interpret these two examples is, firstly, the one of precariousness and precarity (Butler 2009). And secondly, the concept of recognition derived from Honneth's pertinent theory and Butler's account of recognizability will play a pivotal role. While Honneth's approach allows us to emphasize the normative and existential role of the fulfilment of our basic desire for recognition and the detrimental implications of disregard, Butler provides us with the means to thoroughly analyse the socio-historical conditions of misrecognition and social invisibility. Moreover, Butler focuses specifically on the recognizability of precariousness (Honneth's triad of love, being respected as a rights bearer and solidarity shows a different focus). Combining qualitative research on precarious live circumstances with a theoretical perspective on recognition can also be found in a stunning research on couples in atypical working relations (Wimbauer and Motakef 2019). Proceeding from these theories and ‘applying' them to our empirical material, we seek to call into question a too generalizing and hegemonic picture of how people were affected by pertinent restrictions. Qualitative interviews are able to point us to significant differences in the experience of the restrictions. In terms of an outlook, we suggest that a sensitization for previously excluded kinds of experiences forms a crucial basis for a less normalizing, that is, more inclusive account of interpreting the affectedness and needs of variegated social groups;the pandemic has influenced and altered structures of the recognition of vulnerability and, by the same token, made them more explicit. It thus is an occasion for a critical engagement with the recognizability of needs, deprivation, discrimination, and related phenomena. © 2023, The Author(s).

Restricted by Measures Against the Coronavirus? Difficulties at the Transition from School to Work in Times of a Pandemic

The paper begins with the prerequisite assumption that social deprivation is a fragile and porous category. Thus, our hypothesis is, that how people are affected by the restrictions against the spreading of the coronavirus is often discussed in far too general and simplistic terms. It is often taken as a given, that the virus and the restriction measures not only have caused severe difficulties for us all (due to social distancing, fear, affected health, etc.), but that the measures have exacerbated already previously existing forms of social deprivation. Therefore, it is assumed that marginalized groups are particularly affected by these effects of the pandemic. Two major German studies show the alleged effects of the relevant measures on adolescents and emerging adults (COPSY and FIBS) against the backdrop of social and economic deprivation;their results confirmed that social deprivation entails a higher degree of being affected by the pandemic.However, this picture becomes thwarted by considering the results of 10 narrative interviews, that were conducted by us with emerging adults in a German vocational training institute between April and August 2021 and showed variegated forms of experiencing issues related to the pandemic. In our analysis, we used the method of objective hermeneutics. In this paper, we present our considerations by outlining two contrastive experiences with the Covid-19 pandemic, in order to highlight the divergent ways in which the pandemic has been experienced even among individuals who previously had been affected by social deprivation – at least at first glance – in similar ways. The conceptual lens through which we interpret these two examples is, firstly, the one of precariousness and precarity (Butler 2009). And secondly, the concept of recognition derived from Honneth's pertinent theory and Butler's account of recognizability will play a pivotal role. While Honneth's approach allows us to emphasize the normative and existential role of the fulfilment of our basic desire for recognition and the detrimental implications of disregard, Butler provides us with the means to thoroughly analyse the socio-historical conditions of misrecognition and social invisibility. Moreover, Butler focuses specifically on the recognizability of precariousness (Honneth's triad of love, being respected as a rights bearer and solidarity shows a different focus). Combining qualitative research on precarious live circumstances with a theoretical perspective on recognition can also be found in a stunning research on couples in atypical working relations (Wimbauer and Motakef 2019). Proceeding from these theories and ‘applying' them to our empirical material, we seek to call into question a too generalizing and hegemonic picture of how people were affected by pertinent restrictions. Qualitative interviews are able to point us to significant differences in the experience of the restrictions.In terms of an outlook, we suggest that a sensitization for previously excluded kinds of experiences forms a crucial basis for a less normalizing, that is, more inclusive account of interpreting the affectedness and needs of variegated social groups;the pandemic has influenced and altered structures of the recognition of vulnerability and, by the same token, made them more explicit. It thus is an occasion for a critical engagement with the recognizability of needs, deprivation, discrimination, and related phenomena. [ FROM AUTHOR]

Development of a composite regional vulnerability index and its relationship with the impacts of the COVID-19 pandemic.

The interactions between vulnerability and human activities have largely been regarded in terms of the level of risk they pose, both internally and externally, for certain groups of disadvantaged individuals and regions/areas. However, to date, very few studies have attempted to develop a comprehensive composite regional vulnerability index, in relation to travel, housing, and social deprivation, which can be used to measure vulnerability at an aggregated level in the social sciences. Therefore, this research aims to develop a composite regional vulnerability index with which to examine the combined issues of travel, housing and socio-economic vulnerability (THASV index). It also explores the index's relationship with the impacts of the COVID-19 pandemic, reflecting both social and spatial inequality, using Greater London as a case study, with data analysed at the level of Middle Layer Super Output Areas (MSOAs). The findings show that most of the areas with high levels of composite vulnerability are distributed in Outer London, particularly in suburban areas. In addition, it is also found that there is a spatial correlation between the THASV index and the risk of COVID-19 deaths, which further exacerbates the potential implications of social deprivation and spatial inequality. Moreover, the results of the multiscale geographically weighted regression (MGWR) show that the travel and socio-economic indicators in a neighbouring district and the related vulnerability indices are strongly associated with the risk of dying from COVID-19. In terms of policy implications, the findings can be used to inform sustainable city planning and urban development strategies designed to resolve urban socio-spatial inequalities and the potential related impacts of COVID-19, as well as guiding future policy evaluation of urban structural patterns in relation to vulnerable areas.

Socioeconomic Deprivation, Sleep Duration, and Mental Health during the First Year of the COVID-19 Pandemic.

The coronavirus disease 2019 (COVID-19) has had a rapid and sustained negative impact on sleep and mental health in the United States with disproportionate morbidity and mortality among socioeconomically deprived populations. We used multivariable and logistic regression to evaluate the associations among sleep duration, mental health, and socioeconomic deprivation (social deprivation index) in 14,676 Ohio residents from 1101 zip code tabulation areas from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) survey. Higher socioeconomic deprivation was associated with shorter sleep and poorer mental health after adjusting for covariates (age, sex, race, education, income, and body mass index) in the multivariable linear regression models. Those in the highest socioeconomically deprived areas had 1.6 and 1.5 times higher odds of short sleep (duration < 6 h) and poor mental health (>14 poor mental health days), respectively, in the logistic regression models. Previous researchers have focused on limited socio-environmental factors such as crowding and income. We examined the role of a composite area based measure of socioeconomic deprivation in sleep duration and mental health during the first year of COVID-19. Our results suggest the need for a broader framework to understand the associations among socioeconomic deprivation, sleep duration, and mental health during a catastrophic event.

Adversity, social support and risk of self-harm during the COVID-19 pandemic.

Little is known about the degree to which social factors interact with COVID-19-related adversity to increase the risk of self-harm thoughts and behaviours. Using data derived from a UK cohort study, Paul & Fancourt found that loneliness was associated with an increase in the odds of self-harm thoughts and behaviours, whereas high-quality social support protected against self-harm thoughts and behaviours. The authors concluded that it is the quality of social support and interactions, rather than the act of engaging in social interaction per se, that protects against self-harm in the context of adversity. The COVID-19 pandemic may exert longer-lasting effects on population mental health, and continued surveillance of mental health, including self-harm status, will be essential. If accompanied by appropriate measures of the availability and quality of social support, such monitoring could also inform the development of more effective adaptive interventions for those at risk of engaging in self-harm.

How evolutionary science can help us understand vaccine refusal in the COVID-19 pandemic.

Unvaccinated people have a mortality rate from COVID-19 that is 32-fold that of fully vaccinated people. Yet, in the UK, more than 4% of adults have not accepted a vaccine to protect them against COVID-19 and at the time of writing only 73% of people were fully vaccinated. Psychological and societal factors underlying vaccine hesitation or refusal are complex. In this paper, we use evolutionary science to help explain how vaccine refusal can be the result of an historic adaptation to protect against the repetition of past trauma, including, for many, that of systemic racism and/or deprivation, and misguided attempt to preserve fertility. We discuss some resulting cognitive biases and conclude with recommendations for practice.

Increasing Uptake of COVID-19 Vaccination and Reducing Health Inequalities in Patients on Renal Replacement Therapy-Experience from a Single Tertiary Centre.

BACKGROUND: COVID-19 vaccination has changed the landscape of the COVID-19 pandemic; however, decreased uptake due to vaccine hesitancy has been observed, particularly in patients from minority ethnic backgrounds and socially deprived areas. These patient characteristics are common in patients on Renal Replacement Therapy (RRT), a population at extremely high risk of developing serious illness from COVID-19 and who would thus benefit the most from the vaccination programme. We designed a bespoke COVID-19 vaccination programme for our RRT population with the aim of decreasing health inequalities and increasing vaccination uptake. METHODS: Key interventions included addressing vaccine hesitancy by deploying the respective clinical teams as trusted messengers, prompt eligible patient identification and notification, the deployment of resources to optimise vaccine administration in a manner convenient to patients, and the timely collection and analysis of local safety and efficacy data. First, COVID-19 vaccination data in relation to ethnicity and social deprivation in our RRT population, measured by the multiple deprivation index, were analysed and compared to uptake data in the total regional adult clinically extremely vulnerable (CEV) population in Greater Manchester (GM). Univariate logistic regression analysis was used to explore the factors associated with not receiving a vaccine. RESULTS: Out of 1156 RRT patients included in this analysis, 96.7% received the first dose of the vaccination compared to 93% in the cohort of CEV patients in the GM. Age, gender, ethnicity, and a lower index of multiple deprivation were not identified as significant risk factors for poor first dose vaccine uptake in our cohort. Vaccine uptake in Asian and Black RRT patients was 94.9% and 92.3%, respectively, compared to 93% and 76.2% for the same ethnic groups in the reference CEV GM. Vaccine uptake was 96.1% for RRT patients in the lowest quartile of the multiple deprivation index, compared to 90.5% in the GM reference population. CONCLUSION: Bespoke COVID-19 vaccination programmes based on local clinical teams as trusted messengers can improve negative attitudes towards vaccination and reduce health inequalities.

How resilient are mountain livelihoods against extreme events? Learnings from Central Mexico in a COVID-19 world

People living in mountains tend to be more vulnerable in their livelihoods. In Mexico, the pandemic of COVID-19 hit hard and has raised challenges in trying to prevent parts of the population from falling back into extreme poverty. To better understand these challenges, we explore how federal government policy on the containment of COVID-19 has been applied in mountain regions during the first half-year of 2020 and describe how stakeholders working and living in the Valley of Mexico are coping with the situation (status: September 2020). Results from a systematic literature review and eight semi-structured interviews indicate that the COVID-19 pandemic underlined existing problems such as high rates of informal labor and income insecurity. We find that sources of contagion were linked to the organization of the food supply chain between city and mountain regions or to socio-cultural practices, and there are no specific strategies for helping people living and working in mountain regions to deal with the socio-economic effects of the pandemic. All respondents in our pilot study have been affected in some way by the pandemic: income loss, food security, or access/restriction to their workplaces. The majority of the respondents do not agree with the measures for containment of COVID-19 implemented by the federal government. We could identify coping mechanisms of our respondents, which include the reduction of consumption, diversification of income sources, and claiming support from the government. However, there is a legitimate threat of falling back to (extreme) poverty or experiencing social deprivation, if the challenges of the current pandemic will not be addressed quickly and more efficiently in the rural mountain areas of the Valley of Mexico. © 2021 Elsevier Inc.

The Impact of Social Deprivation on the Psychological Well-Being of Young People During the Coronavirus Pandemic

The article deals with the problem of psychological well-being of young people during the coronavirus pandemic, the impact of social deprivation on the emotional, intellectual, behavioral activity of a person. The role of communication in human life is presented on the basis of the analysis of views, opinions, ideas of scientists of the humanities. The essence of the concept of social deprivation and its impact on the psychosocial well-being of young people is considered. Mental deprivation can be represented in a combination of its types: sensory, motor, emotional, cognitive and social, which confirms the interdependence of social deprivation and a person's mental well-being. The analysis of the results of a study on the impact of the coronavirus pandemic on the psychological well-being of young people is presented. The study involved 170 people. More than half of the respondents felt restrictions in activity and communication. Ethical consciousness and self-awareness have changed, qualitative changes have been observed in the ideological rethinking of some values: understanding the essence and importance of personal freedom, responsibility, self-attitude, long-term planning, attitude to other people, relatives and friends. At the same time, a conscious, realistic, pragmatic understanding of what is happening and the formed adaptive, habitual interaction of young people in the digital space did not allow them to succumb to panic, emotional depression, apathy. Young people, even with external restrictions, continued to develop and implement their activity, virtual communication with benefits for personal growth and development. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Unequal effects of climate change and pre-existing inequalities on the mental health of global populations.

Climate change is already having unequal effects on the mental health of individuals and communities and will increasingly compound pre-existing mental health inequalities globally. Psychiatrists have a vital part to play in improving both awareness and scientific understanding of structural mechanisms that perpetuate these inequalities, and in responding to global calls for action to promote climate justice and resilience, which are central foundations for good mental and physical health.

Influence of socioeconomic deprivation on interventions and outcomes for patients admitted with COVID-19 to critical care units in Scotland: A national cohort study.

BACKGROUND: Coronavirus disease 2019 (COVID-19) can lead to significant respiratory failure with between 14% and 18% of hospitalised patients requiring critical care admission. This study describes the impact of socioeconomic deprivation on 30-day survival following critical care admission for COVID-19, and the impact of the COVID-19 pandemic on critical care capacity in Scotland. METHODS: This cohort study used linked national hospital records including ICU, virology testing and national death records to identify and describe patients with COVID-19 admitted to critical care units in Scotland. Multivariable logistic regression was used to assess the impact of deprivation on 30-day mortality. Critical care capacity was described by reporting the percentage of baseline ICU bed utilisation required. FINDINGS: There were 735 patients with COVID-19 admitted to critical care units across Scotland from 1/3/2020 to 20/6/2020. There was a higher proportion of patients from more deprived areas, with 183 admissions (24.9%) from the most deprived quintile and 100 (13.6%) from the least deprived quintile. Overall, 30-day mortality was 34.8%. After adjusting for age, sex and ethnicity, mortality was significantly higher in patients from the most deprived quintile (OR 1.97, 95%CI 1.13, 3.41, p=0.016). ICUs serving populations with higher levels of deprivation spent a greater amount of time over their baseline ICU bed capacity. INTERPRETATION: Patients with COVID-19 living in areas with greatest socioeconomic deprivation had a higher frequency of critical care admission and a higher adjusted 30-day mortality. ICUs in health boards with higher levels of socioeconomic deprivation had both higher peak occupancy and longer duration of occupancy over normal maximum capacity. FUNDING: None.

Coronavirus disease 2019: achieving good mental health during social isolation.

The coronavirus disease 2019 pandemic has led to unprecedented disruption to the normal way of life for people around the globe. Social distancing, self-isolation or shielding have been strongly advised or mandated in most countries. We suggest evidence-based ways that people can maintain or even strengthen their mental health during this crisis.