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1.
JAMA Netw Open ; 4(12): e2139585, 2021 12 01.
Article in English | MEDLINE | ID: covidwho-1589284

ABSTRACT

Importance: Although evictions have been associated with adverse mental health outcomes, it remains unclear which stages of the eviction process are associated with mental distress among renters. Variation in COVID-19 pandemic eviction protections across US states enables identification of intervention targets within the eviction process to improve renters' mental health. Objective: To measure the association between the strength of eviction protections (ie, stages blocked by eviction moratoriums) and mental distress among renters during the COVID-19 pandemic. Design, Setting, and Participants: This cohort study used individual-level, nationally representative data from the Understanding Coronavirus in America Survey to measure associations between state eviction moratorium protections and mental distress. The sample of 2317 respondents included renters with annual household incomes less than $75 000 who reported a state of residence and completed surveys between March 10 and September 3, 2020, prior to the federal eviction moratorium order by the Centers for Disease Control and Prevention. Exposures: Time-varying strength of state moratorium protections as a categorical variable: none, weak (blocking court hearings, judgments, or enforcement without blocking notice or filing), or strong (blocking all stages of the eviction process beginning with notice and filing). Main Outcomes and Measures: Moderate to severe mental distress was measured using the 4-item Patient Health Questionnaire. Linear regression models were adjusted for time-varying state COVID-19 incidence and mortality, public health restrictions, and unemployment rates. Models included individual and time fixed effects as well as clustered standard errors. Results: The sample consisted of 2317 individuals (20 853 total observations) composed largely (1788 [78%] weighted) of middle-aged adults (25-64 years of age) and women (1538 [60%]); 640 respondents (23%) self-reported as Hispanic or Latinx, 314 respondents (20%) as non-Hispanic Black, and 1071 respondents (48%) as non-Hispanic White race and ethnicity. Relative to no state-level eviction moratorium protections, strong protections were associated with a 12.6% relative reduction (risk ratio, 0.87; 95% CI, 0.76-0.99) in the probability of mental distress, whereas weak protections were not associated with a statistically significant reduction (risk ratio, 0.96; 95% CI, 0.86-1.06). Conclusions and Relevance: This analysis of the Understanding Coronavirus in America Survey data found that strong eviction moratoriums were associated with protection against mental distress, suggesting that distress begins early in the eviction process with notice and filing. This finding is consistent with the idea that to reduce mental distress among renters, policy makers should focus on primary prevention of evictions.


Subject(s)
COVID-19/epidemiology , Pandemics , Psychological Distress , Public Policy , State Government , Adult , Female , Humans , Income , Male , Middle Aged , SARS-CoV-2 , Unemployment , United States
2.
J Nutr Educ Behav ; 53(12): 1055-1059, 2021 12.
Article in English | MEDLINE | ID: covidwho-1536664

ABSTRACT

OBJECTIVES: To examine whether the decrease in very low food security (VLFS) observed in California shortly after California's coronavirus disease (COVID-19) shutdown remained throughout Federal Fiscal Year (FFY) 2020. To investigate associations among unemployment, Supplemental Nutrition Assistance Program (SNAP) enrollment, and VLFS across FFY 2020. METHODS: Telephone interview responses from mothers from randomly sampled households from low-income areas throughout California to the 6-item US Department of Agriculture Food Security Survey Module identified VLFS families. Logistic regression examined VLFS rates before vs after California's COVID-19 shutdown, with race/ethnicity, age, and education as covariates. Pearson correlations were calculated for unemployment, SNAP enrollment, and VLFS. RESULTS: Most (66.4%) of the 2,682 mothers were Latina. VLFS declined from 19.3% before to 14.5% after California's COVID-19 shutdown (adjusted odds ratio, 0.705; P = 0.002). The correlation for unemployment and SNAP household participation was 0.854 (P = 0.007), and for SNAP participation and VLFS was -0.869 (P = 0.005). CONCLUSIONS AND IMPLICATIONS: Publicly-funded assistance programs may lower food insecurity, even during a time of increased economic hardship. Examining the specific factors responsible for the observed decline in VLFS has merit. Whether VLFS remains below the rate observed before California's COVID-19 shutdown is worthy of ongoing study.


Subject(s)
COVID-19 , Food Assistance , California , Female , Food Insecurity , Food Supply , Humans , SARS-CoV-2 , Unemployment
3.
Gac Med Mex ; 157(3): 263-270, 2021.
Article in English | MEDLINE | ID: covidwho-1535083

ABSTRACT

INTRODUCTION: Historically, pandemics have resulted in higher mortality rates in the most vulnerable populations. Social determinants of health (SDH) have been associated with people morbidity and mortality at different levels. OBJECTIVE: To determine the relationship between SDH and COVID-19 severity and mortality. METHODS: Retrospective study, where data from patients with COVID-19 were collected at a public hospital in Chile. Sociodemographic variables related to structural SDH were classified according to the following categories: gender, age (< 65 years, ≥ 65 years), secondary education (completed or not), work status (active, inactive) and income (< USD 320, ≥ USD 320). RESULTS: A total of 1,012 laboratory-confirmed COVID-19 cases were included. Average age was 64.2 ± 17.5 years. Mortality of the entire sample was 14.5 %. Age, level of education, unemployment and income had a strong association with mortality (p < 0.001). CONCLUSIONS: The findings reinforce the idea that SDH should be considered a public health priority, which is why political efforts should focus on reducing health inequalities for future generations.


Subject(s)
COVID-19/epidemiology , Social Determinants of Health , Age Factors , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/physiopathology , Chile/epidemiology , Educational Status , Female , Hospitals, Public , Humans , Income/statistics & numerical data , Male , Middle Aged , Retrospective Studies , Risk Factors , Severity of Illness Index , Unemployment/statistics & numerical data
4.
Rev Bras Ginecol Obstet ; 43(10): 765-774, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1517657

ABSTRACT

OBJECTIVE: To investigate depression and sexual function among pregnant and non-pregnant women throughout the COVID-19 pandemic. METHODS: A total of 188 women, 96 pregnant and 92 non-pregnant were included. The Beck Depression Inventory (BDI) and the Arizona Sexual Experience Scale (ASEX) were applied to the participants after obtaining sociodemographic data. RESULTS: The depression scores of pregnant and non-pregnant women were similar (p = 0.846). We found that the depression scores were significantly higher among the group of participants who have lower economic status (p = 0.046). Moreover, the depression score was significantly higher among women who lost their income during the pandemic (p = 0.027). The score on the ASEX was significantly higher, and sexual dysfunction was more prevalent among women who have lower levels of schooling and income (p < 0.05). Likewise, the ASEX scores were significantly higher (p = 0.019) among the group who experienced greater income loss throughout the pandemic. Upon comparing the pregnant and non-pregnant groups, we detected that sexual dysfunction had a significantly higher rate among pregnant women (p < 0.001). CONCLUSION: In times of global crisis, such as the current pandemic, low-income families have an increased risk of experiencing depression and sexual dysfunction. When we compared pregnant women with non-pregnant women, depression scores were similar, but pregnant women were at a 6.2 times higher risk of developing sexual dysfunction.


Investigar a depressão e as funções sexuais de mulheres grávidas e não grávidas durante a pandemia de Covid-19. MéTODOS: Um total de 188 mulheres, 96 grávidas e 92 não grávidas, foram incluídas. O Inventário de Depressão de Beck (Beck Depression Inventory, BDI, em inglês) e a Escala de Experiências Sexuais do Arizona (Arizona Sexual Experience Scale, ASEX, em inglês) foram aplicados aos participantes após a obtenção dos dados sociodemográficos.As pontuações de depressão de mulheres grávidas e não grávidas foram semelhantes (p = 0,846). Verificou-se que as pontuações de depressão foram significativamente maiores no grupo de participantes de menor nível econômico (p = 0,046). Além disso, a pontuação de depressão foi significativamente maior em mulheres que perderam sua renda durante a pandemia (p = 0,027). A pontuação na ASEX foi significativamente maior, e a disfunção sexual foi mais prevalente em pessoas com menores escolaridade e nível de renda (p < 0,05). Da mesma forma, as pontuações na ASEX foram significativamente mais altas (p = 0,019) no grupo que experimentou maior perda de renda durante a pandemia. Ao comparar os grupos de gestantes e não gestantes, detectou-se que a disfunção sexual apresentava índice significativamente maior entre as gestantes (p <0,001). CONCLUSãO: Em tempos de crise global, como a atual pandemia, famílias de baixa renda têm um risco maior de sofrer depressão e disfunção sexual. Quando comparamos mulheres grávidas e mulheres não grávidas, as pontuações de depressão foram semelhantes, mas as mulheres grávidas apresentaram um risco 6,2 vezes maior de desenvolver disfunção sexual.


Subject(s)
COVID-19/epidemiology , COVID-19/psychology , Depression/epidemiology , Pandemics , Pregnant Women/psychology , Sexual Dysfunctions, Psychological/epidemiology , Adolescent , Adult , Cross-Sectional Studies , Economic Factors , Female , Humans , Middle Aged , Pregnancy , SARS-CoV-2 , Sexual Behavior , Turkey/epidemiology , Unemployment/psychology , Young Adult
5.
Saudi Med J ; 42(4): 384-390, 2021 Apr.
Article in English | MEDLINE | ID: covidwho-1513255

ABSTRACT

OBJECTIVES: To measure the Saudi population's sleep quality during the lockdown of COVID-19. METHODS: An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS. RESULTS: A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction. CONCLUSION: Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.


Subject(s)
COVID-19 , Disorders of Excessive Somnolence/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep , Adult , Communicable Disease Control , Cross-Sectional Studies , Educational Status , Female , Humans , Male , Marital Status/statistics & numerical data , Middle Aged , Prevalence , Public Policy , Risk Factors , SARS-CoV-2 , Saudi Arabia/epidemiology , Sex Factors , Sleep Latency , Surveys and Questionnaires , Unemployment/statistics & numerical data
6.
Am J Public Health ; 111(S3): S215-S223, 2021 10.
Article in English | MEDLINE | ID: covidwho-1496725

ABSTRACT

Public Health 3.0 approaches are critical for monitoring disparities in economic, social, and overall health impacts following the COVID-19 pandemic and its associated policy changes to slow community spread. Timely, cross-sector data as identified using this approach help decisionmakers identify changes, track racial disparities, and address unintended consequences during a pandemic. We applied a monitoring and evaluation framework that combined policy changes with timely, relevant cross-sector data and community review. Indicators covered unemployment, basic needs, family violence, education, childcare, access to health care, and mental, physical, and behavioral health. In response to increasing COVID-19 cases, nonpharmaceutical intervention strategies were implemented in March 2020 in King County, Washington. By December 2020, 554 000 unemployment claims were filed. Social service calls increased 100%, behavioral health crisis calls increased 25%, and domestic violence calls increased 25%, with disproportionate impact on communities of color. This framework can be replicated by local jurisdictions to inform and address racial inequities in ongoing COVID-19 mitigation and recovery. Cross-sector collaboration between public health and sectors addressing the social determinants of health are an essential first step to have an impact on long-standing racial inequities. (Am J Public Health. 2021;111(S3):S215-S223. https://doi.org/10.2105/AJPH.2021.306422).


Subject(s)
COVID-19 , Health Policy , Health Services Accessibility , Health Status Disparities , Public Health , COVID-19/economics , COVID-19/prevention & control , Humans , Mental Health , Population Surveillance , Unemployment/statistics & numerical data , Washington
7.
Int J Environ Res Public Health ; 18(21)2021 10 24.
Article in English | MEDLINE | ID: covidwho-1488538

ABSTRACT

Economic crises cause significant shortages in disposable income and a sharp decline in the living conditions, affecting healthcare sector, hitting the profitability and sustainability of companies leading to raises in unemployment. At micro level, these sharp decreases in earnings associated with unemployment and furthermore with the lack of social protection will impact the quality of life and finally the health of individuals. In time of crisis, it becomes vital to support not only the critical sectors of the economy, the assets, technology, and infrastructure, but to protect jobs and workers. This health crisis has hit hard the jobs dynamics through unemployment and underemployment, the quality of work (through wages, or access to social protection), and through the effects on specific groups, with a higher degree of vulnerability to unfavorable labor market outcomes. In this context, providing forecasts as recent as possible for the unemployment rate, a core indicator of the Romanian labor market that could include the effects of the market shocks it becomes fundamental. Thus, the paper aims to offer valuable forecasts for the Romanian unemployment rate using univariate vs. multivariate time series models for the period 2021-2022, highlighting the main patterns of evolution. Based on the univariate time series models, the paper predict the future values of unemployment rate based on its own past using self-forecasting and implementing ARFIMA and SETAR models using monthly data for the period January 2000-April 2021. From the perspective of multivariate time series models, the paper uses VAR/VECM models, analyzing the temporal interdependencies between variables using quarterly data for the period 2000Q1-2020Q4. The empirical results pointed out that both SETAR and VECM provide very similar results in terms of accuracy replicating very well the pre-pandemic period, 2018Q2-2020Q1, reaching the value of 4.1% at the beginning of 2020, with a decreasing trend reaching the value of 3.9%, respectively, 3.6% at the end of 2022.


Subject(s)
Quality of Life , Unemployment , Economics , Employment , Humans , Income , Romania , Socioeconomic Factors
8.
Crit Care Med ; 49(11): e1157-e1162, 2021 11 01.
Article in English | MEDLINE | ID: covidwho-1467424

ABSTRACT

OBJECTIVES: Joblessness is common in survivors from critical care. Our aim was to describe rates of return to work versus unemployment following coronavirus disease 2019 acute respiratory distress syndrome requiring intensive care admission. DESIGN: Single-center, prospective case series. SETTING: Critical Care Follow-Up Clinic, Humanitas Clinical and Research Center-IRCCS, Rozzano, Italy. PATIENTS: One hundred and one consecutive laboratory-confirmed coronavirus disease 2019 patients were discharged from our hospital following an ICU stay between March 1, 2020, and June 30, 2020. Twenty-five died in the ICU. Seventy-six were discharged alive from hospital. Two patients refused participation, while three were unreachable. The remaining 71 were alive at 6 months and interviewed. INTERVENTIONS: Baseline and outcome healthcare data were extracted from the electronic patient records. Employment data were collected using a previously published structured interview instrument that included current and previous employment status, hours worked per week, and timing of return to work. Health-related quality of life status was assessed using the Italian EQ-5D-5L questionnaire. MEASUREMENTS AND MAIN RESULTS: Of the 71 interviewed patients, 45 (63%) were employed prior to coronavirus disease 2019, of which 40 (89%) of them worked full-time. Thirty-three (73%) of the previously employed survivors had returned to work by 6 months, 10 (22%) were unemployed, and 2 (5%) were newly retired. Among those who returned to work, 20 (85%) of them reported reduced effectiveness at work. Those who did not return to work were either still on sick leave or lost their job as a consequence of coronavirus disease 2019. Reported quality of life of survivors not returning to work was worse than of those returning to work. CONCLUSIONS: The majority of coronavirus disease 2019 survivors following ICU in our cohort had returned to work by 6 months of follow-up. However, most of them reported reduced work effectiveness. Prolonged sick leave and unemployment were common findings in those not returning.


Subject(s)
COVID-19/epidemiology , Critical Care/statistics & numerical data , Respiratory Distress Syndrome/epidemiology , Return to Work/statistics & numerical data , Unemployment/statistics & numerical data , Age Factors , Aged , Comorbidity , Female , Frailty/epidemiology , Humans , Length of Stay , Male , Middle Aged , Patient Discharge/statistics & numerical data , Quality of Life , Retirement/statistics & numerical data , SARS-CoV-2 , Severity of Illness Index , Sex Factors , Socioeconomic Factors
9.
Int J Environ Res Public Health ; 18(19)2021 09 23.
Article in English | MEDLINE | ID: covidwho-1463633

ABSTRACT

BACKGROUND: Unemployment, underemployment, and the quality of work are national occupational health risk factors that drive critical national problems; however, to date, there have been no systematic efforts to document the public health impact of this situation. METHODS: An environmental scan was conducted to explore the root causes and health impacts of underemployment and unemployment and highlight multilevel perspectives and factors in the landscape of underemployment and unemployment. METHODS: included a review of gray literature and research literature, followed by key informant interviews with nine organizational representatives in employment research and policy, workforce development, and industry to assess perceived needs and gaps in practice. RESULTS: Evidence highlights the complex nature of underemployment and unemployment, with multiple macro-level underlying drivers, including the changing nature of work, a dynamic labor market, inadequate enforcement of labor protection standards, declining unions, wage depression, and weak political will interacting with multiple social determinants of health. Empirical literature on unemployment and physical, mental, and psychological well-being, substance abuse, depression in young adults, and suicides is quite extensive; however, there are limited data on the impacts of underemployment on worker health and well-being. Additionally, organizations do not routinely consider health outcomes as they relate to their work in workforce or policy development. DISCUSSION AND CONCLUSIONS: Several gaps in data and research will need to be addressed in order to assess the full magnitude of the public health burden of underemployment and unemployment. Public health needs to champion a research and practice agenda in partnership with multisector stakeholders to illuminate the role of employment quality and status in closing the gap on health inequities, and to integrate workforce health and well-being into labor and economic development agendas across government agencies and industry.


Subject(s)
Suicide , Unemployment , Employment , Humans , Perception , Public Health , Socioeconomic Factors , United States , Young Adult
10.
Pan Afr Med J ; 39: 227, 2021.
Article in English | MEDLINE | ID: covidwho-1449269

ABSTRACT

Introduction: as the COVID-19 pandemic rages on, sub-Saharan Africa remains at high risk given the poor adherence to pandemic control protocols. Misconceptions about the contagion may have given rise to adverse risk behaviours across population groups. This study evaluates risk perception among 2,244 residents of seven countries in sub-Saharan Africa (Botswana, Kenya, Malawi, Nigeria, Tanzania, Zambia and Zimbabwe) in relation to socio-demographic determinants. Methods: an online survey was conducted via social media platforms to a random sample of participants. Risk perception was evaluated across six domains: loss of income, food scarcity, having a relative infected, civil disorder, criminal attacks, or losing a friend or relative to COVID-19. A multivariable ordinal logistic regression was conducted to assess socio-demographic factors associated with the perceived risk of being affected by COVID-19. Results: 595 (27%) respondents did not consider themselves to be at risk, while 33% perceived themselves to be at high risk of being affected by the pandemic with respect to the six domains evaluated. Hospital-based workers had the highest proportional odds (3.5; 95%CI: 2.3-5.6) high perceived risk. Teenage respondents had the highest predictive probability (54.6%; 95% CI: 36.6-72.7%) of perceiving themselves not to be at risk of being affected by COVID-19, while Zambia residents had the highest predictive probability (40.7%; 95% CI: 34.3-47.0%) for high-risk perception. Conclusion: this study reveals the need to increase awareness of risks among socio-demographic groups such as younger people and the unemployed. Targeted risk communication strategies will create better risk consciousness, as well as adherence to safety measures.


Subject(s)
COVID-19/epidemiology , Guideline Adherence , Risk-Taking , Adult , Africa South of the Sahara , Age Factors , COVID-19/psychology , Communication , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Perception , Personnel, Hospital/statistics & numerical data , Probability , Risk Factors , Surveys and Questionnaires , Unemployment , Young Adult
11.
Sci Rep ; 11(1): 18538, 2021 09 17.
Article in English | MEDLINE | ID: covidwho-1428898

ABSTRACT

This paper analyzes the impact of mobility contraction on employee furlough and excess deaths in Italy during the COVID-19 crisis. Our approach exploits rainfall patterns across Italian administrative regions as a source of exogenous variation in human mobility to pinpoint the causal effect of mobility restrictions on excess deaths and furlough workers. Results confirm that the first countrywide lockdown has effectively curtailed the COVID-19 epidemics restricting it mainly to the northern part of the country, with the drawback of a countrywide increase in unemployment risk. Our analysis points out that a mobility contraction of 1% leads to a mortality reduction of 0.6%, but it induces an increase of 10% in Wage Guarantee Funds allowed hours. We discuss return-to-work policies and prioritizing policies for administering COVID-19 vaccines in the most advanced stage of a vaccination campaign when the healthy active population is left to be vaccinated.


Subject(s)
COVID-19 Vaccines , COVID-19/prevention & control , Communicable Disease Control , Unemployment , COVID-19/epidemiology , Humans , Italy , Risk , Survival Rate
12.
J Affect Disord ; 296: 59-66, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1415506

ABSTRACT

BACKGROUND: Severe psychological and psychosocial consequences of the COVID-19 pandemic are expected, especially for people already vulnerable to biological or psychosocial stressors, including those with mental health problems. The study aimed to investigate factors associated with the loss of jobs and unemployment during the COVID-19 pandemic. In particular, we investigated whether mental illness was associated with a higher risk of losing one's job because of the COVID-19 pandemic. METHODS: Nineteen thousand four hundred ninety-six adults living in Italy were administered an online protocol including a sociodemographic checklist and questionnaires investigating suicide ideation and risk, mental health status and general distress (stress, anxiety, and depression), resilience, and perceived support. RESULTS: One thousand two hundred seventy-four reported having lost their job because of the COVID-19 pandemic, and 5.4% of the sample reported a mental illness (mostly a depressive disorder). Unemployment was independently associated with mental illness, poor mental health, and depression. Mental illness was associated with the risk of losing one's job because of the COVID-19 pandemic, but not at the multivariate analyses. Those who lost their job because of the COVID-19 pandemic (compared to others) reported worse mental health and depression. LIMITATIONS: The presence of mental illness was self-reported by respondents and the administered measures were self-reported questionnaires affected by social desirability and other response bias. CONCLUSIONS: The COVID-19 pandemic and social isolation measures and lockdown used to contain its spread among the Italian population were associated with occupational insecurity, especially among the more vulnerable social categories.


Subject(s)
COVID-19 , Mental Disorders , Adult , Anxiety , Communicable Disease Control , Depression , Humans , Italy/epidemiology , Mental Disorders/epidemiology , Pandemics , SARS-CoV-2 , Unemployment
13.
Health Aff (Millwood) ; 40(9): 1491-1500, 2021 09.
Article in English | MEDLINE | ID: covidwho-1398944

ABSTRACT

The COVID-19 pandemic precipitated an unemployment crisis in the US that surpassed the Great Recession of 2007-09 within the first three months of the pandemic. This article builds on the limited early evidence of the relationship between the pandemic and health insurance coverage, using county-level unemployment and Medicaid enrollment data from North Carolina, a large state that did not expand Medicaid. We used linear and county fixed effects models to assess this relationship, accounting for county-level social vulnerability, physical and virtual access to Medicaid enrollment, and COVID-19 case burden. Using data from January 2018 through August 2020, we estimated that the passthrough rate-the share of unemployed people who gained Medicaid coverage-was approximately 15 percent statewide but higher in more socially vulnerable counties. This low passthrough rate during a period of increased unemployment resulting from the COVID-19 pandemic means that Medicaid was unable to completely fulfill its countercyclical role, in which it grows to meet greater need during periods of widespread economic hardship, because of North Carolina's stringent Medicaid eligibility criteria. Working toward greater adoption of Medicaid expansion may help ensure that the US is better prepared for the next crisis by ensuring access to health insurance coverage.


Subject(s)
COVID-19 , Medicaid , Humans , Insurance Coverage , North Carolina , Pandemics , SARS-CoV-2 , Unemployment , United States
14.
Pediatr Blood Cancer ; 68(11): e29324, 2021 11.
Article in English | MEDLINE | ID: covidwho-1380406

ABSTRACT

Childhood cancersurvivors may be differentially impacted by coronavirus disease 2019 (COVID-19). From April to June of 2020, we examined psychosocial/health concerns in 4148 adult survivors and 571 siblings. Although more survivors reported concerns about getting sick (p = .002) and needing hospitalization (p = .003) in general, survivors and siblings were comparably concerned about being infected with and the consequences of COVID-19. Cranial radiation was associated with social isolation (relative risk [RR] = 1.3, CI = 1.1-1.7), and central nervous system (CNS) tumors were associated with unemployment due to COVID-19 (RR = 1.7, CI = 1.2-2.2). Some survivors appear more vulnerable and may require more support to meet health care and vocational needs during COVID-19, though siblings also perceive substantial risk.


Subject(s)
COVID-19 , Cancer Survivors , Neoplasms , Adult , COVID-19/epidemiology , Child , Female , Humans , Male , Middle Aged , Neoplasms/epidemiology , Neoplasms/psychology , Retrospective Studies , Siblings , Social Isolation , Unemployment
15.
Soc Sci Med ; 287: 114339, 2021 10.
Article in English | MEDLINE | ID: covidwho-1370683

ABSTRACT

There is evidence that loneliness and unemployment each have a negative impact on public health. Both are experienced across the life course and are of increasing concern in light of the COVID-19 pandemic. This review seeks to examine the strength and direction of the relationship between loneliness and unemployment in working age individuals, and in particular the potential for a self-reinforcing cycle with combined healthcare outcomes. A systematic search was undertaken in Medline, PubMed, PsycINFO, Embase and EconLit from inception to December 2020. PRISMA reporting guidelines were followed throughout this review, study quality was assessed using the Joanna Briggs Institute checklist and results were summarised in a narrative synthesis. English language studies evaluating the relationship between loneliness and unemployment in higher income western countries were included. Thirty-seven studies were identified; 30 cross-sectional and 7 longitudinal. Loneliness was measured by a direct question or loneliness scale while unemployment was self-reported or retrieved from a national register. A positive association between unemployment and increased loneliness was observed across all studies. Thus, across the life-course a clear yet complex relationship exists between unemployment and greater experience of loneliness. The magnitude of this relationship increases with the severity of loneliness and appears to peak at age 30-34 and 50-59. Logistic regression provided the greatest consistency at statistical significance revealing at least a 40% increase in the likelihood of reporting loneliness when unemployed. Recent longitudinal studies identified in this review found higher levels of loneliness following job loss, but also that loneliness was predictive of unemployment suggesting potential bi-directionality in the relationship. This bi-directionality may create a multiplier effect between loneliness and unemployment to form a self-reinforcing relationship and greater health concerns for those most at risk. Thus, review findings suggest the need for cross-sector awareness and intervention to tackle both loneliness and unemployment.


Subject(s)
COVID-19 , Loneliness , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2 , Unemployment
17.
Lancet Digit Health ; 3(8): e526-e533, 2021 08.
Article in English | MEDLINE | ID: covidwho-1333841

ABSTRACT

Digital health, including the use of mobile health apps, telemedicine, and data analytics to improve health systems, has surged during the COVID-19 pandemic. The social and economic fallout from COVID-19 has further exacerbated gender inequities, through increased domestic violence against women, soaring unemployment rates in women, and increased unpaid familial care taken up by women-all factors that can worsen women's health. Digital health can bolster gender equity through increased access to health care, empowerment of one's own health data, and reduced burden of unpaid care work. Yet, digital health is rarely designed from a gender equity perspective. In this Viewpoint, we show that because of lower access and exclusion from app design, gender imbalance in digital health leadership, and harmful gender stereotypes, digital health is disadvantaging women-especially women with racial or ethnic minority backgrounds. Tackling digital health's gender inequities is more crucial than ever. We explain our feminist intersectionality framework to tackle digital health's gender inequities and provide recommendations for future research.


Subject(s)
/statistics & numerical data , Feminism , Minority Groups/statistics & numerical data , Sexism , Telemedicine , Women's Health , COVID-19 , Domestic Violence , Female , Health Services Accessibility , Humans , Mobile Applications , Unemployment , Women's Health/statistics & numerical data , Women's Health/trends
18.
PLoS One ; 16(7): e0255050, 2021.
Article in English | MEDLINE | ID: covidwho-1331997

ABSTRACT

AIMS: The present study aimed to investigate whether the psychological impact of the COVID-19 crisis varied with regards to young Swiss men's pre-crisis level of education and socioeconomic status and to changes in their work situation due to it. METHODS: A cohort of 2345 young Swiss men (from 21 out of 26 Swiss cantons; mean age = 29) completed survey-based assessments shortly before (April 2019 to February 2020) and early on during the COVID-19 crisis (May to June 2020). Outcomes measured were psychological outcomes before and during the COVID-19 crisis (depression, perceived stress and sleep quality), and the fear, isolation and psychological trauma induced by it. We investigated associations between these outcomes and their predictors: pre-crisis socioeconomic status (relative financial status, difficulty paying bills, level of education), changes in work situation during the crisis (job loss, partial unemployment, working from home, change in workload) and working in contact with potentially infected people, both inside and outside the healthcare sector. For outcomes measured before and during the crisis, the analyses were adjusted for their pre-crisis levels. RESULTS: About 21% of participants changed their employment status (job loss, partial unemployment or lost money if self-employed) and more than 40% worked predominantly from home during the COVID-19 crisis. Participants with a lower relative socioeconomic status already before the crisis experienced a higher psychological impact due to the COVID-19 crisis, compared to participants with an average socioeconomic status (major depression (b = 0.12 [0.03, 0.22]), perceived stress (b = 0.15 [0.05, 0.25]), psychological trauma (b = 0.15 [0.04, 0.26]), fear (b = 0.20 [0.10, 0.30]) and isolation (b = 0.19 [0.08, 0.29])). A higher impact was also felt by participants who lost their job due to the COVID-19 crisis, the partially unemployed, those with an increased workload or those who worked mainly from home (e.g. depression b = 0.25 [0.16, 0.34] for those working 90%+ at home, compared to those not working at home). CONCLUSIONS: Even in a country like Switzerland, with relatively high social security benefits and universal healthcare, the COVID-19 crisis had a considerable psychological impact, especially among those with a lower socioeconomic status and those who experienced deteriorations in their work situation due to the COVID-19 crisis. Supporting these populations during the crisis may help to prevent an amplification of inequalities in mental health and social status. Such support could help to lower the overall impact of the crisis on the mental well-being of Switzerland's population.


Subject(s)
COVID-19/psychology , Men/psychology , Adult , Cohort Studies , Depression/psychology , Employment/psychology , Fear/psychology , Humans , Male , Mental Health , Social Class , Stress, Psychological/psychology , Surveys and Questionnaires , Switzerland , Unemployment/psychology
20.
BMJ Open ; 11(7): e047997, 2021 07 19.
Article in English | MEDLINE | ID: covidwho-1318031

ABSTRACT

OBJECTIVES: An association between youth unemployment and poorer mental health later in life has been found in several countries. Little is known about whether this association is consistent across individuals or differs in strength. We adopt a quantile regression approach to explore heterogeneity in the association between youth unemployment and later mental health along the mental health distribution. DESIGN: Prospective longitudinal cohort of secondary schoolchildren in England followed from age 13/14 in 2004 to age 25 in 2015. SETTING: England, UK. PARTICIPANTS: 7707 participants interviewed at age 25.Primary and secondary outcome measures12-Item General Health Questionnaire (GHQ) Likert score, a measure of minor psychiatric morbidity. RESULTS: Youth unemployment was related to worse mental health at age 25. The association was several times stronger at deciles of GHQ representing the poorest levels of mental health. This association was only partly attenuated when adjusting for confounding variables and for current employment status. In fully adjusted models not including current employment status, marginal effects at the 50th percentile were 0.73 (95% CI -0.05 to 1.54, b=0.11) points, while marginal effects at the 90th percentile were 3.76 (95% CI 1.82 to 5.83; b=0.58) points. The results were robust to different combinations of control variables. CONCLUSIONS: There is heterogeneity in the longitudinal association between youth unemployment and mental health, with associations more pronounced at higher levels of psychological ill health. Youth unemployment may signal clinically relevant future psychological problems among some individuals.


Subject(s)
Mental Health , Unemployment , Adolescent , Adult , Child , England/epidemiology , Humans , Prospective Studies , Regression Analysis
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