Mental health inequalities during the second COVID-19 wave among Millennials who grew up in England: Evidence from the Next Steps cohort study.

BACKGROUND: There is relatively little evidence on socioeconomic inequalities in mental health among young adults after the end of the first COVID-19 wave in the UK, despite this group having faced the worse mental health and economic shocks across age groups at the start of the pandemic. METHODS: We examined differences in mental health across two points - September 2020 and February 2021 - in a cohort of 4167 Millennials aged 30-31 using life dissatisfaction, psychological distress (GHQ-12), anxiety (GAD-2), and depressive symptoms (PHQ-2). We report adjusted prevalence ratios (aPR) from random-intercept models, testing differences by educational attainment and time-varying conditions (relationship status, living arrangements with adults and children, work status, and financial changes compared with before the outbreak), adjusting for baseline covariates at ages 13-14 and health covariates at ages 25-26. RESULTS: Only dissatisfaction with life changed between time points (PR = 1.26, 95%CI 1.02-1.55). Educational attainment was not significantly associated with mental health. Being single (aPRs from 1.36 to 1.89) and being financially worse off since the start of the pandemic (aPRs from 1.58 to 1.76) were each associated with worse mental health. These associations did not further vary by educational attainment. CONCLUSION: Among Millennials who grew up in England, educational attainment was not associated with mental health whereas negative social and financial conditions were associated with worse mental health during the second COVID-19 wave. Mental health inequalities in this generation are likely to have continued increasing after the end of the first COVID-19 wave.

Parenthood and psychological distress among English Millennials during the second wave of the COVID-19 pandemic: evidence from the Next Steps cohort study.

PURPOSE: The COVID-19 pandemic led to disproportionate mental health responses in younger adults and parents. The aim of the study was to investigate how Millennial parents' experiences were associated with psychological distress over the first year of the pandemic. METHODS: We examined data in September 2020 (n men = 994; n women = 1824) and February 2021 (n men = 1054; n women = 1845) from the Next Steps cohort study (started ages 13-14 in 2003-04). In each wave, we examined differences in GHQ-12 scores between parent groups defined by the age and number of children, adjusting for background characteristics at ages 13-14, psychological distress at ages 25-26, and other circumstances during the pandemic. We also examined if differences varied by work status, financial situation before the outbreak and relationship status. RESULTS: Whereas mothers with one or two children and children aged 0-2 reported less distress than non-mothers in September 2020, there were no such differences in February 2021. Fathers with three or more children reported more distress in February 2021. Compared with non-fathers who worked, fathers were also disproportionally distressed if they were working with one child or with children aged 2 or less in September 2020. CONCLUSION: The distribution of psychological distress among Millennial parents and non-parents has varied by age, sex, parenting stage, work status and the timing of the pandemic. Generous family policies are needed, with special attention dedicated to parents combining work and family responsibilities.

Mental distress among young adults in Great Britain: long-term trends and early changes during the COVID-19 pandemic.

PURPOSE: In Great Britain, few studies documented mental health trends in young adults in the years preceding 2020, the mental health dimensions affected, and how these compare with changes observed during the COVID-19 pandemic. METHODS: Long-term trends in mental health among 16-34 year old men and women between 1991 and 2018, and changes between 2018-19 and July-September 2020 were examined using all waves from the British Household Panel Study (1991-2008), the UK Household Longitudinal Study (2009-20), and the first five UKHLS COVID-19 waves administered in April, May, June, July, and September 2020. Findings are based on the GHQ-12 continuous score (0-36), clinically significant cases (4 + /12) and severe cases (7 + /12) for mental distress, and item endorsements. RESULTS: Between 1991 and 2018, the prevalence of cases (4 + /12) increased from 14-22% to 19-32% across groups. Increases were largest in women aged 16-24. In April 2020, the risk of caseness (4 + /12) increased across groups by 55% to 80% compared to the 2018-19 baseline. This increase, however, rapidly diminished over time: in July-September 2020, there was only a higher risk of caseness (4 + /12) in men aged 25-34 (prevalence ratio = 1.29, 95% CI 1.01-1.65) compared to the 2018-19 baseline. CONCLUSION: Whereas distress surged in April 2020, its return to pre-pandemic levels by September 2020 highlights the nuanced impact that the pandemic may have over time. Given the magnitude of the decline in mental health over the past decade, attention must be given to young adults once the pandemic ends.

Work-family life courses and BMI trajectories in three British birth cohorts.

BACKGROUND/OBJECTIVES: Combining work and family responsibilities has previously been associated with improved health in mid-life, yet little is known about how these associations change over time (both biographical and historical) and whether this extends to body mass index (BMI) trajectories for British men and women. The purpose of this study was to investigate relationships between work-family life courses and BMI trajectories across adulthood (16-42 years) for men and women in three British birth cohorts. SUBJECTS/METHODS: Multiply imputed data from three nationally representative British birth cohorts were used-the MRC National Survey of Health and Development (NSHD; 1946 birth cohort, n=3012), the National Child Development Study (NCDS; 1958 birth cohort, n=9614) and the British Cohort Study (BCS; 1970 birth cohort, n=8140). A typology of work-family life course types was developed using multi-channel sequence analysis, linking annual information on work, partnerships and parenthood from 16 to 42 years. Work-family life courses were related to BMI trajectories using multi-level growth models. Analyses adjusted for indicators of prior health, birthweight, child BMI, educational attainment and socioeconomic position across the life course, and were stratified by gender and cohort. RESULTS: Work-family life courses characterised by earlier transitions to parenthood and weaker long-term links to employment were associated with greater increases in BMI across adulthood. Some of these differences, particularly for work-family groups, which are becoming increasingly non-normative, became more pronounced across cohorts (for example, increases in BMI between 16 and 42 years in long-term homemaking women: NSHD: 4.35 kg m-2, 95% confidence interval (CI): 3.44, 5.26; NCDS: 5.53 kg m-2, 95% CI: 5.18, 5.88; BCS: 6.69 kg m-2, 95% CI: 6.36, 7.02). CONCLUSIONS: Becoming a parent earlier and weaker long-term ties to employment are associated with greater increases in BMI across adulthood in British men and women.

Children's emotional and behavioural well-being and the family environment: findings from the Health Survey for England.

Recent trends towards diversity in family structure have posed important challenges for traditional social theories on the family. This critical debate has not, however, had much influence on policy discussions of the impact of diverse family structures on children's psychological health, where two-parent families are presumed ideal. In 1997, the annual Health Survey for England focussed on the health of children and young people. The Strengths and Difficulties Questionnaire (SDQ), used to assess children's psychological health, was administered to the parents of 5705 children aged 4-15 using a self-completion booklet. The effect of family structure, socio-economic indicators, parental working status and parental psychological status on children's psychological health was explored using multi-variate logistic regression models. Findings indicated that the high prevalence of psychological morbidity among children of lone-mothers was a consequence of socio-economic effects. disappearing when benefits receipt, housing tenure and maternal education were taken into account. Socio-economic factors did not, however, explain the higher proportion of psychological morbidity among children with stepparents, or the strong relationship between parents' and children's psychological morbidity.

Birthweight and behavioural problems in children: a modifiable effect?

BACKGROUND: Low birthweight has been shown to predict behavioural problems in children. Less is known about the effect of birthweight, and how this may interact with the social environment in determining behaviour in a general population sample. We have examined the relationship between birthweight and social factors on childhood psychological well-being. METHODS: Cross-sectional analysis of data on 5181 children aged 4-15 years from a randomly selected household population, the 1997 Health Survey for England. The main outcome measures were behavioural problems as defined by the Strengths and Difficulties Questionnaire (SDQ) in relation to birthweight and social environmental factors. RESULTS: Birthweight was a significant predictor of total difficulties score (odds ratio [OR] = 1.27, 95% CI : 1.07, 1.49), hyperactivity in boys (OR = 1.25, 95% CI : 1.05, 1.51), and peer problems in girls (OR = 1.24, 95% CI : 0.99, 1.53). There was a strong social class gradient in the prevalence of behavioural problems for all birthweight tertiles. Bivariate analysis showed that high total difficulties score was significantly more common in lower birthweight tertiles for social classes III non-manual and III manual (P:-value for trend 0.05 and 0.03, respectively). There were smaller, non-significant effects of birthweight on the prevalence of behavioural problems in social class I and II, and IV and V. Statistical tests for an interaction between birthweight and social class were not significant. CONCLUSIONS: Early life factors, such as birthweight and social class have important influences on psychological well-being in children. The birthweight effect is influenced by social factors, with the possibility that an advantaged social environment protects against the development of behavioural problems, and a disadvantaged environment increases the risk of behavioural problems, regardless of birthweight.

Health service utilization in London's African migrant communities: implications for HIV prevention.

The objective of this study was to examine health service utilization in relation to HIV/AIDS prevention in Ugandan migrants living in southeast London. A cross-sectional survey was carried out, with face-to-face interviews using a semi-structured questionnaire about knowledge and use of health services, receipt of health promotion information and satisfaction with services. One-hundred-and-eighteen Ugandan migrants residing in the London boroughs of Lambeth, Southwark or Lewisham, selected using non-probability snowball techniques, completed interviews between June and December 1996. Ninety-seven per cent were registered with a local GP and 94% of people reported having been to the GP, of whom 98% had been in the past year. Sixty-nine per cent had had contact with at least one African organization. The vast majority of health promotion information was received from GP surgeries. Sixty-one per cent of respondents desired further information on HIV/AIDS, while 56% indicated that the GP surgery was the most convenient place to receive this information. A large majority of the Ugandan migrants in this study were avid users of primary care and felt it was the most convenient place to receive health promotion information. HIV prevention strategies in sub-Saharan African communities should integrate the work of African community organizations and primary care providers.