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ObjectivesThe COVID-19 pandemic has substantially affected workers mental health. We investigated changes in UK workers mental health by industry, social class, and occupation and differential effects by UK country of residence, gender and age. MethodsWe used representative Understanding Society data from 6,474 adults (41,207 observations) in paid employment who participated in pre-pandemic (2017-2020) and at least one COVID-19 survey. The outcome was psychological distress (General Health Questionnaire-12; score>=4). Exposures were industry, social class and occupation and are examined separately. Mixed-effects logistic regression was used to estimate relative (OR) and absolute (%) increases in distress before and during pandemic. Differential effects were investigated for UK countries of residence (Non-England/England), gender (Male/female), and age (Younger/Older) using 3-way interaction effects. ResultsPsychological distress increased in relative terms most for professional, scientific and technical (OR:3.15, 95% CI 2.17-4.59) industry in the pandemic versus pre-pandemic period. Absolute risk increased most in hospitality (+11.4%). For social class, small employers/self-employed were most affected in relative and absolute terms (OR:3.24, 95% CI 2.28-4.63; +10.3%). Across occupations Sales and customer service (OR:3.01, 95% CI 1.61-5.62; +10.7%) had the greatest increase. Analysis with 3-way interactions showed considerable gender differences, while for UK country of residence and age results are mixed. ConclusionsPsychological distress increases during the COVID-19 pandemic were concentrated among professional and technical and hospitality industries, small employers/self-employed and sales and customers service workers. Female workers often exhibited greater differences in risk by industry and occupation. Policies supporting these industries and groups are needed. O_TEXTBOXWhat is already known about this subject?Employment has been disrupted by the COVID-19 pandemic and non-pharmaceutical interventions (e.g. national and regional lockdowns) introduced to control the pandemic. The pandemic has impacted on different occupational groups in different ways and has been linked to substantial deteriorations in mental health. What are the new findings?The effect of the COVID-19 pandemic on mental health has been particularly pronounced for those working in professional and technical industries, hospitality, customer service occupations, small employers and the self-employed as well as female workers. How might this impact on policy or clinical practice in the foreseeable future?Policies should prioritise support to certain industries, occupations, the self-employed/small business owners, and particular demographic groups (e.g., women in sales and customer service occupations, younger construction or non-England workers in Public Administration and Defence) with high risk. C_TEXTBOX
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BackgroundThere are concerns that COVID-19 mitigation measures, including the "lockdown", may have unintended health consequences. We examined trends in mental health and health behaviours in the UK before and during the initial phase of the COVID-19 lockdown and differences across population subgroups. MethodsRepeated cross-sectional and longitudinal analysis of the UK Household Longitudinal Study, including representative samples of adults (aged 18+) interviewed in four survey waves between 2015 and 2020 (n=48,426). 9,748 adults had complete data for longitudinal analyses. Outcomes included psychological distress (General Health Questionnaire-12 (GHQ)), loneliness, current cigarette smoking, use of e-cigarettes and alcohol consumption. Cross-sectional prevalence estimates were calculated and multilevel Poisson regression assessed associations between time period and the outcomes of interest, as well as differential associations by age, gender, education level and ethnicity. ResultsPsychological distress increased one month into lockdown with the prevalence rising from 19.4% (95% CI 18.7%-20.0%) in 2017-19 to 30.3% (95% CI 29.1%-31.6%) in April 2020 (RR=1.3, 95% CI: 1.1,1.4). Groups most adversely affected included women, young adults, people from an Asian background and those who were degree educated. Loneliness remained stable overall (RR=0.9, 95% CI: 0.6,1.5). Smoking declined (RR=0.9, 95% CI=0.8,1.0) and the proportion of people drinking four or more times per week increased (RR=1.4, 95% CI: 1.3,1.5), as did binge drinking (RR=1.5, 95% CI: 1.3,1.7). ConclusionsPsychological distress increased one month into lockdown, particularly among women and young adults. Smoking declined, but adverse alcohol use generally increased. Effective measures are required to mitigate adverse impacts on health. O_LSTWhat is already known on this topicC_LSTO_LICountries around the world have implemented radical COVID-19 lockdown measures, with concerns that these may have unintended consequences for a broad range of health outcomes. C_LIO_LIEvidence on the impact of lockdown measures on mental health and health-related behaviours remains limited. C_LI O_LSTWhat this study addsC_LSTO_LIIn the UK, psychological distress markedly increased during lockdown, with women particularly adversely affected. C_LIO_LICigarette smoking fell, but adverse drinking behaviour generally increased. C_LI
