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Mental health in relation to changes in sleep, exercise, alcohol and diet during the COVID-19 pandemic: examination of four UK cohort studies

Published online by Cambridge University Press:  16 December 2021

Aase Villadsen Open the ORCID record for Aase Villadsen [Opens in a new window] ,
Praveetha Patalay Open the ORCID record for Praveetha Patalay [Opens in a new window]  and
David Bann Open the ORCID record for David Bann [Opens in a new window]
Aase Villadsen*
Affiliation:
Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
Praveetha Patalay
Affiliation:
Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK MRC Unit for Lifelong Health and Ageing, Population Science and Experimental Medicine, UCL, London, UK
David Bann
Affiliation:
Centre for Longitudinal Studies, Social Research Institute, University College London, London, UK
*
Author for correspondence: Aase Villadsen, E-mail: [email protected]
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Abstract

Background

Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health.

Methods

We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis.

Results

Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2–26.2) before lockdown, 25.5% (20.0–30.3) in May and 28.2% (21.2–35.2) in September.

Conclusions

Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

Keywords

Alcohol useCOVID-19 pandemicdietexerciseinequalities in health behavioursmental healthsleep
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 7 , May 2023 , pp. 2748 - 2757
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press.

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