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Pre-pandemic socio-economic status and changes in employment during the first lockdown (2020) on the health of middle-aged people in England: a longitudinal study

Pre-pandemic socio-economic status and changes in employment during the first lockdown (2020) on the health of middle-aged people in England: a longitudinal study
Pre-pandemic socio-economic status and changes in employment during the first lockdown (2020) on the health of middle-aged people in England: a longitudinal study

Background: The COVID-19 pandemic markedly disrupted people’s lives. It caused higher mortality and morbidity amongst individuals from poorer socio-economic position (SEP). It is well-recognised that job loss has a negative impact on health. We hypothesised that health effects of the pandemic on middle-aged people might be different depending on SEP and changes in employment. Methods: Data are from the Health and Employment After Fifty (HEAF), a cohort recruited 2013–2014 when aged 50–64 through 24 English general practices. At baseline and annually since, participants completed a questionnaire reporting about demographics, employment, health, lifestyle, and finances. In 2021 we sent an e-survey to all contactable HEAF participants, asking about effects of the first lockdown (March-July 2020). Outcomes were participants’ perception of worsening of mental, physical health, and self-rated health (SRH) since lockdown. Associations between SEP, COVID-19 related employment changes and health were explored with Poisson regression with robust standard error, with adjustment for age, sex, and pre-pandemic SRH. Results: In total, 2,469 (53%) returned a usable questionnaire, amongst whom 2,344 provided complete information for these analyses (44% men, mean age 65.7 years). Worsening of mental, physical or SRH since lockdown was reported by 21%, 27% and 17% respectively. Mutually adjusted models showed that reporting struggling financially pre-pandemic (versus living comfortably) was associated with an increased risk of deterioration in: mental (RR = 2.0, 95%CI 1.7–2.5), physical health (RR = 2.0, 95%CI 1.6–2.3), and SRH (RR = 1.6, 95%CI 1.2–2.1). Participants working from home during lockdown and those who lost their job (as opposed to those with unchanged employment) were at increased risk of reporting deterioration in mental health and SRH. Conclusion: In a cohort of older workers, working from home, job loss and poorer pre-pandemic SEP were all associated with worsening of mental health and SRH since lockdown.

COVID-19, employment changes, mental health, older workers, physical health, self-rated health, socio-economic status
1471-2458
D'angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
D'angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109

D'angelo, Stefania, Ntani, Georgia, Bloom, Ilse and Walker-Bone, Karen (2022) Pre-pandemic socio-economic status and changes in employment during the first lockdown (2020) on the health of middle-aged people in England: a longitudinal study. BMC Public Health, 22 (1), [1902]. (doi:10.1186/s12889-022-14248-9).

Record type: Article

Abstract

Background: The COVID-19 pandemic markedly disrupted people’s lives. It caused higher mortality and morbidity amongst individuals from poorer socio-economic position (SEP). It is well-recognised that job loss has a negative impact on health. We hypothesised that health effects of the pandemic on middle-aged people might be different depending on SEP and changes in employment. Methods: Data are from the Health and Employment After Fifty (HEAF), a cohort recruited 2013–2014 when aged 50–64 through 24 English general practices. At baseline and annually since, participants completed a questionnaire reporting about demographics, employment, health, lifestyle, and finances. In 2021 we sent an e-survey to all contactable HEAF participants, asking about effects of the first lockdown (March-July 2020). Outcomes were participants’ perception of worsening of mental, physical health, and self-rated health (SRH) since lockdown. Associations between SEP, COVID-19 related employment changes and health were explored with Poisson regression with robust standard error, with adjustment for age, sex, and pre-pandemic SRH. Results: In total, 2,469 (53%) returned a usable questionnaire, amongst whom 2,344 provided complete information for these analyses (44% men, mean age 65.7 years). Worsening of mental, physical or SRH since lockdown was reported by 21%, 27% and 17% respectively. Mutually adjusted models showed that reporting struggling financially pre-pandemic (versus living comfortably) was associated with an increased risk of deterioration in: mental (RR = 2.0, 95%CI 1.7–2.5), physical health (RR = 2.0, 95%CI 1.6–2.3), and SRH (RR = 1.6, 95%CI 1.2–2.1). Participants working from home during lockdown and those who lost their job (as opposed to those with unchanged employment) were at increased risk of reporting deterioration in mental health and SRH. Conclusion: In a cohort of older workers, working from home, job loss and poorer pre-pandemic SEP were all associated with worsening of mental health and SRH since lockdown.

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Accepted/In Press date: 21 September 2022
Published date: 12 October 2022
Additional Information: © 2022. The Author(s).
Keywords: COVID-19, employment changes, mental health, older workers, physical health, self-rated health, socio-economic status

Identifiers

Local EPrints ID: 471517
URI: http://eprints.soton.ac.uk/id/eprint/471517
ISSN: 1471-2458
PURE UUID: e777296b-a985-4547-945b-e7c9ef6b1993
ORCID for Stefania D'angelo: ORCID iD orcid.org/0000-0002-7267-1837
ORCID for Ilse Bloom: ORCID iD orcid.org/0000-0002-4893-1790
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

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Date deposited: 10 Nov 2022 17:30
Last modified: 12 Nov 2022 02:43

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Contributors

Author: Stefania D'angelo ORCID iD
Author: Georgia Ntani
Author: Ilse Bloom ORCID iD

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