Gendered impact of the pandemic on mental health

Background

Cast your mind back to the spring of 2020. As the crocuses and daffodils started to, we were hearing rumblings about a new virus. As the days went on, and the Facebook U was filled with infectious disease experts, it became clear that we were in for an “unprecedented” public health emergency. I would gather around the TV with my flatmates, watching Downing Street briefings, waiting to see what was going to happen. March 2023 was just the beginning. As we headed into lockdowns, we had no way of knowing that more than 3 million people would die in 2020 alone from a disease that we had not even heard of months earlier.

In the UK, a national lockdown was implemented from March 23 through May 11, after which some restrictions were relaxed. This lockdown included strict measures about permitted reasons to leave your house (e.g. daily exercise, walking dogs, or going grocery shopping). Schools were closed and students moved to online learning from home. Most offices were shut, and any non-essential workers started working from home, converting kitchen tables and bedrooms into office space. Bars and restaurants were closed and all other forms of socialising were prohibited.

These restrictions, while necessary for the containment of a major infectious disase threat, caused disruption and distress. People were facing the stress of a largely unknown threat, daily uncertainty, and stress.

Without a doubt, many people were struggling, unmoored from the activities of “normal” life, facing the constant stress of an unknown threat, heightened worry about vulnerable loved ones, and uncertainty of everyday life.

This struggle has been quantified by research, with many studies showing that mental health declined substantially during the pandemic compared to pre-pandemic levels.

Importantly, this deterioration in mental health was not experienced equally for all in the population, and research has found that women experienced a more substantial decrease in their mental health compared to men. This deterioration of mental health was seen most dramatically in women,¹ however explanations for this gender difference have not yet been explored.²

There are many possible drivers for the gendered impact of the pandemic on mental health, including women being more likely to face:

• A disproportionate burden of housework and unpaid domestic labour

• Extra childcare responsibilities, including overseeing online education

• Higher levels of employment disruption (e.g. being laid off or “furloughed”, having hours cut/reducing hours due to domestic responsibilities, or losing jobs in impacted industries)

• Elevated feelings of loneliness

Hypothesised pathways between gender and mental healh

Why did we do this study?

This paper aimed to explore these 4 possible pathways to see if the gendered impact of the pandemic on mental health can be explained by these explanations.

What did we do?

We used data from Understanding Society, a UK longitudinal household survey. This included data from over 9,000 participants who had taken part in the survey in 2019 before the pandemic, and again in 2020 (April, May, or June).

Mental health was measured using a 12-item quesionnarie (the General Health Questionnaire - GHQ-12), a way of estimating symptoms of common mental disorders like anxiety and depression.

We used structural equation modelling, a statistical analysis technique, to explore the relationship between gender and mental health, testing the four potential ‘mediating’ pathways mentioned above (housework, childcare, employment disruption, and loneliness).

What did we find?

We found that the worse mental health reported by women in the initial period of COVID-19 was partly explained by experiences of loneliness. Experiences of loneliness, for example in April 2020, had a strong impact on mental health in May and continued to have an impact on mental health problems in June. This was not found to be the case for housework, childcare or employment disruption.

What does this mean?

We demonstrated that loneliness was a key driver of the worse mental health experienced by women during the pandemic.

This finding highlights the importance of supporting social connection during disruptive periods of change, such as the pandemic, to prevent mental health problems in women.

Read more

The full article was published in PLoS One and is available here

Behind the research

This paper was led by my superstar pre-doctoral fellow, Kate Dotsikas, who has since moved to Paris to continue her social epi career at the Sorbonne. Another pre-doctoral fellow, Liam Crosby, worked on this analysis as well, before moving into an exciting role in public health practice.