Changes in economic activity and mental distress among young adults during the COVID-19 pandemic: Differences between the first and second infection waves in the UK

BACKGROUND: While infection rates, lockdown policies, and labor market conditions substantially varied across COVID-19 waves, the majority of evidence on young adults' mental health remains focused on initial responses in early 2020. The variability of the relationship between economic activity and mental health over time therefore remains poorly understood in this age group. METHODS: Using linear mixed models, we investigated the relationship between current activity and changes in activity and mental distress (GHQ-12) among 1,390 young adults aged 16-34 via the UK Household Longitudinal Study COVID-19 survey. The association was explored in the first (from April to July 2020) and second (from September 2020 to March 2021) infection waves. Current activity was defined as "not working", "working = 35 hours/week". Changes in activity were derived from current and pre-pandemic working hours and divided into four categories: "working with no reduced hours", "working fewer hours", "no longer working", and "did not work before the pandemic". RESULTS: During the first wave, no association reached statistical significance. During the second wave: 1) compared to "currently not working", working 35 or more hours was associated with decreased distress (b = -1.54; 95%CI -2.39, -0.69) and working less than 17.5 hours was not (b = -0.62; 95%CI -1.66, 0.41); 2) compared to "working with no reduced hours compared with before the outbreak", no longer working was associated with increased distress (b = 1.58, 95%CI 0.61, 2.55) and working with reduced hours was not (b = 0.47, 95%CI -0.24, 1.17). CONCLUSION: Above the mental health inequalities experienced at the start of the pandemic, full-time work-even with variation in work hours-continued to be a protective factor against mental distress among young adults during the second wave in the UK. Stable, full-time work can better support this age group's mental well-being over time

The mental and physical health of young carers: a systematic review

The health of those who care for someone with a health condition or advanced age is poorer, on average, than non-carers. However, the health of young carers (<18 years of age) has been under-researched, especially in quantitative studies. This systematic review aimed to summarise studies assessing the mental and physical health of young carers. 1162 unique studies were screened and 14 associations between being a young carer and health were identified (two studies were treated as a single unit of analysis as they had information from the same sample). Most of the included studies were done in the UK, with the remaining studies done in the USA, Canada, Australia, and Austria. A cross-European study of 21 countries was also included. Five of the included studies investigated both mental and physical health outcomes, seven studies investigated only mental health outcomes, and one study investigated only physical health outcomes of being a young carer. All of the included studies, except one, were cross-sectional in design. Most studies found that young carers had poorer physical and mental health, on average, than their non-caregiving peers. However, the evidence is relatively weak and more quantitative research is needed, particularly research that is longitudinal in design and assesses physical health outcomes

Unemployment and inflammatory markers in England, Wales and Scotland, 1998-2012: Meta-analysis of results from 12 studies.

Unemployment represents for many affected individuals a substantial source of psychosocial stress, and is linked to both increased risk of morbidity and mortality and adverse health-related behaviours. Few studies have examined the association of unemployment with systemic inflammation, a plausible mediator of the associations of psychosocial stress and health, and results are mixed and context dependent. This study examines the association of unemployment with C-reactive protein (CRP) and fibrinogen, two markers of systemic inflammation.A random-effects meta-analysis was performed using a multilevel modelling approach, including 12 national UK surveys of working-age participants in which CRP and fibrinogen were measured between 1998 and 2012 (N=30,037 economically active participants). The moderating impact of participant age and UK country was explored.CRP and fibrinogen were elevated in unemployed compared to employed participants; jobseekers were also more likely (Odds Ratio: 1.39, p3mg/L), after adjustment for age, gender, education, long-term illness, smoking, and body mass index. Associations were not explained by mental health. Associations peaked in middle-age, and were stronger in Scotland and Wales than in England.Our study demonstrates that systemic inflammation is associated with an important but little-studied aspect of the social environment, as it is elevated in unemployed compared to employed survey participants. Modifications suggest the association of unemployment and inflammation is substantially influenced by contextual factors, and may be especially strong in Wales, where further investigation of this relationship is needed

Role of inflammation in the socioeconomic inequalities of neurocognitive disorders

Background: Socioeconomic position has been shown to be associated with inflammation. However, little is known about the role of inflammation in socioeconomic inequalities in relation to neurocognitive disorders in later life and the potential underlying inflammatory mechanisms. This study has used longitudinal data to investigate the mediation effects of inflammation in the relationship between socioeconomic position and neurocognitive disorders in older adults. // Methods: Using data from the English Longitudinal Study of Ageing (ELSA, n = 4,815), we ascertained neurocognitive disorders using a recognised consensus criterion and included the following categories: (1) No Cognitive Impairment (NOCI) (2) Cognitive Impairment No Dementia (CIND) and (3) Dementia. We examined whether socioeconomic position (education, occupation, and wealth) measured in 2008/09 was associated with neurocognitive disorders measured in 2018/19. Mediation analyses were carried out to investigate the role of inflammatory markers [C-Reactive Protein (CRP), plasma fibrinogen and white blood cells (WBC)] in the association between socioeconomic inequalities and subsequent neurocognitive disorders. Sensitivity analyses were conducted to assess the mediating role of lifestyle behaviours and body mass index (BMI). // Results: Higher education, occupation and wealth were longitudinally associated with a lower likelihood of cognitive impairment and dementia. WBC mediated the association between latent socioeconomic position and CIND [β = -0.037 (CI: −0.06 to −0.01)], but not the association with dementia. Indirect effects were attenuated but remained significant when other mediators, such as lifestyle behaviours and BMI were considered. In a separate analysis accounting for main confounders, CRP and fibrinogen mediated the association between education and CIND, all three inflammatory biomarkers mediated the association of occupation and CIND, while WBC mediated the association between wealth and CIND. // Conclusion: These findings emphasise that socioeconomic inequalities in mid and later life could contribute to the prevalence of neurocognitive disorders in later life. Our results provide some evidence for the biological embedding of WBC in the association between socioeconomic inequalities and cognitive impairment via elevated inflammation. Future studies should explore other plausible biological mechanisms

Individualization, opportunity and jeopardy in American women's work and family lives: A multi-state sequence analysis

AbstractLife course sociologists are increasingly concerned with how the general character of biographies is transformed over historical time – and with what this means for individual life chances. The individualization thesis, which contends that contemporary biographies are less predictable, less orderly and less collectively determined than were those lived before the middle of the 20th century, suggests that life courses have become both more internally dynamic and more diverse across individuals. Whether these changes reflect expanding opportunities or increasing jeopardy is a matter of some debate. We examine these questions using data on the employment, marital and parental histories, over the ages of 25–49, for five birth cohorts of American women (N=7150). Our results show that biographical change has been characterized more by growing differences between women than by increasing complexity within individual women's lives. Whether the mounting diversity of work and family life paths reflects, on balance, expanding opportunities or increasing jeopardy depends very much on the social advantages and disadvantages women possessed as they entered their prime working and childrearing years

Age at first birth and cardiovascular risk factors in the 1958 British birth cohort

Background To assess relationships between age at first birth and cardiovascular risk factors in a large longitudinal study of men and women. By assessing associations for both genders, we were able to investigate biological versus social and behavioural explanations from early life through to adulthood. Methods Multiply-imputed data on more than 7600 men and women of a British birth cohort study (National Child Development Study, 1958 British birth cohort) were used. Cardiovascular risk factors at age 44/45 years included body mass index, waist:hip ratio, blood pressure (systolic and diastolic), cholesterol (total, low and highdensity lipoprotein), triglycerides, glycated haemoglobin, C reactive protein, von Willebrand factor and fibrinogen. Age at first birth was categorised as 34 years. Results Being younger than 20 years of age at time of first birth was associated with an adverse cardiovascular profile by mid-life. Conversely, older parents had a lower cardiovascular risk as captured by lower body mass index, waist:hip ratio, blood pressure, high and lowdensity lipoprotein cholesterol, triglycerides, glycated haemoglobin, C reactive protein and fibrinogen. The relationship between age at first birth and cardiovascular risk factors was graded. Few differences between men and women were observed. Associations were largely unchanged after adjustment for early life factors but were partially mediated through adult social and behavioural factors. Conclusions Age at first birth is inversely associated with differences in cardiovascular risk factors in mid-life in a large prospective birth cohort. Our results potentially suggest a social and behavioural rather than a biological explanation

A Bourdieusian Latent Class Analysis of Cultural, Arts, Heritage and Sports Activities in the UK Representative Understanding Society Dataset

To Bourdieu, interaction with culture has symbolic power and drives the manifestation of social stratification. Many have adapted his theory and methodology, developing new models of cultural engagement. Here, to further integrate these theoretical and methodological approaches, Bourdieu’s tools were used to operationalise and interpret a Latent Class Analysis of cultural engagement in the Understanding Society dataset. Six classes of increasing engagement were established, and were increasingly correlated with youth, capital and social advantage. However, some qualitative differences in engagement were also seen. The classes also varied by which characteristics correlated with membership. For example, economic capital was associated with sports engagement, while advantaged social position was associated with broad-scale engagement. Overall, this analysis combined Bourdieusian theory with contemporary methodology in the largest representative UK dataset and highlights the broader relevance of cultural engagement patterns in indicating (and possibly generating) status, identity, capital and social position

Do social relationships mediate or moderate social inequalities in health? A systematic review protocol

INTRODUCTION: Explanations for health inequalities include material, behavioural and psychosocial pathways. Social relationships are an important determinant of health, and research has consistently found that a lack of support networks may diminish favourable health outcomes. There is some evidence that social network structures, partly shaped by socioeconomic factors, contribute to health inequalities. This protocol will summarise the systematic review process. METHODS AND ANALYSES: The Systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic database search of MEDLINE, Embase Classic + Embase and PsychINFO using the OvidSP platform will be undertaken. Databases will be searched from the earliest date of entry until 10 June 2022. Articles that have quantitatively assessed the role of social relationships in mediating or moderating health inequalities will be included and any health outcome (mental/physical) will be considered. The database search will be supplemented by reference list screening of all relevant full-text articles identified through the search. Two independent reviewers will be responsible for screening of articles, data extraction and assessment of bias. Observational studies will be risk assessed for bias using a modified version of the Newcastle-Ottawa Quality Assessment Scale, and intervention studies will be assessed using the revised Cochrane risk-of-bias tool. It is anticipated that the eligible studies will be highly variable; therefore, a meta-analysis will only be considered if the available data of the selected studies are similar. If the studies are too heterogeneous, a narrative synthesis of the extracted data will be presented. CONCLUSION: The results of the systematic review will examine the link between social relationships and health inequalities. The findings of the review will identify gaps in knowledge where further research is needed. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42020181706

Does providing informal care in young adulthood impact educational attainment and employment in the UK?

Most research on the effects of caring has focused on older spouses or working-age carers providing care for older people, but providing care in early adulthood may have longer-term consequences, given the importance of this life stage for educational and employment transitions. This study aims to investigate the impact of informal care in early adulthood on educational attainment and employment in the UK and to test whether these associations differ by gender or socio-economic circumstances. Data are from young adults (age 16–29 at first interview, n = 27,209) in the UK Household Longitudinal Study wave 1 (2009/11) to wave 10 (2018/2020). Carers are those who provide informal care either inside or outside the household. We also considered six additional aspects of caring, including weekly hours spent caring, number of people cared for, relationship to care recipient, place of care, age at which caring is first observed, and duration of care. Cox regression was used to analyse the association between caring and educational qualifications and employment transitions. We found that young adult carers were less likely to obtain a university degree and enter employment compared to young adults who did not provide care. In terms of care characteristics, weekly hours spent caring were negatively associated with the likelihood of obtaining a university degree qualification and being employed. Providing care after full-time education age negatively influenced employment entry, but having a university degree buffered the negative influence of providing care on entering employment. The influence on unemployment may be stronger for female carers than for male carers. Our results highlight the importance of supporting the needs of young adults who are providing informal care while making key life course transitions

Inequalities in associations between young adult caregiving and social relationships: Evidence from the UK Household Longitudinal Study

Introduction: Young adult caregivers (aged 16–29 years) are an important but underrecognized group of informal caregivers. There is some evidence suggesting that young adult caregivers have fewer social relationships. However, this research has been largely cross-sectional in design or restricted to caregivers, providing no comparison with noncaregivers. Further, there is little evidence on whether and to what extent there are inequalities in associations between young adult caregiving and social relationships by gender, age, caregiving intensity, or household income./ Methods: Using five waves of data on 3-4000 young adults aged 16–29 from the UK Household Longitudinal Study, we investigated associations between becoming a young adult caregiver and subsequent social relationships (number of close friends and participation in organized social activities) in the short-term (1–2 years after caregiving initiation) and longer-term (4–5 years later). We also assessed differences by gender, age, household income, and caregiving intensity./ Results: Overall, those who became young adult caregivers, and particularly those providing 5+ h/week, reported fewer friends in the short- but not longer-term. No associations were observed between young adult caregiving and participation in organized social activities. Also, there was no evidence of differences by gender, age, income, or caregiving hours./ Conclusions: Becoming a young adult caregiver is associated with a reduction in number of close friends, particularly in the short-term. Given the importance of practical and emotional support provided by friends, the early identification of young adult caregivers and greater population awareness of caring in young adulthood may help to mitigate the effects on social relationships