Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries
<strong>Background<br></strong> To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2022
|
| _version_ | 1797110609477632000 |
|---|---|
| author | Aknin, LB Andretti, B Goldszmidt, R Helliwell, JF Petherick, A De Neve, J-E Dunn, E Fancourt, D Goldberg, E Jones, SP Karadag, O Karam, E Layard, R Saxena, S Thornton, E Whillans, A Zaki, J |
| author_facet | Aknin, LB Andretti, B Goldszmidt, R Helliwell, JF Petherick, A De Neve, J-E Dunn, E Fancourt, D Goldberg, E Jones, SP Karadag, O Karam, E Layard, R Saxena, S Thornton, E Whillans, A Zaki, J |
| author_sort | Aknin, LB |
| collection | OXFORD |
| description | <strong>Background<br></strong>
To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic.
<br><strong>
Methods<br></strong>
In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy).
<br><strong>
Findings<br></strong>
Controlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·014 [95% CI 0·005 to 0·023] for psychological distress; β=–0·010 [–0·015 to –0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·016 [0·008 to 0·025] for psychological distress; β=–0·010 [–0·017 to –0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed.
<br><strong>
Interpretation<br></strong>
Changes in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects. |
| first_indexed | 2024-03-07T07:57:12Z |
| format | Journal article |
| id | oxford-uuid:3bc93069-ccb5-44a7-b6b9-1e6be9d4fc45 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:57:12Z |
| publishDate | 2022 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:3bc93069-ccb5-44a7-b6b9-1e6be9d4fc452023-09-04T15:28:58ZPolicy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countriesJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3bc93069-ccb5-44a7-b6b9-1e6be9d4fc45EnglishSymplectic ElementsElsevier2022Aknin, LBAndretti, BGoldszmidt, RHelliwell, JFPetherick, ADe Neve, J-EDunn, EFancourt, DGoldberg, EJones, SPKaradag, OKaram, ELayard, RSaxena, SThornton, EWhillans, AZaki, J<strong>Background<br></strong> To date, public health policies implemented during the COVID-19 pandemic have been evaluated on the basis of their ability to reduce transmission and minimise economic harm. We aimed to assess the association between COVID-19 policy restrictions and mental health during the COVID-19 pandemic. <br><strong> Methods<br></strong> In this longitudinal analysis, we combined daily policy stringency data from the Oxford COVID-19 Government Response Tracker with psychological distress scores and life evaluations captured in the Imperial College London-YouGov COVID-19 Behaviour Tracker Global Survey in fortnightly cross-sections from samples of 15 countries between April 27, 2020, and June 28, 2021. The mental health questions provided a sample size of 432 642 valid responses, with an average of 14 918 responses every 2 weeks. To investigate how policy stringency was associated with mental health, we considered two potential mediators: observed physical distancing and perceptions of the government's handling of the pandemic. Countries were grouped on the basis of their response to the COVID-19 pandemic as those pursuing an elimination strategy (countries that aimed to eliminate community transmission of SARS-CoV-2 within their borders) or those pursuing a mitigation strategy (countries that aimed to control SARS-CoV-2 transmission). Using a combined dataset of country-level and individual-level data, we estimated linear regression models with country-fixed effects (ie, dummy variables representing the countries in our sample) and with individual and contextual covariates. Additionally, we analysed data from a sample of Nordic countries, to compare Sweden (that pursued a mitigation strategy) to other Nordic countries (that adopted a near-elimination strategy). <br><strong> Findings<br></strong> Controlling for individual and contextual variables, higher policy stringency was associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·014 [95% CI 0·005 to 0·023] for psychological distress; β=–0·010 [–0·015 to –0·004] for life evaluation). Pandemic intensity (number of deaths per 100 000 inhabitants) was also associated with higher mean psychological distress scores and lower life evaluations (standardised coefficients β=0·016 [0·008 to 0·025] for psychological distress; β=–0·010 [–0·017 to –0·004] for life evaluation). The negative association between policy stringency and mental health was mediated by observed physical distancing and perceptions of the government's handling of the pandemic. We observed that countries pursuing an elimination strategy used different policy timings and intensities compared with countries pursuing a mitigation strategy. The containment policies of countries pursuing elimination strategies were on average less stringent, and fewer deaths were observed. <br><strong> Interpretation<br></strong> Changes in mental health measures during the first 15 months of the COVID-19 pandemic were small. More stringent COVID-19 policies were associated with poorer mental health. Elimination strategies minimised transmission and deaths, while restricting mental health effects. |
| spellingShingle | Aknin, LB Andretti, B Goldszmidt, R Helliwell, JF Petherick, A De Neve, J-E Dunn, E Fancourt, D Goldberg, E Jones, SP Karadag, O Karam, E Layard, R Saxena, S Thornton, E Whillans, A Zaki, J Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title | Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title_full | Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title_fullStr | Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title_full_unstemmed | Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title_short | Policy stringency and mental health during the COVID-19 pandemic: a longitudinal analysis of data from 15 countries |
| title_sort | policy stringency and mental health during the covid 19 pandemic a longitudinal analysis of data from 15 countries |
| work_keys_str_mv | AT akninlb policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT andrettib policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT goldszmidtr policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT helliwelljf policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT pethericka policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT deneveje policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT dunne policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT fancourtd policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT goldberge policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT jonessp policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT karadago policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT karame policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT layardr policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT saxenas policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT thorntone policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT whillansa policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries AT zakij policystringencyandmentalhealthduringthecovid19pandemicalongitudinalanalysisofdatafrom15countries |