Study: How is the COVID-19 pandemic affecting our lives, mental health and well-being? Design and preliminary findings of the pan-Canadian longitudinal coherence study. Image credit: Tomas Ragina/Shutterstock
Record
The onset of the COVID-19 pandemic has significantly reduced many social factors, including opportunities to access resources that promote health and well-being and personal social contacts. Patient safety efforts to limit transmission have halted economic activity, resulting in massive unemployment and income losses, limiting people’s daily mobility and the opportunity for face-to-face social communication. COVID-19 restrictions such as lockdown, confinement, and physical separation reduce social interactions, increase feelings of isolation and emotional distress, and decrease levels of social engagement. These factors have significantly affected the well-being and mental health of the world’s populations. According to data from Canada, certain populations, including teenagers, older people, women and racial communities, are disproportionately at risk of social isolation, domestic violence and stress. Restrictive measures impede daily movement and physical activity, and zones of lower activity have been associated with depressive symptoms and sleep problems. In addition, the reduction of outdoor spaces and legislative restrictions limit regular travel. Therefore, living conditions have acquired an increasingly vital role. Studies have shown that the prevalence of COVID-19 is higher among priority communities struggling under substandard social and environmental conditions. Urban sprawl and living in poor housing facilities affect mental health and well-being. In addition, constant proximity to the home environment during lockdown exacerbates these effects. Economic hardship, associated with declining wages and job insecurity, has contributed significantly to the mental health burden on Canadians – and is also linked to housing instability and food insecurity. As a result, harmful health behaviors such as alcoholism or drug abuse are increasing and have been associated with worsening mental health outcomes. In light of these conditions, there is a growing need to understand the relationships between factors such as living and neighborhood conditions and behavioral patterns, for example – transportation, interpersonal interactions, sleep and mental well-being dynamics – specifically, the unpredictable long-term effects of the ongoing COVID pandemic -19 and mitigation measures. Furthermore, the effects are likely to differ across demographic groups, for example – by gender, age, ethnic communities or level of deprivation.
The study
This study included the COHESION study. the COHESION project is a two-phase, pan-Canadian, population-based prospective cohort study. COHESION Phase 1 took place between May 2020 and September 2021. During this period, the COHESION research platform collected monthly data on COVID-19, including infection and vaccination status, beliefs and attitudes about measures related to pandemic and information about participants health and wellness, sleep, boredom, adaptability, drug use, standard of living, interpersonal relationships, events and transportation. Phase 2 COHESION started in May 2022. All participants in Phase 1 were invited to participate in Phase 2 and an additional 10,000 people were recruited. The present study reported that COHESION was unique in incorporating the Visualization and Evaluation of Itineraries, Travel Destinations, Activity Spaces and Social Interactions (VERITAS-Social) questionnaire at baseline, as well as follow-up surveys of the two phases. Modified for COHESION to specify a possible list of up to twenty tasks. Veritas-Social is an interactive map-based questionnaire that collects an individual’s social network and activity locations. It is adapted from the VERITAS tool, which provides information about places and activities. Phase 2 of COHESION will continue to apply the survey method at the health area level, based on 2016 Census data (ie, age composition, gender, income, education level and ethnicity). Researchers collected geotargeted respondents based on sampling quotas.
Results
The Phase 1 COHESION Study includes 1,268 participants who are mostly from Ontario (47%) and Quebec (33%), aged 48 ± 16 years, and are predominantly female and White, with a bachelor’s degree (63%) and live in large urban areas. The first year of follow-up showed significant temporal variation in standardized measures of well-being, anxiety, depression, loneliness, and psychological distress as indicated by monthly prospective questionnaires. Significant temporal variations in standardized indices of well-being, anxiety, depressed mood, loneliness, and emotional distress were observed during the first year of follow-up. At baseline, 72%, 14%, and 18% of subjects reported monthly use of alcohol, cigarettes and/or vaping, and cannabis, respectively. Therefore, throughout the study, well-being fell in waves, although sleep duration remained unchanged. However, loneliness levels remained higher during all follow-up waves compared to the pre-pandemic era. Furthermore, variations in mental health indicators were found throughout the follow-up period. Indices of depression and emotional stress were much lower during the holiday season.
conclusion
The study highlights the importance of monitoring and assessing the unintended consequences of the ongoing COVID-19 pandemic on mental health and health equity. They deserve effective and modified public health policies and programs, for example – pedestrianizing streets, expanding access to parks, improving housing and neighborhood conditions, providing permanent supportive housing, and implementing neighborhood greening programs. The study presents a comprehensive picture of how the COVID-19 pandemic has affected the mental health and well-being of the Canadian population. Flexible infrastructure can meet the local needs of the population and could enable a better recovery from the effects of the ongoing pandemic.
*Important note
medRxiv publishes preliminary scientific reports that have not been peer-reviewed and therefore should not be considered definitive, guide clinical practice/health-related behavior, or be treated as established information.
