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How vulnerable are we in a pandemic and who is actually the hardest hit?

Jesper Sundewall and Marta Skibild Stenz. foto.
Jesper Sundewall and Marta Skibild Stenz.

Many people feel mentally unwell during the pandemic, especially, it seems, those who are already exposed to socio-economic inequalities. But who really suffers the most when restrictions, loneliness, depression have become commonplace? Researchers from Lund University have tried to find out in a cross-sectional study where young adults are identified as a particularly vulnerable group.

After more than a year with the coronavirus pandemic, we know more and more about how the virus affects the body. At the same time, there are studies on how our mental health is affected by all the things the pandemic does to society. But so far, there are few research results, especially in relation to Swedish conditions. In a recent survey from Lund University, people living in Sweden answered questions about their self-perceived health before and during the pandemic.

"Our analyses show that people under the age of 30 feel to a greater extent that the pandemic has a negative impact on their physical and mental health," says Jesper Sundewall, associate researcher and head of the project, which was part of a student's master's thesis in the Public Health Programme at Lund University.

The study confirms that the pandemic is causing noticeable changes in the mental and physical health of the population. A low level of education was identified as a risk factor for loss of income and poorer perceived mental health. People born abroad also appear to be at greater risk of poorer perceived mental health and loss of income. The researchers argue that these results highlight the groups in society that experience the greatest self-reported impact of the pandemic in terms of physical, mental and economic well-being. They also provide an indication of socio-economic and demographic factors that may be associated with perceived deterioration in health.

"Identifying particularly vulnerable groups is very important for society to be able to offer more targeted support to these groups during the pandemic and during future crises. It is in fact necessary to prevent the continued development of long-term socio-economic inequalities in Sweden," says Jesper Sundewall.

The researchers have not looked into what kind of support vulnerable groups may need, what other countries have done or what is effective. They believe that more knowledge about the impact is needed because measures can be more or less effective in different countries and contexts.

The voice of the people was examined

The researchers designed a survey based in part on the 3-D Commission People's Voice Survey from Boston University, USA. The questions adapted to Swedish conditions were linked to different outcome variables about how respondents themselves experience economic welfare, physical and mental health. In order to reach as many people as possible at the same time, the survey was translated into four different languages, Swedish, English, Arabic and Somali, and spread via social media. More than 1,000 people responded to the survey, and a total of 636 full survey responses were analysed.

"The people who answered all the questions generally had higher education and income than the average for the population in Sweden, which may affect how representative the answers are for the population as a whole," says Marta Skibild Stenz, a student in the Public Health Programme who is behind the master's thesis and has been responsible for the data collection.

Despite an increasing number of reports indicating that the pandemic is having a negative impact on our mental and physical health, it is still difficult to determine the long-term effects of the coronavirus pandemic on public health. It is particularly difficult at this stage to identify the impact of the pandemic on psychosocial factors that may, in the long run, also contribute to increased health inequalities in society," explains Jesper Sundewall. We also know from past experience that crises tend to reinforce existing health and income inequalities. It is therefore particularly important to continue to investigate the consequences for those people who, even before the pandemic, belonged to particularly vulnerable groups.

The research project was initiated at Lund University and carried out in collaboration with researchers at Karolinska Institutet. The survey is part of a master's thesis at the Master's Programme in Public Health at Lund University. The next step is to see how the pandemic has affected people in different countries and compare the results of the Swedish survey with results from surveys conducted in Brazil, the USA, Indonesia, Germany, China, India and Egypt within the 3-D Commission People's Voice Survey.
 

Facts about the study

The research project was initiated at Lund University and carried out in collaboration with researchers at Karolinska Institutet. The survey is part of a master's thesis at the Master's Programme in Public Health at Lund University. The next step is to see how the pandemic has affected people in different countries and compare the results of the Swedish survey with results from surveys conducted in Brazil, the USA, Indonesia, Germany, China, India and Egypt within the 3-D Commission People's Voice Survey (Boston University-Rockefeller Foundation Commission on Health Determinants, Data and Decision-making).

Link to 3-D Commission

Master's thesis by Marta Skibild Stenz: "Exploring the impact of the COVID-19 pandemic on self-reported mental and physical health: a cross-sectional survey of the general adult population of Sweden"
supervisor: Jesper Sundewall (Lund University) and Olivia Biermann and Kristi Sidney Annerstedt (Karolinska Institutet)

Brief facts about the study:

Subject: Public health
Type of publication: Master's thesis
Study design:Quantitative study, survey study
Observational study: Cross-sectional study
 

Public health during the pandemic


The Public Health Agency of Sweden's compilation of international research showing that mental well-being seems to have decreased at the same time as mental health problems have increased during the pandemic. However, there seems to be a correlation between reporting mental health problems and having been ill in COVID-19 or having a relative or acquaintance who has been ill. The Public Health Agency of Sweden's own survey in Sweden gives a slightly different picture. The proportion of people who report mental health problems is not very different from figures reported under normal circumstances. The survey also showed that 13 percent of older adults felt very worried about becoming seriously ill in COVID-19. One in 10 were also very worried about not getting care if they needed it. However, the results show that some groups have been affected more than others, and those who were already living in conditions that put them at increased risk of ill health seem to have had a more difficult time during the pandemic. Health promotion and prevention need to be strengthened and prioritised to maintain good public health and reduce health inequalities. All in all, broader work is needed in the various areas of the welfare society in order for everyone to have good conditions for growing up, reasonable livelihoods, education and safe living conditions.

Source: Public Health Agency of Sweden