The UK Coronavirus Job Retention Scheme and diet, physical activity, and sleep during the COVID-19 pandemic: evidence from eight longitudinal population surveys
Tóm tắt
In March 2020, the UK implemented the Coronavirus Job Retention Scheme (furlough) to minimise job losses. Our aim was to investigate associations between furlough and diet, physical activity, and sleep during the early stages of the COVID-19 pandemic. We analysed data on 25,092 participants aged 16–66 years from eight UK longitudinal studies. Changes in employment, including being furloughed, were based on employment status before and during the first lockdown. Health behaviours included fruit and vegetable consumption, physical activity, and sleep. Study-specific estimates obtained using modified Poisson regression, adjusting for socio-demographic characteristics and pre-pandemic health and health behaviours, were statistically pooled using random effects meta-analysis. Associations were also stratified by sex, age, and education. Across studies, between 8 and 25% of participants were furloughed. Compared to those who remained working, furloughed workers were slightly less likely to be physically inactive (RR = 0.85; [95% CI 0.75–0.97]; I
2 = 59%) and did not differ overall with respect to low fruit and vegetable consumption or atypical sleep, although findings for sleep were heterogenous (I
2 = 85%). In stratified analyses, furlough was associated with lower fruit and vegetable consumption among males (RR = 1.11; [1.01–1.22]; I
2 = 0%) but not females (RR = 0.84; [0.68–1.04]; I
2 = 65%). Considering changes in quantity, furloughed workers were more likely than those who remained working to report increases in fruit and vegetable consumption, exercise, and hours of sleep. Those furloughed exhibited similar health behaviours to those who remained in employment during the initial stages of the pandemic. There was little evidence to suggest that adoption of such social protection policies in the post-pandemic recovery period and during future economic crises had adverse effects on population health behaviours.
Tài liệu tham khảo
Winpenny EM, Smith M, Penney T, Foubister C, Guagliano JM, Love R, et al. Changes in physical activity, diet, and body weight across the education and employment transitions of early adulthood: a systematic review and meta-analysis. Obes Rev. 2020;21:1–13. https://doi.org/10.1111/obr.12962.
Smed S, Tetens I, Lund TB, Holm L, Nielsen AL. The consequences of unemployment on diet composition and purchase behaviour: a longitudinal study from Denmark. Public Health Nutr. 2018;21:580–92.
Gough M. A couple-level analysis of participation in physical activity during unemployment. SSM - Popul Heal. 2017;3:294–304.
Blanchflower DG, Bryson A. Unemployment disrupts sleep. Cambridge: Econ Hum Biol; 2021. https://doi.org/10.1016/j.ehb.2021.101042.
Office for National Statistics. Coronavirus and the latest indicators for the UK economy and society: 18 February 2021. https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/coronavirustheukeconomyandsocietyfasterindicators/18february2021. Accessed 19 Feb 2021.
International Monetary Fund. The great lockdown: worst economic downturn since the great depression. 2020. https://blogs.imf.org/2020/04/14/the-great-lockdown-worst-economic-downturn-since-the-great-depression/. Accessed 19 May 2021.
Dias MC, Joyce R, Postel-Vinay F, Xu X. The challenges for labour market policy during the Covid-19 pandemic. https://www.ifs.org.uk/publications/14767. Accessed 16 Apr 2021.
Powell A, Francis-Devine B, Foley N, House of Commons Library. Coronavirus: impact on the labour market. 2021;:1–13. https://commonslibrary.parliament.uk/research-briefings/cbp-8898/. Accessed 19 May 2021.
Office for National Statistics. Comparison of furloughed jobs data, UK: March 2020 to June 2021. 2021. https://www.ons.gov.uk/businessindustryandtrade/business/businessservices/articles/comparisonoffurloughedjobsdata/march2020tojune2021.
Adams-Prassl A, Boneva T, Golin M, Rauh C. Furloughing*. Fisc Stud. 2020;41:591–622. https://doi.org/10.1111/1475-5890.12242.
Green MJ, Maddock J, Di GG, Wielgoszewska B, Parsons S, Griffith GJ, et al. The UK COVID-19 furlough scheme and associations with smoking, alcohol consumption and vaping: evidence from 8 UK longitudinal population surveys. medRxiv. 2021;2021.10.28.21265593. https://doi.org/10.1101/2021.10.28.21265593.
Joshi H, Fitzsimons E. The Millennium Cohort Study: the making of a multi-purpose resource for social science and policy. Longit Life Course Stud. 2016;7:409–30. https://doi.org/10.14301/llcs.v7i4.410.
Matt Brown A, Goodman A, Peters A, Ploubidis GB, Sanchez A, Silverwood R, et al. COVID-19 survey in five national longitudinal studies waves 1, 2 and 3 user guide (Version 3) How to cite this guide. 2021. www.cls.ucl.ac.uk. Accessed 25 Jan 2022.
Boyd A, Golding J, Macleod J, Lawlor DA, Fraser A, Henderson J, et al. Cohort profile: the ‘children of the 90s’-the index offspring of the Avon longitudinal study of parents and children. Int J Epidemiol. 2013;42:111–27. https://doi.org/10.1093/ije/dys064.
Northstone K, Smith D, Bowring C, Wells N, Crawford M, Haworth S, et al. The Avon longitudinal study of parents and children - a resource for COVID-19 research: questionnaire data capture May-July 2020. Wellcome open Res. 2020;5. https://doi.org/10.12688/WELLCOMEOPENRES.16225.2.
Calderwood L, Sanchez C. Next Steps (formerly known as the Longitudinal Study of Young People in England). Open Heal Data. 2016;4:2. https://doi.org/10.5334/OHD.16.
Elliott J, Shepherd P. Cohort profile: 1970 British birth cohort (BCS70). Int J Epidemiol. 2006;35:836–43. https://doi.org/10.1093/ije/dyl174.
Power C, Elliott J. Cohort profile: 1958 British birth cohort (National Child Development Study). Int J Epidemiol. 2006;35:34–41. https://doi.org/10.1093/ije/dyi183.
University of Essex, Institute for Social and Economic Research. Understanding society: Waves 1-11, 2009-2020 and Harmonised BHPS: Waves 1-18, 1991-2009: Special Licence Access. [data collection]. 14th Edition. UK Data Service. SN: 6931. 2022. https://doi.org/10.5255/UKDA-SN-6931-13.
Institute for Social and Economic Research. Understanding society COVID-19. User guide. Version 10.0, October 2021. Colchester: University of Essex; https://www.understandingsociety.ac.uk/sites/default/files/downloads/documentation/covid-19/user-guides/covid-19-user-guide.pdf.
Steptoe A, Breeze E, Banks J, Nazroo J. Cohort profile: the English longitudinal study of ageing. Int J Epidemiol. 2013;42:1640–8.
Steptoe A, Addario G, Banks J, Batty D, Coughlin K, Crawford R, et al. English longitudinal study of ageing COVID-19 study, waves 1-2, 2020. [data collection]. 2nd edition. SN: 8688: UK Data Service; 2021. https://doi.org/10.5255/UKDA-SN-8688-3.
Smith BH, Campbell A, Linksted P, Fitzpatrick B, Jackson C, Kerr SM, et al. Cohort profile: Generation Scotland: Scottish Family Health Study (GS:SFHS). The study, its participants and their potential for genetic research on health and illness. Int J Epidemiol. 2013;42:689–700. https://doi.org/10.1093/IJE/DYS084.
Fawns-Ritchie C, Altschul DM, Campbell A, Huggins C, Nangle C, Dawson R, et al. CovidLife: a resource to understand mental health, well-being and behaviour during the COVID-19 pandemic in the UK. Wellcome Open Res. 2021;2021(6176):6:176. https://doi.org/10.12688/wellcomeopenres.16987.1.
Fraser A, Macdonald-wallis C, Tilling K, Boyd A, Golding J, Davey Smith G, et al. Cohort profile: the Avon Longitudinal Study of Parents and Children: ALSPAC mothers cohort. Int J Epidemiol. 2013;42:97–110. https://doi.org/10.1093/IJE/DYS066.
Moizer J, Farrar S, Hyde M. UK state pension deferral incentives and sustainability. Appl Econ. 2018;50:2356–68. https://doi.org/10.1080/00036846.2017.1397850.
Brown M, Goodman A, Peters A, Ploubidis GB, Sanchez A, Silverwood R, et al. COVID-19 survey in five national longitudinal studies: waves 1 and 2 user guide (Version 2). London; 2020. https://cls.ucl.ac.uk/covid-19-survey/content-and-data/. Accessed 19 May 2021
Aune D, Giovannucci E, Boffetta P, Fadnes LT, Keum NN, Norat T, et al. Fruit and vegetable intake and the risk of cardiovascular disease, total cancer and all-cause mortality-a systematic review and dose-response meta-analysis of prospective studies. Int J Epidemiol. 2017;46:1029–56. https://doi.org/10.1093/ije/dyw319.
Department of Health and Social Care. UK. Chief Medical Officers’ physical activity guidelines. 2019. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/832868/uk-chiefmedical-officers-physical-activity-guidelines.pdf.
United Kingdom National Health Service. How to get to sleep - NHS. 2019. https://www.nhs.uk/live-well/sleep-and-tiredness/how-to-get-to-sleep/. Accessed 19 May 2021.
Zou G. A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159:702–6. https://doi.org/10.1093/aje/kwh090.
Pang M, Kaufman JS, Platt RW. Studying noncollapsibility of the odds ratio with marginal structural and logistic regression models. Stat Methods Med Res. 2016;25:1925–37. https://doi.org/10.1177/0962280213505804.
Trikalinos TA, Hoaglin DC, Schmid CH. An empirical comparison of univariate and multivariate meta-analyses for categorical outcomes. Stat Med. 2014;33:1441–59. https://doi.org/10.1002/sim.6044.
Price MJ, Blake HA, Kenyon S, White IR, Jackson D, Kirkham JJ, et al. Empirical comparison of univariate and multivariate meta-analyses in Cochrane Pregnancy and Childbirth reviews with multiple binary outcomes. Res Synth Methods. 2019;10:440–51. https://doi.org/10.1002/jrsm.1353.
Puig-Barrachina V, Giró P, Artazcoz L, Bartoll X, Cortés-Franch I, Fernández A, et al. The impact of active labour market policies on health outcomes: a scoping review. Eur J Public Health. 2020;30:36–42. https://doi.org/10.1093/eurpub/ckz026.
Korpi T. Is utility related to employment status? Employment, unemployment, labor market policies and subjective well-being among Swedish youth. Labour Econ. 1997;4:125–47.
Bann D, Villadsen A, Maddock J, Hughes A, Ploubidis GB, Silverwood R, et al. Changes in the behavioural determinants of health during the COVID-19 pandemic: gender, socioeconomic and ethnic inequalities in five British cohort studies. J Epidemiol Community Health. 2021;0:jech-2020-215664. https://doi.org/10.1136/jech-2020-215664.
Niedzwiedz CL, Green MJ, Benzeval M, Campbell D, Craig P, Demou E, et al. Mental health and health behaviours before and during the initial phase of the COVID-19 lockdown: longitudinal analyses of the UK Household Longitudinal Study. J Epidemiol Commun Health. 2021;75:224–31. https://doi.org/10.1136/jech-2020-215060.
Dorling D. Unemployment and health. BMJ (Online). 2009;338:1091. https://doi.org/10.1136/bmj.b829.
Bartley M. Unemployment and ill health: understanding the relationship. J Epidemiol Commun Health. 1994;48:333–7. https://doi.org/10.1136/jech.48.4.333.
Kim TJ, Von Dem Knesebeck O. Is an insecure job better for health than having no job at all? A systematic review of studies investigating the health-related risks of both job insecurity and unemployment. BMC Public Health. 2015;15. https://doi.org/10.1186/s12889-015-2313-1.
Bambra C. Work, worklessness and the political economy of health inequalities. J Epidemiol Commun Health. 2011;65:746–50. https://doi.org/10.1136/jech.2009.102103.
Roelfs DJ, Shor E, Davidson KW, Schwartz JE. Losing life and livelihood: a systematic review and meta-analysis of unemployment and all-cause mortality. Soc Sci Med. 2011;72:840–54. https://doi.org/10.1016/j.socscimed.2011.01.005.
Nandi A, Charters TJ, Strumpf EC, Heymann J, Harper S. Economic conditions and health behaviours during the “Great Recession”. J Epidemiol Commun Health. 2013;67:1038–46. https://doi.org/10.1136/jech-2012-202260.
Mostafa T, Narayanan M, Pongiglione B, Dodgeon B, Goodman A, Silverwood RJ, et al. Missing at random assumption made more plausible: evidence from the 1958 British birth cohort. J Clin Epidemiol. 2021;136:44–54.