The effect of financial support on depression among young adults during the COVID-19 pandemic

Abstract Background To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments provided financial support (e.g., emergency aid funds) as well as family via personal assistance. This study aims to assess the moderating effect of financial support from the government or from family on the association between income loss and depression among young adults. Methods Two online cross-sectional surveys among young adults (18-29) living in Canada and France were conducted in October-December 2020 (n = 4511) and July-December 2021 (n = 3329). Depressive symptoms were measured using PHQ-9 score+10. Two logistic regression models were performed for each survey with an interaction term between income loss and financial support (government or family modeled separately), controlling for demographics (e.g., country, age, gender, income, living conditions). Results In the total sample, half reported depressive symptoms (2020/2021: 53%/46%), and over a third lost income (2020/2021: 10%/12% all income, 38%/22% some income). In 2020, 41% received government financial support (2021: 18%) while family/friends support was constant (12%). In both surveys, among those who received government support, income loss was associated with depression, whether participants lost all income (2020: AOR 1.75 [1.29-2.44]; 2021: AOR 2.17 [1.36-3.44]), or some income (2020: AOR 1.31 [1.17-1.81]; 2021: AOR 1.46 [0.99-2.16]). However, among those who received family support, income loss was no longer significantly associated with depression, whether participants lost all income (2020: AOR 1.37 [0.78-2.40]; 2021: AOR 1.51 [0.88-2.56]), or some income (2020: AOR 1.31 [0.86-1.99]; 2021: AOR 1.10 [0.67-1.81]). Conclusions Association between income loss and depression was moderated by receipt of family financial support but not by receipt of government support. Financial support may help to mitigate the negative effects of income loss on young adults mental health during public health crisis. Key messages • Financial support may help to minimize risk of depressive symptoms among youth who lost income related to the COVID-19 pandemic. • Financial support through personal assistance (e.g., family, friends) appears to have a greater impact on youth mental health than COVID-specific government assistance funds.


Background:
Evidence about how population mental health has evolved from before and over the COVID-19 pandemic remains mixed, with impacts on mental health inequalities being unclear. We investigated changes in mental health and sociodemographic inequalities from before and across the first year of the pandemic. Methods: Data from 11 UK longitudinal population-based studies with pre-pandemic measures of psychological distress were analysed, estimates pooled, and stratified by age, sex, ethnicity, country and lone household status. Trends in the prevalence of poor mental health were assessed before the pandemic (TP0) and across the pandemic at three time periods (initial lockdown (TP1), easing of restrictions (TP2), and a subsequent lockdown (TP3)).

Conclusions:
The substantial deterioration in mental health seen in the UK during the first lockdown did not reverse when lockdown lifted and a sustained worsening was observed across the pandemic. Mental health declines have been unequal across the population and these results have implications for policy, including the need for specific investment for support for those most affected to mitigate the effects of the pandemic and measures to reduce inequalities within these specific groups.

Key messages:
A sustained deterioration in mental health was observed from before the start of the COVID-19 pandemic, and did not recover when social restrictions were eased. Deterioration in mental health varied by sociodemographic factors, namely age, sex, and education, and highlights a need for improved mental health care provision to minimise widening inequalities.

Background:
To mitigate the adverse effects of the COVID-19 pandemic on financial resources, governments provided financial support (e.g., emergency aid funds) as well as family via personal assistance. This study aims to assess the moderating effect of financial support from the government or from family on the association between income loss and depression among young adults.

Methods:
Two online cross-sectional surveys among young adults (18-29) living in Canada and France were conducted in October-December 2020 (n = 4511) and July-December 2021 (n = 3329). Depressive symptoms were measured using PHQ-9 score+10. Two logistic regression models were performed for each survey with an interaction term between income loss and financial support (government or family modeled separately), controlling for demographics (e.g., country, age, gender, income, living conditions).

Results:
In the total sample, half reported depressive symptoms (2020/ 2021: 53%/46%), and over a third lost income (2020/2021: 10%/12% all income, 38%/22% some income). In 2020, 41% received government financial support (2021: 18%) while family/friends support was constant (12%). In both surveys, among those who received government support, income loss was associated with depression, whether participants lost all income ( , and a social support score (how emotionally supported they feel). We computed post-hoc multilinear regression models to evaluate which factors can predict the CEQ2, PSS and EPDS scores.

Results:
Mothers had a worse birth experience, perceived less stress and had more depressive symptoms during the pandemic than previously reported cohorts. The CEQ2 was predicted by the birth risk (negatively), the access to a midwife (positively) and the perception of sufficient access of the visitors in the hospital (positively) (adjusted R2 = 0.26, F(4, 1738) = 155.64, p < 0.001). The PSS was predicted by the pandemic repercussions (positively), the social support (negatively), and the presence of a coping mechanism (negatively) (adjusted R2 = 0.28, F(4, 1959) = 195.1, p < 0.001). The EPDS was similarly predicted by the same factors as the PSS (adjusted R2 = 0.28, F(4, 1959) = 189.59, p < 0.001).

Conclusions:
Social support and strong coping mechanisms can lower the stress and depression scores. Instructing the population about how to improve these factors might be a target for future social policies.
Key messages: Compared to historical cohorts, mothers who gave birth during the pandemic had a worse birth experience, and, postnatally, perceived less stress but had more depressive symptoms. The visitors' access to the hospital and the mother's access to a midwife impacted the birth experience, while the social support and the coping mechanisms affected the stress and depression scores.

Background:
Mitigation actions during the COVID-19 pandemic, in particular lockdowns and curfews, may impact mental health and suicide in general populations. We aimed to analyse the evolution in suicide deaths from January 2020 to March 2022 in France.

Methods:
Using free-text medical causes in death certificates, we built an algorithm, which aimed to identify suicide deaths. We measured its retrospective performances by comparing suicide deaths identified using the algorithm with deaths which had either an ICD10 code for 'intentional self-harm' or for 'external cause of undetermined intent' as underlying cause. The number of suicide deaths from January 2020 to November 2021 was then compared with the expected number estimated using a generalized additive model. The analysis was stratified by age group and gender. Analysis from December 2021 to March 2022 was conducted using electronic death certificates only.

Results:
The free-text algorithm demonstrated high performances. From January 2020 to November 2021, suicide mortality declined during France's three lockdowns, particularly in men, and remained quite comparable with expected values between and after both of the country's lockdowns. Provisional results based on electronic death certificates suggest that suicide mortality remained stable until March 2022.

Conclusions:
Monitoring suicide mortality is possible in France with a 4month delay; this will be reduced to two days when electronic death certification is fully deployed. This study highlighted the absence of an increase in suicide mortality during France's COVID-19 pandemic, and a substantial decline during lockdowns periods, something already observed in other countries. Further studies are required to explain the factors for this decline.
Key messages: In the absence of reactive coding of medical causes of deaths, the study proposed an approach to reactively identify suicide based on free-text medical causes from death certificates.
15th European Public Health Conference 2022