Comparing the mental health trajectories of four different types of keyworkers with non-keyworkers: 12-month follow-up observational study of 21 874 adults in England during the COVID-19 pandemic.

Feifei Bu,Daisy Fancourt,Hei Wan Mak,Elise Paul

doi:10.1192/bjp.2021.205

Abstract

BackgroundThere are concerns that keyworkers may be at a greater risk for psychological distress than non-keyworkers during the COVID-19 pandemic. However, little research has included keyworkers outside of the healthcare sector or has disaggregated keyworkers into different subgroups.AimsTo examine longitudinal changes in mental health over 12 months during the COVID-19 pandemic comparing four different groups of keyworkers with non-keyworkers.MethodLongitudinal data were from 21 874 adults living in England (21 March 2020 to 22 February 2021). Latent growth modelling was utilised to compare growth trajectories of depressive and anxiety symptoms in non-keyworkers and four types of keyworkers: (a) health and social care workers, (b) teachers and child care workers, (c) public service workers, and (d) essential services keyworkers (such as food chain or utility workers).ResultsWhen accounting for both time-invariant and time-varying covariates, keyworkers in the essential services category had consistently higher levels of depressive and anxiety symptoms than non-keyworkers across the whole of the study period. There was little difference in the mental health trajectories between health/social care, teachers/child care and public service worker categories and non-keyworkers.ConclusionsOur findings suggest that the risk for poorer mental health during the COVID-19 pandemic varies within the broad category of keyworkers generally, and that those working in utility, food chain and transport roles are especially at risk. Future research should focus on identifying which aspects of working conditions may be contributing to occupational stress in these groups.

Highlights

There are concerns that keyworkers may be at a greater risk for psychological distress than non-keyworkers during the COVID-19 pandemic
Our findings suggest that the risk for poorer mental health during the COVID-19 pandemic varies within the broad category of keyworkers generally, and that those working in utility, food chain and transport roles are especially at risk
A second study conducted in Australia reported keyworkers other than in the healthcare sector to have higher levels of anxiety, depression, stress and poorer quality of life than healthcare workers and the rest of the population.[18]. These findings suggest that keyworkers broadly may be more vulnerable to experiencing poorer mental health than the rest of the population during the COVID-19 pandemic,[9,11] keyworkers in other roles may be more at risk than those in the healthcare sector.[11,18]

Summary

Introduction

There are concerns that keyworkers may be at a greater risk for psychological distress than non-keyworkers during the COVID-19 pandemic. Despite keyworkers comprising a significant proportion of the population (33% in the UK),[3] and fulfilling a large variety of roles with differing levels of exposure to the public and to the virus itself,[4] the majority of the research on keyworkers’ mental health has focused exclusively on healthcare workers[5, 6] or has examined keyworkers broadly as a collective.[7,8,9,10] Keyworkers in general have been found to be more likely than non-keyworkers to meet criteria for clinically significant mental distress[9] and probable criteria for depression, anxiety and post-traumatic stress disorders than non-keyworkers.[11] other studies conducted during the COVID-19 pandemic have not found keyworkers to report more depressive or anxiety symptoms than non-keyworkers.[7,8,12] These equivocal findings may be because of the heterogeneity involved when grouping all keyworkers together. Even among the specific category of healthcare workers, those whose jobs require direct contact with patients who have COVID-19 display more symptoms of anxiety, depression, insomnia and traumatic stress than healthcare workers not working directly with patients who have COVID-19.5,6

Methods

Results

Conclusion