Trajectories of the socioeconomic gradient of mental health: Results from the CLSA COVID-19 Questionnaire Study

• Published in: Health policy (Amsterdam) Vol. 131; p. 104758
• Main Authors: Asada, Yukiko, Grignon, Michel, Hurley, Jeremiah, Stewart, Samuel A., Smith, Nathan K., Kirkland, Susan, McMillan, Jacqueline, Griffith, Lauren E., Wolfson, Christina, Raina, Parminder
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.05.2023
• Subjects: Aged; COVID-19; COVID-19 - epidemiology; Health inequalities; Humans; Longitudinal Studies; Mental Health; Ontario - epidemiology; Pandemics; Socioeconomic Factors; Surveys and Questionnaires; Ontario; COVID-19; Health inequalities; Mental health
• DOI: 10.1016/j.healthpol.2023.104758
• ISSN: 0168-8510; 1872-6054

•In April-December 2020, the prevalence of anxiety remained unchanged.•The prevalence of self-reported feeling generally unwell decreased.•Relative and absolute income-related inequalities in anxiety and feeling unwell were unchanged.•The early pandemic in Canada neither equalized nor exacerbated inequality. As the coronavirus disease (COVID-19) pandemic prolongs, documenting trajectories of the socioeconomic gradient of mental health is important. We describe changes in the prevalence and absolute and relative income-related inequalities of mental health between April and December 2020 in Canada. We used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study and the pre-pandemic CLSA Follow-up 1. We estimated the prevalence proportion, the concentration index (relative inequality), and the generalized concentration index (absolute inequality) for anxiety and self-reported feeling generally unwell at multiple points in April-December 2020, overall, by sex and age group, by region, and among those who reported poor or fair overall health and mental health pre-pandemic. Overall, the prevalence of anxiety remained unchanged (22.45 to 22.10%, p = 0.231), but self-reported feeling generally unwell decreased (9.83 to 5.94%, p = 0.004). Relative and absolute income-related inequalities were unchanged for both anxiety and self-reported feeling generally unwell, with exceptions of an increased concentration of self-reported feeling generally unwell among the poor, measured by the concentration index, overall (-0.054 to -0.115, p = 0.004) and in Ontario (-0.035 to -0.123, p = 0.047) and British Columbia (-0.055 to -0.141, p = 0.044). The COVID-19 pandemic appeared to neither exacerbate nor ameliorate existing income-related inequalities in mental health among older adults in Canada between April and December 2020. Continued monitoring of inequalities is necessary.