Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, Canada.
Women's Health Research Institute, Vancouver, Canada.
PLoS One. 2021 Nov 22;16(11):e0259676. doi: 10.1371/journal.pone.0259676. eCollection 2021.
The SARS-CoV-2 (COVID-19) pandemic has had profound physical and mental health effects on populations around the world. Limited empirical research has used a gender-based lens to evaluate the mental health impacts of the pandemic, overlooking the impact of public health measures on marginalized groups, such as women, and the gender diverse community. This study used a gender-based analysis to determine the prevalence of psychosocial symptoms and substance use (alcohol and cannabis use in particular) by age, ethnicity, income, rurality, education level, Indigenous status, and sexual orientation.
Participants in the study were recruited from previously established cohorts as a part of the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) study. Those who agreed to participate were asked to self-report symptoms of depression, anxiety, pandemic stress, loneliness, alcohol use, and cannabis use across five phases of the pandemic as well as retrospectively before the pandemic.
For all psychosocial outcomes, there was a significant effect of time with all five phases of the pandemic being associated with more symptoms of depression, anxiety, stress, and loneliness relative to pre-COVID levels (p < .0001). Gender was significantly associated with all outcomes (p < .0001) with men exhibiting lower scores (i.e., fewer symptoms) than women and gender diverse participants, and women exhibiting lower scores than the gender diverse group. Other significant predictors were age (younger populations experiencing more symptoms, p < .0001), ethnicity (Chinese/Taiwanese individuals experiencing fewer symptoms, p = .005), and Indigenous status (Indigenous individuals experiencing more symptoms, p < .0001). Alcohol use and cannabis use increased relative to pre-pandemic levels, and women reported a greater increase in cannabis use than men (p < .0001).
Our findings highlight the need for policy makers and leaders to prioritize women, gender-diverse individuals, and young people when tailoring public health measures for future pandemics.
SARS-CoV-2（COVID-19）大流行对全球人口的身心健康造成了深远影响。有限的实证研究从性别视角评估了大流行对心理健康的影响，但忽视了公共卫生措施对边缘化群体（如女性和性别多样化群体）的影响。本研究采用性别分析方法，按年龄、族裔、收入、城乡、教育程度、原住民地位和性取向，确定心理社会症状和物质使用（特别是酒精和大麻使用）的患病率。
研究参与者是从先前建立的队列中招募的，作为 COVID-19 快速证据研究省级人群性别和性研究（RESPPONSE）研究的一部分。那些同意参与的人被要求在大流行的五个阶段以及大流行前自我报告抑郁、焦虑、大流行压力、孤独、酒精使用和大麻使用的症状。
对于所有心理社会结果，时间都有显著影响，大流行的五个阶段都与 COVID 前水平相比，抑郁、焦虑、压力和孤独症状更多（p <.0001）。性别与所有结果显著相关（p <.0001），男性的得分（即症状较少）低于女性和性别多样化参与者，女性的得分低于性别多样化群体。其他显著预测因素是年龄（年轻人群经历更多症状，p <.0001）、族裔（中国/台湾人经历较少症状，p =.005）和原住民地位（原住民经历更多症状，p <.0001）。酒精和大麻使用量相对于大流行前水平增加，女性报告的大麻使用量增加大于男性（p <.0001）。
我们的研究结果强调，政策制定者和领导者在为未来的大流行调整公共卫生措施时，需要优先考虑女性、性别多样化个体和年轻人。
