Worlds apart – The Social Determinants of Health

This month, the government has released a new report – the ‘COVID-19: mental health and wellbeing surveillance‘ report.

“A study (using data from over 30,000 participants of the COVID-19 Social Study) found that levels of self-reported depressive symptoms were relatively stable during the first 6 weeks of the lockdown. Experience of abuse, pre-existing mental or physical health conditions, low social support and low socioeconomic position were associated with higher levels of depression.”

This report shows the sharp differences between families who have all the resources they need to cope with the pandemic and the risk that it presents versus those who came into the crisis with less capacity to deal with adversity. For well-off families, the children and young people benefited because they had less stress, more support and better access to technology which allowed them to access a wide variety of support. These families enjoyed more time with their parents, greater freedom because they no longer had to fit in with the normal timetable and school stress. Many of the parents in this category were furloughed and will be able to return to work when the crisis is over.

In contrast are parents who have experienced high levels of stress because they came into the pandemic with worse health, unstable unemployment and high exposure to the disease because of the work they did. Families who live in rented housing, have no garden or access to outside space, live in cramped conditions with little room for quiet space in which to work or study, found the pandemic worsened their physical and mental health.

The report shows that some experience symptoms of PTSD, increased levels of anxiety and depression, with a significant increase in reported loneliness.

“Young adults, women, people with lower education, people with low income, people who are economically inactive, people with an existing mental health condition, people living alone, and urban residents were more likely to report being lonely during the pandemic. These groups at increased risk were almost identical to those at increased risk pre-lockdown.”

While the report does identify family stress as a key risk to the children and young people, it does not measure the mental health and well-being in younger children, particularly primary age. These formative years are a crucial time for young people to build resilience so if their support networks are taken away, this is likely to have a significant impact on their development.

Unless public policy and finances are used to provide preventative support and clear outreach to these young people and their families, then the impact of this will be felt by generations to come in both their mental and physical well-being. Families, where there is parental mental illness, will have suffered more than most but their situation finds no space in these reports or in public policy generally.