Associations of socioeconomic position and adverse childhood experiences with health-related behaviour changes and changes to employment during the first COVID-19 lockdown in the UK
Authors: Smith Madeleine L , Herbert Annie , Hughes Amanda , Northstone Kate , Howe Laura D 
Published: May 2021

Background

Non-pharmaceutical interventions to reduce the spread of COVID-19 may have disproportionately affected already disadvantaged populations.

Methods

We analysed data from 2710 young adult participants of the Avon Longitudinal Study of Parents and Children. We assessed the associations of socioeconomic position (SEP) and Adverse Childhood Experiences (ACEs, e.g. abuse, neglect, measures of family dysfunction) with changes to health-related behaviours (meals, snacks, exercise, sleep, alcohol and smoking/vaping), and to financial and employment status during the first UK lockdown between March-June 2020.

Results

Experiencing 4 or more ACEs was associated with reporting decreased sleep quantity during lockdown (OR 1.53, 95% CI: 1.07-2.18) and increased smoking and/or vaping (OR 1.85, 95% CI: 0.99-3.43); no other associations were seen between ACEs or SEP and health-related behaviour changes. Adverse financial and employment changes were more likely for people with low SEP and for people who had experienced multiple ACEs; e.g. people who had been in the ‘never worked or long-term unemployed’ or ‘routine and manual occupation’ categories pre-lockdown were almost 3 times more likely to have stopped working during lockdown compared with people who were in a higher managerial, administrative or professional occupation pre-lockdown (OR 2.83, 95% CI: 1.45-5.50 and OR 2.68, 95% CI: 1.63-4.42 respectively).

Conclusion

Adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities. Despite this, in this sample of young adults, there was little evidence that lockdown worsened inequalities in health-related behaviours.

BOX

What is already known on this subject?

Non-pharmaceutical interventions implemented to mitigate the spread of COVID-19 (e.g. nationwide lockdown) have affected the lifestyles and livelihoods of many, with potential consequences for physical health and financial wellbeing.

Existing evidence suggests sociodemographic inequalities in the effects of lockdown, but details of the factors influencing these inequalities remain unclear.

What this study adds?

A history of adverse childhood experiences may be associated with decreased sleep and increased smoking/vaping during lockdown. SEP and ACEs were not associated with changes in other health-related behaviours in this cohort of young adults.

Adverse financial and employment consequences of lockdown were more likely to be experienced by people who have already experienced socioeconomic deprivation or childhood adversity, thereby widening social inequalities. Our findings highlight a need for continued support of people who experience ACEs into adulthood, and demonstrate that this need may have increased during the COVID-19 pandemic.