Labor market participation and depression during the COVID-19 epidemic among young adults (18 to 30 years): a nationally representative study in France
Authors: Melchior Maria , Florence Aline-Marie , Davisse-Paturet Camille , Falissard Bruno , Galéra Cédric , Hazo Jean-Baptiste , Vuillermoz Cécile , Warszawski Josiane , Dione Fallou , Rouquette Alexandra ,   the EPICOV study group
Published: March 2022

AbstractObjectiveTo examine the relationship between young adults’ labor force participation and depression in the context of the COVID-19 pandemic.Design, Setting, ParticipantsData come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews) among 2217 participants aged 18-30 years. Participants with prior mental health disorder (n=50) were excluded from the statistical analyses.ResultsUsing Generalized Estimating Equation (GEE) models controlled for participants’ socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariate ORs respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed than unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariate ORs respectively 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariate OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariate ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariate ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15).Conclusions and relevanceOur study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the Covid-19 pandemic on the mental health of young adults.Key PointsQuestionIs labor force participation associated with young adults’ likelihood of depression during the COVID-19 pandemic?FindingsIn a nationally-representative cohort study in France, compared to young adults who are employed, those who are studying or experience unemployment had elevated odds of depression in 2020 and 2021.MeaningYoung people are experiencing the highest burden of mental health problems in the context of the COVID-19 epidemic – our study implies that those who are studying or are unemployed are at especially high risk and should be the focus of attention in terms of prevention and treatment.