Experiences of lockdown during the Covid-19 pandemic: descriptive findings from a survey of families in the Born in Bradford study

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Abstract

Background: Lockdown measures implemented to contain the Covid-19 virus have increased health inequalities, with families from deprived and ethnically diverse backgrounds most likely to be adversely affected. This paper describes the experiences of families living in the multi-ethnic and deprived city of Bradford, England.

Methods: A wave of survey data collection using a combination of email, text and phone with postal follow-up during the first Covid-19 UK lockdown (10th April to 30 ^th June 2020) with parents participating in two longitudinal studies. Cross tabulations explored variation by ethnicity and financial insecurity. Text from open questions was analysed using thematic analysis.

Results: Of 7,652 families invited, 2,144 (28%) participated. The results presented are based on the 2,043 (95%) mothers’ responses: 957 (47%) of whom were of Pakistani heritage, 715 (35%) White British and 356 (18%) other ethnicity 971 (46%) lived in the most deprived decile of material deprivation in England. and 738 (37%) were financially insecure.

Many families lived in poor quality (N=574, 28%), overcrowded (N=364, 19%) housing. Food (N=396, 20%), employment (N=728, 37%) and housing (N=204, 10%) insecurities were common, particularly in those who were furloughed, self-employed not working or unemployed. Clinically important depression and anxiety were reported by 372 (19%) and 318 (16%) mothers. Ethnic minority and financially insecure families had a worse experience during the lockdown across all domains, with the exception of mental health which appeared worse in White British mothers. Open text responses corroborated these findings and highlighted high levels of anxiety and fear about Covid-19.

Conclusions: There is a need for policy makers and commissioners to better support vulnerable families during and after the pandemic. Future work will use longitudinal data from before the pandemic, and from future surveys during the pandemic, to describe trajectories and the long-term consequences of the pandemic on vulnerable populations.

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Most cited references 20

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Using thematic analysis in psychology

Virginia Braun, Victoria Clarke (2014)

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Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population.

Bernd Löwe, Oliver Decker, Stefanie H. Müller … (2008)

The 7-item Generalized Anxiety Disorder Scale (GAD-7) is a practical self-report anxiety questionnaire that proved valid in primary care. However, the GAD-7 was not yet validated in the general population and thus far, normative data are not available. To investigate reliability, construct validity, and factorial validity of the GAD-7 in the general population and to generate normative data. Nationally representative face-to-face household survey conducted in Germany between May 5 and June 8, 2006. Five thousand thirty subjects (53.6% female) with a mean age (SD) of 48.4 (18.0) years. The survey questionnaire included the GAD-7, the 2-item depression module from the Patient Health Questionnaire (PHQ-2), the Rosenberg Self-Esteem Scale, and demographic characteristics. Confirmatory factor analyses substantiated the 1-dimensional structure of the GAD-7 and its factorial invariance for gender and age. Internal consistency was identical across all subgroups (alpha = 0.89). Intercorrelations with the PHQ-2 and the Rosenberg Self-Esteem Scale were r = 0.64 (P < 0.001) and r = -0.43 (P < 0.001), respectively. As expected, women had significantly higher mean (SD) GAD-7 anxiety scores compared with men [3.2 (3.5) vs. 2.7 (3.2); P < 0.001]. Normative data for the GAD-7 were generated for both genders and different age levels. Approximately 5% of subjects had GAD-7 scores of 10 or greater, and 1% had GAD-7 scores of 15 or greater. Evidence supports reliability and validity of the GAD-7 as a measure of anxiety in the general population. The normative data provided in this study can be used to compare a subject's GAD-7 score with those determined from a general population reference group.

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The PHQ-8 as a measure of current depression in the general population.

Kurt Kroenke, Tara Strine, Robert L Spitzer … (2009)

The eight-item Patient Health Questionnaire depression scale (PHQ-8) is established as a valid diagnostic and severity measure for depressive disorders in large clinical studies. Our objectives were to assess the PHQ-8 as a depression measure in a large, epidemiological population-based study, and to determine the comparability of depression as defined by the PHQ-8 diagnostic algorithm vs. a PHQ-8 cutpoint > or = 10. Random-digit-dialed telephone survey of 198,678 participants in the 2006 Behavioral Risk Factor Surveillance Survey (BRFSS), a population-based survey in the United States. Current depression as defined by either the DSM-IV based diagnostic algorithm (i.e., major depressive or other depressive disorder) of the PHQ-8 or a PHQ-8 score > or = 10; respondent sociodemographic characteristics; number of days of impairment in the past 30 days in multiple domains of health-related quality of life (HRQoL). The prevalence of current depression was similar whether defined by the diagnostic algorithm or a PHQ-8 score > or = 10 (9.1% vs. 8.6%). Depressed patients had substantially more days of impairment across multiple domains of HRQoL, and the impairment was nearly identical in depressed groups defined by either method. Of the 17,040 respondents with a PHQ-8 score > or = 10, major depressive disorder was present in 49.7%, other depressive disorder in 23.9%, depressed mood or anhedonia in another 22.8%, and no evidence of depressive disorder or depressive symptoms in only 3.5%. The PHQ-8 diagnostic algorithm rather than an independent structured psychiatric interview was used as the criterion standard. The PHQ-8 is a useful depression measure for population-based studies, and either its diagnostic algorithm or a cutpoint > or = 10 can be used for defining current depression.

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Author and article information

Contributors

Josie Dickerson: Role: ConceptualizationRole: Funding AcquisitionRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0003-0121-3406

Brian Kelly: Role: Formal AnalysisRole: MethodologyRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

Bridget Lockyer: Role: Formal AnalysisRole: MethodologyRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-2195-5549

Sally Bridges: Role: ConceptualizationRole: Data CurationRole: MethodologyRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-9378-0055

Christopher Cartwright: Role: MethodologyRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-7807-2536

Kathryn Willan: Role: Data CurationRole: MethodologyRole: Writing – Review & Editing

Katy Shire: Role: Data CurationRole: MethodologyRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-2093-181X

Kirsty Crossley: Role: Data CurationRole: MethodologyRole: SupervisionRole: Writing – Review & Editing

Maria Bryant: Role: ConceptualizationRole: Funding AcquisitionRole: MethodologyRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0001-7690-4098

Trevor A. Sheldon: Role: ConceptualizationRole: Funding AcquisitionRole: SupervisionRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-7479-5913

Deborah A. Lawlor: Role: ConceptualizationRole: Funding AcquisitionRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-6793-2262

John Wright: Role: ConceptualizationRole: Funding AcquisitionRole: MethodologyRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0001-9572-7293

Rosemary R C McEachan: Role: ConceptualizationRole: Funding AcquisitionRole: MethodologyRole: SupervisionRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0003-1302-6675

Kate E. Pickett: Role: ConceptualizationRole: Funding AcquisitionRole: MethodologyRole: SupervisionRole: Writing – Original Draft PreparationRole: Writing – Review & Editing

ORCID: https://orcid.org/0000-0002-8066-8507

Journal

Journal ID (nlm-ta): Wellcome Open Res

Journal ID (iso-abbrev): Wellcome Open Res

Journal ID (pmc): Wellcome Open Res

Title: Wellcome Open Research

Publisher: F1000 Research Limited (London, UK )

ISSN (Electronic): 2398-502X

Publication date (Electronic): 26 February 2021

Publication date Collection: 2020

Volume: 5

Electronic Location Identifier: 228

Affiliations

[1 ]Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford Royal Infirmary, Duckworth Lane, Bradford, BD9 6RJ, UK

[2 ]Hull York Medical School, University of York, Heslington, York, YO10 5DD, UK

[3 ]Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York, YO10 5DD, UK

[4 ]Institute of Population Health Sciences, Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, Yvonne Carter Building, 58 Turner Street, London, E1 2AB, UK

[5 ]MRC Integrative Epidemiology Unit, University of Bristol, Oakfield House, Oakfield Grove, Bristol, BS8 2BN, UK

[6 ]Population Health Science, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK

[7 ]Bristol National Institute for Health Research Biomedical Research Centre, University of Bristol, Bristol, BS8 2BN, UK

[1 ]Policy and Equity, Murdoch Children's Research Institute, Melbourne, Australia

[2 ]Population Health, Murdoch Children's Research Institute, Melbourne, Australia

[1 ]Policy and Equity, Murdoch Children's Research Institute, Melbourne, Australia

[2 ]Population Health, Murdoch Children's Research Institute, Melbourne, Australia

Bradford Hospitals National Health Service Trust, UK

[1 ]Social Epidemiology, Indian Institute of Technology Gandhinagar, Gandhinagar, India

Bradford Hospitals National Health Service Trust, UK

Author notes

[a ] Josie.Dickerson@ 123456bthft.nhs.uk

Competing interests: DA Lawlor reports receiving support form Roche Diagnostics and Medtronic Ltd for research unrelated to the research presented here. All other authors report no competing interests were disclosed.

Competing interests: No competing interests were disclosed.

Author information

Josie Dickerson https://orcid.org/0000-0003-0121-3406

Bridget Lockyer https://orcid.org/0000-0002-2195-5549

Sally Bridges https://orcid.org/0000-0002-9378-0055

Christopher Cartwright https://orcid.org/0000-0002-7807-2536

Katy Shire https://orcid.org/0000-0002-2093-181X

Maria Bryant https://orcid.org/0000-0001-7690-4098

Trevor A. Sheldon https://orcid.org/0000-0002-7479-5913

Deborah A. Lawlor https://orcid.org/0000-0002-6793-2262

John Wright https://orcid.org/0000-0001-9572-7293

Rosemary R C McEachan https://orcid.org/0000-0003-1302-6675

Kate E. Pickett https://orcid.org/0000-0002-8066-8507

Article

DOI: 10.12688/wellcomeopenres.16317.2

PMC ID: 7927208

PubMed ID: 33709038

SO-VID: 68171ba0-b663-44c3-bec3-97204645da71

License:

This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date accepted : 15 February 2021

Funding

Funded by: ActEarly UK Prevention Research Partnership Consortium

Award ID: MR/S037527/1

Funded by: Medical Research Council

Award ID: MR/N024391/1

Funded by: Wellcome Trust

Award ID: 101597

Funded by: National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber

Award ID: NIHR200166

Funded by: Economic and Social Research Council

Award ID: MR/N024391/1

Funded by: The Health Foundation

Award ID: 2301201

Funded by: National Institute for Health Research

Funded by: The National Lottery Community Fund

This study has been funded through The Health foundation COVID-19 Award [2301201]. This work was supported by a Wellcome Trust infrastructure grant [101597] (PI: DAL, JW, RM); a joint grant from the UK Medical Research Council (MRC) and UK Economic and Social Research Council (ESRC) [MR/N024391/1] (PI: KP and DAL, JW, RM); the National Institute for Health Research under its Applied Research Collaboration Yorkshire and Humber [NIHR200166] (PI: JW; KP, RM, JD, CC); ActEarly UK Prevention Research Partnership Consortium [MR/S037527/1] (PI JW; CIs RM, JD, KP, TS, LS); the NIHR Clinical Research Network, which provided research delivery support for this study; and the National Lottery Community Fund, which provided funding for BiBBS through the Better Start Bradford programme.

Experiences of lockdown during the Covid-19 pandemic: descriptive findings from a survey of families in the Born in Bradford study

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Novel Coronavirus Disease COVID-19

Most cited references 20

Using thematic analysis in psychology

Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population.

The PHQ-8 as a measure of current depression in the general population.

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