Moderating effect of country-level health determinants on the association between hobby engagement and mental health: cross-cohort multi-level models, meta-analyses, and meta-regressions.

BACKGROUND: Theories from anthropology, evolutionary psychology, and sociology have focused on the potential adaptive benefits of hobby engagement for mental health in older adults. However, previous studies have used data from single countries, potentially biased by specific measurement and methodological approaches, cohort effects, or cultural specificities. Whether there are genuine benefits for mental health in older adults cross-culturally remains unknown. This study explored the consistency of this association across 16 different nations. METHODS: For this epidemiological study, we used data from adults aged 65 years or older across 16 countries in the USA, Europe, and Asia, represented in five longitudinal studies (ELSA, JAGES, HRS, SHARE and CHARLS; N=93 263, 45-62% female, mean age 72-76 years, data collected 2008-20). We harmonised measures of self-reported engagement in hobbies and past-times, depressive symptoms (validated scales), and Likert scale responses for self-reported health, happiness, and life satisfaction. We conducted fixed-effects models and longitudinal regression models of hobbies and mental health for each country and then pooled in multinational meta-analyses. We accounted for all time-constant factors including those unobserved (eg, genetics, past leisure behaviour, medical history, psychological traits) and identified time-varying factors (eg, sociodemographic background, clinical conditions, daily functioning). We tested the potential moderating effects of country-level determinants of health in meta-regressions and multilevel models. FINDINGS: Meta-analytic fixed-effects findings showed that having a hobby was associated with fewer depressive symptoms (pooled coefficient -0·10, 95% CI -0·13 to -0·07, I2=69·5%, H2=3·28), and higher levels of self-reported health (0·06, 0·03 to 0·08, I2=48·1%, H2=1·93), happiness (0·09, 0·06 to 0·13, I2=67·0%, H2=3·03), and life satisfaction (0·10, 0·08 to 0·12, I2=33·6%, H2=1·51). Results were consistent in meta-analyses of longitudinal regression models testing directionality of findings. Macro-level factors such as life expectancy, world happiness index, country wealth, and income inequality predicted prevalence of hobby engagement, but they showed only marginal moderating effects on the association between hobbies and mental health. INTERPRETATION: Despite some heterogeneity in measurement between the cohorts, the apparent universality of the health benefits of hobbies internationally suggests that facilitating greater opportunities for engagement across demographic groups and between countries could be an important part of multidisciplinary care. Findings have implications for social prescribing schemes (currently in trial in many countries) and multidisciplinary work on origins and human behavioural patterns of hobby engagement. FUNDING: National Endowment for the Arts, Wellcome Trust, Belgian Nnational Scientific Fund (FNRS).

Longitudinal associations between loneliness, social isolation, and healthcare utilisation trajectories: a latent growth curve analysis.

PURPOSE: To explore the longitudinal associations between eight-year trajectories of loneliness, social isolation and healthcare utilisation (i.e. inpatient, outpatient, and nursing home care) in US older adults. METHODS: The study used data from the Health and Retirement Study in 2006-2018, which included a nationally representative sample of American adults aged 50 and above (N = 6,832). We conducted latent growth curve models to assess the associations between trajectories of loneliness and isolation and healthcare utilisation over 8 years. RESULTS: Independent of sociodemographic and health-related confounders, social deficits were associated with a lower likelihood of baseline physician visits (loneliness ß= -0.15, SE = 0.08; social isolation ß= -0.19, SE = 0.08), but there was a positive association between loneliness and number of physician visits (ß = 0.06, SE = 0.03), while social isolation was associated with extended hospital (ß = 0.07, SE = 0.04) and nursing home stays (ß = 0.05, SE = 0.02). Longer nursing home stays also predicted better trajectories of loneliness and isolation over time. CONCLUSION: Loneliness and social isolation are cross-sectionally related to complex patterns of different types of healthcare. There was no clear evidence that social deficits led to specific trajectories of healthcare utilisation, but nursing home stays may over time help provide social contact, supporting trajectories of isolation and potentially loneliness. Non-clinical services such as social prescribing could have the potential to address unmet social needs and further promote patients' health-seeking profiles for improving healthcare equity.

Comparing the mental health trajectories of four different types of keyworkers with non-keyworkers: 12-month follow-up observational study of 21 874 adults in England during the COVID-19 pandemic.

BACKGROUND: There are concerns that keyworkers may be at a greater risk for psychological distress than non-keyworkers during the COVID-19 pandemic. However, little research has included keyworkers outside of the healthcare sector or has disaggregated keyworkers into different subgroups. AIMS: To examine longitudinal changes in mental health over 12 months during the COVID-19 pandemic comparing four different groups of keyworkers with non-keyworkers. METHOD: Longitudinal data were from 21 874 adults living in England (21 March 2020 to 22 February 2021). Latent growth modelling was utilised to compare growth trajectories of depressive and anxiety symptoms in non-keyworkers and four types of keyworkers: (a) health and social care workers, (b) teachers and child care workers, (c) public service workers, and (d) essential services keyworkers (such as food chain or utility workers). RESULTS: When accounting for both time-invariant and time-varying covariates, keyworkers in the essential services category had consistently higher levels of depressive and anxiety symptoms than non-keyworkers across the whole of the study period. There was little difference in the mental health trajectories between health/social care, teachers/child care and public service worker categories and non-keyworkers. CONCLUSIONS: Our findings suggest that the risk for poorer mental health during the COVID-19 pandemic varies within the broad category of keyworkers generally, and that those working in utility, food chain and transport roles are especially at risk. Future research should focus on identifying which aspects of working conditions may be contributing to occupational stress in these groups.

Frequency of leisure activity engagement and health functioning over a 4-year period: a population-based study amongst middle-aged adults.

RATIONALE: Leisure activities have wide-ranging benefits for physical and mental health. However, previous studies have often focused on "leisure" as a homogeneous group of activities. This study was therefore designed to take a prospective and comparative approach exploring different types of leisure activities, as well as investigating whether frequency of engagement is associated with strength of benefits. METHOD: Data from the 1970 British Cohort Study Waves 9 (age 42) and 10 (age 46) were analysed (N = 5,639). Eight domains derived from the SF-36 health survey questionnaire were used to measure health functioning (general health, vitality, bodily pain, social functioning, physical functioning, mental health, role limitations due to emotional, and role limitations due to physical problems). Leisure activities included physical activity, culture engagement, arts participation, volunteering or community engagement, and literature activities. Both ordinary least squares and logistic regressions were applied. RESULTS: Physical activity was associated with greater levels of physical functioning, general health, and vitality at higher frequencies, while cultural engagement was associated with social functioning and physical functioning when engaged in several times a year. Arts participation and literature activities had a general negative association with health functioning. Engagements in volunteering/community groups showed varying associations with health functioning (both positive and negative) depending on the levels of engagements. CONCLUSION: This research suggests that the types of leisure activities and levels of engagement can have differential associations with health amongst middle-aged adults. This may be helpful for public health initiatives and programmes such as social prescribing schemes when formulating programmes, especially regarding 'dosage' of engagement. Further, the overall benefits of high engagement frequency suggest that increasing leisure engagement could play an important role in supporting improving health and wellbeing at a population level.

Time use and mental health in UK adults during an 11-week COVID-19 lockdown: a panel analysis.

BACKGROUND: There is currently major concern about the impact of the global COVID-19 outbreak on mental health. But it remains unclear how individual behaviours could exacerbate or protect against adverse changes in mental health. AIMS: To examine the associations between specific activities (or time use) and mental health and well-being among people during the COVID-19 pandemic. METHOD: Data were from the UCL COVID-19 Social Study, a panel study collecting data weekly during the COVID-19 pandemic. The analytical sample consisted of 55 204 adults living in the UK who were followed up for the 11-week strict lockdown period from 21 March to 31 May 2020. Data were analysed using fixed-effects and Arellano-Bond models. RESULTS: Changes in time spent on a range of activities were associated with changes in mental health and well-being. After controlling for bidirectionality, behaviours involving outdoor activities such as gardening and exercising predicted subsequent improvements in mental health and well-being, whereas increased time spent following news about COVID-19 predicted declines in mental health and well-being. CONCLUSIONS: These results are relevant to the formulation of guidance for people obliged to spend extended periods in isolation during health emergencies and may help the public to maintain well-being during future lockdowns and pandemics.

Associations between neighbourhood deprivation and engagement in arts, culture and heritage: evidence from two nationally-representative samples.

BACKGROUND: Previous research has shown the benefits of arts and cultural engagement for physical, mental and social wellbeing. This engagement is socially and geographically patterned. Yet it remains unclear whether place-based attributes are associated with engagement behaviour independent of individual factors. Therefore, the aim of this cross-sectional study was to robustly disentangle associations between geographical deprivation and arts engagement from the individual socio-demographic factors that tend to correlate with residential locations. METHODS: Two different samples drawn from two representative surveys of adults living in England were compared - Understanding Society Wave 2 (2010/12) (N = 14,782) and Taking Part survey (2010/11) (N = 4575). Propensity score matching (PSM) was applied to investigate the association between neighbourhood deprivation (20% most deprived vs 20% least deprived) and arts engagement (arts participation, cultural attendance and museums and heritage engagement). RESULTS: Higher levels of neighbourhood deprivation were associated with lower arts, culture and heritage engagement independent of individuals' demographic backgrounds, socio-economic characteristics and regional locations. When exploring subcategories of deprivation, similar results were obtained across deprivation domains. Results were also consistent when using more distinct categories of deprivation (i.e. 10% most deprived vs 10% least deprived) and when comparing people living in the 20% most deprived neighbourhoods with those living in the 40% medium-deprived areas. CONCLUSION: This study is the first to apply a robust PSM technique to examine the association between neighbourhood deprivation and arts engagement using two nationally-representative samples. Results show that neighbourhood deprivation may act as a barrier that could prevent people from engaging in the arts, which in turn may exacerbate social and health inequalities. This highlights the importance of place-based schemes that focus on increasing individual motivation and capacity to engage in arts and cultural activities, especially in areas of high deprivation.

Rates and predictors of uptake of mental health support during the COVID-19 pandemic: an analysis of 26,720 adults in the UK in lockdown.

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has put a great strain on people's mental health. A growing number of studies have shown worsening mental health measures globally during the pandemic. However, there is a lack of empirical study on how people support their mental health during the COVID-19 pandemic. This study aimed to examine a number of formal and informal mental health support. Further, it explored factors that might be associated with the use of different types mental health support. METHODS: Data from 26,720 adults in the UCL COVID-19 Social Study were analysed between 13th April 2020 and 3rd July 2020. Data were analysed using logistic and Poisson regression models. RESULTS: About 45% of people reported talking to friends or family members to support their mental health, 43% engaging in self-care activities, 20% taking medication, 9% speaking to mental health professionals, 8% talking to a GP or other health professional, and another 8% using helpline or online services. Gender, education, living status, loneliness, pre-existing mental health conditions, general depression and anxiety, coping and personality were found to be associated with the use of mental health support. CONCLUSION: While the negative impacts caused by the COVID-19 pandemic are inevitable, people can play an active role in managing their mental health. Understanding the patterns and predictors of various kinds of mental health support during the pandemic is crucial for future service planning and delivery through recognising potential barriers to mental health care faced by certain groups.

Reading for pleasure in childhood and adolescent healthy behaviours: Longitudinal associations using the Millennium Cohort Study.

Leading a heathy lifestyle in adolescence is vital to individual health in later life. Drawing upon various existing theories, this study hypothesised that engagement in reading for pleasure may enhance healthy behaviours amongst young people. Data were analysed from 11,180 children in the UK Millennium Cohort Study and logistic regressions were used to examine the association between reading frequency at age 11 and health behaviours at age 14. Reading most days was associated with lower odds of trying a cigarette and alcohol and a higher likelihood of having two portions of fruit per day independent of confounding factors. However, spending more time reading was associated with less time spent engaging in moderate to vigorous physical activity. Our findings suggest the importance of further studies exploring the potential health benefits of reading amongst young people.

Arts, mental distress, mental health functioning & life satisfaction: fixed-effects analyses of a nationally-representative panel study.

BACKGROUND: Arts engagement within communities is ubiquitous across cultures globally and previous research has suggested its benefits for mental health and wellbeing. However, it remains unclear whether these benefits are driven by arts engagement itself or by important confounders such as socio-economic status (SES), childhood arts engagement, previous mental health, personality, or self-selection bias. The aim of this study is to use fixed effects models that account for unidentified time-constant confounding measures to examine the longitudinal association between arts (frequency of both arts participation and cultural attendance), mental distress, mental health functioning and life satisfaction. METHODS: Data from 23,660 individuals (with a mean age of 47 years) included in the UK Understanding Society wave 2 (2010-2012) and wave 5 (2013-2015) were analyzed. Aside from controlling for all time-constant variables using fixed-effects models, we additionally adjusted for time-varying demographic factors (e.g. age and marital status), health behaviors and social support variables. RESULTS: After controlling for all time-constant variables and identified time-varying confounders, frequent arts participation and cultural attendance were associated with lower levels of mental distress and higher levels of life satisfaction, with arts participation additionally associated with better mental health functioning. Health-related and social time-varying factors were shown partly but not wholly to explain the observed associations. CONCLUSION: Arts engagement amongst the population as a whole may help enhance positive mental health and life satisfaction, and protect against mental distress. These results are independent of a wide range of time-constant confounding factors.

Generational health improvement or decline? Exploring generational differences of British ethnic minorities in six physical health outcomes.

Objectives: To explore ethnic and generational differences in six physical health outcomes and whether these differences can be explained by health-related behaviors and socio-economic status. Design: Multivariate analyses using nationally representative data in 2010-2011 on self-assessed general health, activity-limiting illness, doctor-diagnosed diabetes, doctor-diagnosed high blood pressure, doctor-diagnosed asthma and body mass index from 21,651 White British, 997 Pakistanis, 695 Bangladeshis, 1,126 Indians, 573 Black Caribbeans and 873 Black Africans, adjusted for age, gender, health-related behaviors and socio-economic status. Results: While ethnicity is of great importance in patterning health differences, we find that ethnic differences in activity-limiting illness, diabetes, asthma and body mass index vary across generations. Health-related behaviors and socio-economic status are shown to partly explain ethnic and generational differences in some health outcomes. Conclusions: This study enables a better understanding of more nuanced patterns of ethnic and generational differences in health, highlighting the need to understand ethnicity as a fluid and changing characteristic, and the importance of socio-economic status and health-related behaviors in shaping ethnic differences in certain health outcomes.

Dimensions of the Parent-Child Relationship: Effects on Substance Use in Adolescence and Adulthood.

BACKGROUND: Several studies have uncovered a relationship between parenting styles and the likelihood that adolescents use tobacco, alcohol or illegal drugs. OBJECTIVES: This paper extends existing research in two ways. First, we consider a longer time-frame, investigating the relationship between parenting in adolescence and substance use in adulthood. Second, we explore the pathways by which this relationship is expressed, in particular the extent to which the relationships in question are mediated by age at first use and depression. METHODS: Our analysis is based on data from the National Longitudinal Study of Adolescent Health (Add Health), N = 2954, and is conducted using structural equation modeling (SEM). We consider warmth and control as distinct dimensions of parenting, as well as a typology of parenting which combines the two dimensions. RESULTS: Warmth is associated with reduced risks of problem substance use in adulthood, via reduced risks of early initiation and a lower risk of depression. Parental control also has a protective effect via reduced risks of early initiation, but this is offset by a detrimental effect on depression, particularly in the case of older adolescents. We also find that indulgent parenting is not associated with extra risk of any kind compared with the authoritative style, whereas authoritarian and neglectful styles are. Conclusions/Importance: The nexus of relationships which we uncover has implications for policy aimed at reducing substance use in the longer term, suggesting that initiatives to promote warm and responsive parenting may be most effective in reducing the risks of later substance use problems.

Leisure Engagement and Self-Perceptions of Aging: Longitudinal Analysis of Concurrent and Lagged Relationships.

OBJECTIVES: There is evidence to suggest that leisure engagement may influence self-perceptions of aging, but disentangling potential bidirectionality in this relationship is challenging. A better understanding of the directionality of this association is essential for designing more effective interventions to promote healthy aging. We, therefore, tested concurrent effects and lagged effects in both directions for a univariate measure of leisure engagement as well as specific domains of community, cognitive, creative, and physical activities. METHODS: A total of 17,753 adults aged 50 or above living in the United States from the Health and Retirement Study were included in the analysis. They provided 32,703 observations over 3 waves between 2008/2010 and 2016/2018. Data were analyzed using structural equation modeling with both concurrent and lagged associations between self-perceptions of aging and leisure engagement, controlling for confounders including age, gender, ethnicity, socioeconomic position, and health conditions. RESULTS: We found consistent evidence for leisure engagement as a predictor of self-perceptions of aging. There was also evidence for a reciprocal relationship where leisure engagement was predicted by older adults' self-perceptions of aging. Similar results were observed for specific domains of leisure engagement. DISCUSSION: Our findings provide empirical support for the potential benefits of leisure engagement on positive self-perceptions of aging, regardless of the type of activities. Our study also highlights the importance to consider the directionality in researching leisure engagement and self-perceptions of aging.

Mental health and wellbeing among people with informal caring responsibilities across different time points during the COVID-19 pandemic: a population-based propensity score matching analysis.

AIMS: Due to a prolonged period of national and regional lockdown measures during the coronavirus (COVID-19) pandemic, there has been an increase reliance on informal care for informal carers. In light of this, the current study compared the experiences of carers and non-carers on various mental health and wellbeing measures across six key time points during the pandemic. METHODS: Data analysed were from the University College London (UCL) COVID -19 Social Study. Our study focused on six time points in England: (1) the first national lockdown (March-April 2020); (2) the beginning of first lockdown rules easing (May 2020); (3) the second national lockdown (November 2020); (4) the third national lockdown (January 2021); (5) the easing of the third lockdown (March 2021); and (6) the end of restrictions (July-August 2021). We considered five mental health and wellbeing measures: depressive symptoms, anxiety symptoms, loneliness, life satisfaction, and sense of being worthwhile. Propensity score matching was applied for the analyses. RESULTS: We found that informal carers experienced higher levels of depressive and anxiety symptoms than non-carers across much of the pandemic. During the first national lockdown, carers also experienced a higher sense of life being worthwhile. No association was found between informal caring responsibilities and levels of loneliness and life satisfaction. CONCLUSION: Given that carers are an essential national healthcare support, especially during a pandemic, it is crucial to integrate carers' needs into healthcare planning and delivery. These results highlight that there is a pressing need to provide adequate and targeted mental health support for carers during and following this pandemic.

Hobby engagement and mental wellbeing among people aged 65 years and older in 16 countries.

Growing aging populations pose a threat to global health because of the social and psychological challenges they experience. To mitigate this, many countries promote hobby engagement to support and improve mental health. Yet, it remains unclear whether there is consistency in benefits across different national settings. We harmonized measures of hobby engagement and multiple aspects of mental wellbeing across 16 nations represented in five longitudinal studies (N = 93,263). Prevalence of hobby engagement varied substantially across countries, from 51.0% of Spanish respondents to 96.0% of Danish respondents. Fixed effects models and multinational meta-analyses were applied to compare the longitudinal associations between hobbies and mental wellbeing. Independent of confounders, having a hobby was associated with fewer depressive symptoms (pooled coefficient = -0.10; 95% confidence intervals (CI) = -0.13, -0.07), and higher levels of self-reported health (pooled coefficient = 0.06; 95% CI = 0.03, 0.08), happiness (pooled coefficient = 0.09; 95% CI = 0.06, 0.13) and life satisfaction (pooled coefficient = 0.10; 95% CI = 0.08, 0.12). Further analyses suggested a temporal relationship. The strength of these associations, and prevalence of hobby engagement, were correlated with macrolevel factors such as life expectancy and national happiness levels but overall, little variance in findings was explained by country-level factors (<9%). Given the relative universality of findings, ensuring equality in hobby engagement within and between countries should be a priority for promoting healthy aging.

Expanding the social cure: a mixed-methods approach exploring the role of online group dance as support for young people (aged 16-24) living with anxiety.

There is an increased interest in whether online arts interventions support mental health and social connections. This study explored eight weeks of online group dance as support for young people (aged 16-24) living with anxiety. The applicability of the 'social cure' theoretical framework to the novel context of an online dance class was sought. The study utilised an embedded QUAL+quan design, incorporating participatory focus group discussions (n = 3 groups; n = 11 participants) and one-on-one interviews (n = 2 participants), creative reflections (n = 16 participants) and ethnographic fieldnotes, and a repeated measures design with surveys at three timepoints (week 1, n = 27; week 4, n = 18; week 8, n = 14). Thematic analysis identified two overarching themes demonstrating how the dance classes (i) provided the opportunity to co-construct a meaningful shared identity and (ii) supported holistic wellbeing. The quantitative findings supported this, suggesting lower anxiety, depression, and loneliness and higher wellbeing, self-esteem, self-efficacy, and group closeness. This study expands the social cure to its application to an online dance context for the first time.

Longitudinal associations between going outdoors and mental health and wellbeing during a COVID-19 lockdown in the UK.

The COVID-19 pandemic led to national lockdowns in countries around the world. Whilst lockdowns were shown to be effective in reducing the spread of disease, they were also associated with adverse effects on people's mental health and wellbeing. Previous studies have suggested that time spent outside may have played a role in mitigating these negative effects, but research on this topic remains limited. Therefore, this study was designed to explore the longitudinal associations between going outdoors and people's mental health and wellbeing during the first national lockdown (March-May 2020) in the UK. Data from 35,301 participants from the COVID-19 Social Study were analysed. Fixed effects regression was used to explore the longitudinal association between changes in going outdoors (the number of days spent outside) and changes in depressive symptoms, anxiety symptoms, life satisfaction and loneliness. A range of household and neighbourhood moderators were examined. Results show that an increase in the number of days spent outside was associated with decreases in depressive and anxiety symptoms and an increase in life satisfaction. Associations were more salient amongst people living with others, and those with greater satisfaction with their neighbourhood walkability and green spaces. No longitudinal association was found with loneliness. Overall, our analyses showed a positive association between going outdoors and improved mental health and wellbeing during the first COVID-19 lockdown in the UK. These findings are important for formulating guidance for people to stay well at home during pandemics and for the on-going nature-based social prescribing scheme.

Relationships between Volunteering, Neighbourhood Deprivation and Mental Wellbeing across Four British Birth Cohorts: Evidence from 10 Years of the UK Household Longitudinal Study.

Volunteering is associated with greater mental, physical and social wellbeing. However, less is known about whether the health benefits of volunteering vary with two sets of factors known to shape population health and health-related behaviours: (1) age and birth cohort, and (2) place of residence. This study examined how these factors influence the relationship between volunteering and self-reported mental health using five waves of data from Understanding Society: The UK Household Longitudinal Study (UKHLS) enriched with information on neighbourhood deprivation (Index of Multiple Deprivation 2015). Two self-reported mental health and wellbeing outcomes were examined: mental distress (GHQ-12) and health-related quality of life (SF-12). The sample was stratified by cohort: pre-1945 (born before 1945), Baby Boomers (born 1945-1964), Gen X (born 1965-1979), and Millennials (born from 1980). Fixed-effects regressions revealed that volunteering was associated with reduced levels of mental distress and greater levels of health-related quality of life in older generations, but not amongst younger generations. No moderating effect of area deprivation was found. This study suggests that generational social attitudes and changes in how volunteering is portrayed and delivered could influence not only whether people volunteer, but also whether doing so bolsters health.

Do people reduce compliance with COVID-19 guidelines following vaccination? A longitudinal analysis of matched UK adults.

INTRODUCTION: COVID-19 vaccines do not confer immediate immunity and vaccinated individuals may still be at risk of transmitting the virus. Governments have not exempted vaccinated individuals from behavioural measures to reduce the spread of COVID-19, such as practising social distancing. However, vaccinated individuals may have reduced compliance with these measures, given lower perceived risks. METHODS: We used monthly panel data from October 2020 to March 2021 in the UK COVID-19 Social Study to assess changes in compliance following vaccination. Compliance was measured with two items on compliance with guidelines in general and compliance with social distancing. We used matching to create comparable groups of individuals by month of vaccination (January, February or not vaccinated by February) and fixed effects regression to estimate changes in compliance over the study period. RESULTS: Compliance increased between October 2020 and March 2021, regardless of vaccination status or month of vaccination. There was no clear evidence that vaccinated individuals decreased compliance relative to those who were not yet vaccinated. CONCLUSION: There was little evidence that sample members vaccinated in January or February reduced compliance after receiving vaccination for COVID-19. Continued monitoring is required as younger individuals receive the vaccine, lockdown restrictions are lifted and individuals receive second doses of the vaccine.

Comparisons of home-based arts engagement across three national lockdowns during the COVID-19 pandemic in England.

Between March 2020 and March 2021, the United Kingdom (UK) experienced three lockdowns due to the COVID-19 pandemic. Given the evident association between arts engagement and wellbeing, this study was designed to compare the predictors and patterns of home-based arts engagement during these lockdowns. Data analysed in this study were from the UK COVID-19 Social Study run by University College London. Multinomial logistic regression was used to identify predictors of arts engagement and compare (i) respondents' engagement levels during the first lockdown in April/May 2020 and their levels in pre-pandemic times (N = 23,086), (ii) their engagement levels during the second lockdown in November/December 2020 with their levels during the first lockdown (N = 11,481), and (iii) their engagement levels during the third lockdown in January/February 2021 with their levels during the first lockdown (N = 13,270). During first lockdown, 1 in 4 increased their arts engagement and 1 in 6 decreased it. Of those who increased, 2 in 5 maintained or further increased their engagement in subsequent lockdowns, but just 7% of those who had decreased their engagement increased it. Younger adults (aged 18-29) showed initial increases in first lockdown, whilst people who were not employed and those with a physical health condition showed decreases and people with a mental health condition showed changes during the first lockdown (both increases and decreases). Females and people with higher education showed continuous changes across the three lockdowns, with women being more likely to increase their engagement and those with higher education being less likely to decrease. People of ethnic minorities and those with higher income declined their engagement in the third lockdown. This study provides insight into levels of arts engagement across the three national lockdowns in the UK and suggests that the pandemic may have affected long-term cultural behaviours for some groups.

Urban greenspace and anxiety symptoms during the COVID-19 pandemic: A 20-month follow up of 19,848 participants in England.

This study examined the association between greenspace and the growth trajectories of anxiety symptoms during the COVID-19 pandemic. Using data from 19,848 urban residents in England who were followed for 20 months between March 2020 and October 2021, we found that living in an area with higher greenspace coverage (exposure) was associated with fewer anxiety symptoms independent of population density, area deprivation levels, socio-demographics, and health profiles. There was limited evidence that greenspace was related to the change of anxiety symptoms over time. No association with anxiety trajectories was found when considering distance to nearest greenspace (proximity), highlighting potentially differential mental health effects of simply having access to local parks and recreation areas versus living in areas of greater natural environment land cover. These findings have important implications for mental health intervention and policymaking.