Housing environment and mental health of Europeans during the COVID-19 pandemic: a cross-country comparison.

Many studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87-5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05-0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.

The impact of the initial and second national COVID-19 lockdowns on mental health in young people with and without pre-existing depressive symptoms.

BACKGROUND: The evidence on mental health during COVID-19 evolved fast, but still little is known about the long-lasting impact of the sequential lockdowns. We examine changes in young people's mental health from before to during the initial and second more prolonged lockdown, and whether women and those with pre-existing depressive symptoms were disproportionally impacted. METHODS: Participants reported on mental health indicators in an ongoing 18-year data collection in the Danish National Birth Cohort and in a COVID-19 survey, including 8 data points: 7 in the initial lockdown, and 1 year post. Changes in quality of life (QoL), mental well-being, and loneliness were estimated with random effect linear regressions on longitudinal data (N = 32,985), and linear regressions on repeated cross-sections (N = 28,579). FINDINGS: Interim deterioration in mental well-being and loneliness was observed during the initial lockdown, and only in those without pre-existing depressive symptoms. During the second lockdown, a modest deterioration was again observed for mental well-being and loneliness. QoL likewise only declined among those without pre-existing symptoms, where women showed a greater decline than men. QoL did not normalise during the initial lockdown and remained at lower levels during the second lockdown. These findings were not replicated in the repeated cross-sections. INTERPRETATION: Except for an interim decrease in mental health, and only in those without pre-existing depressive symptoms, this study's findings do not suggest a substantial detrimental impact of the lockdowns.

Impact of housing conditions on changes in youth's mental health following the initial national COVID-19 lockdown: a cohort study.

We aimed to investigate if declines in youth's mental health during lockdown were dependent on housing condition among 7445 youth (median age ~ 20 years) from the Danish National Birth Cohort (DNBC), with data collected at 18 years of age and again three weeks into the first national lockdown (April 2020). We examined associations between housing conditions (access to outdoor spaces, urbanicity, household density, and household composition) and changes in mental health (mental well-being, Quality of Life (QoL) and loneliness). We report results from multivariate linear and logistic regression models. Youth without access to outdoor spaces experienced greater declines in mental well-being (vs. garden; mean difference: - 0·75 (95% CI - 1·14, - 0·36)), and correspondingly greater odds of onset of low mental well-being (vs. garden; OR: 1·72 (95% CI 1·20, 2·48)). Youth in higher density households vs. below median or living alone vs. with parents only also had greater odds of onset of low mental well-being (OR: 1·26 (95% CI 1·08, 1·46) and OR: 1·62 (95% CI 1·17, 2·23), respectively). Living in denser households (vs. below median; OR: 1·18 (95% CI 1·06, 1·33), as well as living alone (vs. with parents; OR: 1·38 (95% CI 1·04, 1·82) was associated with onset of low QoL. Living alone more than doubled odds of onset of loneliness compared to living with parents, OR: 2·12 (95% CI 1·59, 2·82). Youth living alone, in denser households, and without direct access to outdoor spaces may be especially vulnerable to mental health declines.