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      Inequalities in mental health, self-rated health, and social support among sexual minority young adults during the COVID-19 pandemic: analyses from the UK Millennium Cohort Study

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          Abstract

          Purpose

          Young adults who self-identify as a sexual minority may have been particularly harmed by the consequences of lockdown, closure of educational institutions, and social distancing measures as they are likely to have been confined in households that may not be supportive of their sexual orientation. We examine inequalities in the mental health and self-rated health of sexual minority young adults, compared to their heterosexual peers, at the height of lockdown restrictions in the UK.

          Methods

          We analysed data from singletons who participated in waves 6, 7, and the wave 1 COVID-19 survey ( n = 2211) of the Millennium Cohort Study, a nationally representative longitudinal study of infants born in the UK between September 2000 and January 2002. Regression models compared the mental health, self-rated health, and social support of sexual minority young adults to that of their heterosexual peers.

          Results

          One in four young adults self-identified with a sexual orientation or attraction other than completely heterosexual. Sexual minority young adults had significantly lower levels of social support ( β =  − 0.38, SE 0.08), poorer self-rated health (OR 3.91, 95% CI 2.41–6.34), and higher levels of psychological distress ( β = 2.26, SE 0.34), anxiety ( β = 0.40, SE 0.15), and loneliness ( β = 0.66, SE 0.18) when compared to heterosexual young adults.

          Conclusions

          Sexual minority young adults in the UK have been detrimentally impacted by the coronavirus pandemic, experiencing inequalities in mental health, self-rated health, and social support when compared to heterosexual young adults. Implications for policy and practice include a stronger provision of safe spaces in the community and in institutions, and policies that address marginalisation and harassment.

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          Most cited references20

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          Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence.

          Ilan Meyer (2003)
          In this article the author reviews research evidence on the prevalence of mental disorders in lesbians, gay men, and bisexuals (LGBs) and shows, using meta-analyses, that LGBs have a higher prevalence of mental disorders than heterosexuals. The author offers a conceptual framework for understanding this excess in prevalence of disorder in terms of minority stress--explaining that stigma, prejudice, and discrimination create a hostile and stressful social environment that causes mental health problems. The model describes stress processes, including the experience of prejudice events, expectations of rejection, hiding and concealing, internalized homophobia, and ameliorative coping processes. This conceptual framework is the basis for the review of research evidence, suggestions for future research directions, and exploration of public policy implications.
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            Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection.

            Anxiety, although as common as depression, has received less attention and is often undetected and undertreated. To determine the current prevalence, impairment, and comorbidity of anxiety disorders in primary care and to evaluate a brief measure for detecting these disorders. Criterion-standard study performed between November 2004 and June 2005. 15 U.S. primary care clinics. 965 randomly sampled patients from consecutive clinic patients who completed a self-report questionnaire and agreed to a follow-up telephone interview. 7-item anxiety measure (Generalized Anxiety Disorder [GAD]-7 scale) in the clinic, followed by a telephone-administered, structured psychiatric interview by a mental health professional who was blinded to the GAD-7 results. Functional status (Medical Outcomes Study Short Form-20), depressive and somatic symptoms, and self-reported disability days and physician visits were also assessed. Of the 965 patients, 19.5% (95% CI, 17.0% to 22.1%) had at least 1 anxiety disorder, 8.6% (CI, 6.9% to 10.6%) had posttraumatic stress disorder, 7.6% (CI, 5.9% to 9.4%) had a generalized anxiety disorder, 6.8% (CI, 5.3% to 8.6%) had a panic disorder, and 6.2% (CI, 4.7% to 7.9%) had a social anxiety disorder. Each disorder was associated with substantial impairment that increased significantly (P < 0.001) as the number of anxiety disorders increased. Many patients (41%) with an anxiety disorder reported no current treatment. Receiver-operating characteristic curve analysis showed that both the GAD-7 scale and its 2 core items (GAD-2) performed well (area under the curve, 0.80 to 0.91) as screening tools for all 4 anxiety disorders. The study included a nonrandom sample of selected primary care practices. Anxiety disorders are prevalent, disabling, and often untreated in primary care. A 2-item screening test may enhance detection.
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              UCLA Loneliness Scale (Version 3): reliability, validity, and factor structure.

              D. Russell (1996)
              In this article I evaluated the psychometric properties of the UCLA Loneliness Scale (Version 3). Using data from prior studies of college students, nurses, teachers, and the elderly, analyses of the reliability, validity, and factor structure of this new version of the UCLA Loneliness Scale were conducted. Results indicated that the measure was highly reliable, both in terms of internal consistency (coefficient alpha ranging from .89 to .94) and test-retest reliability over a 1-year period (r = .73). Convergent validity for the scale was indicated by significant correlations with other measures of loneliness. Construct validity was supported by significant relations with measures of the adequacy of the individual's interpersonal relationships, and by correlations between loneliness and measures of health and well-being. Confirmatory factor analyses indicated that a model incorporating a global bipolar loneliness factor along with two method factor reflecting direction of item wording provided a very good fit to the data across samples. Implications of these results for future measurement research on loneliness are discussed.
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                Author and article information

                Contributors
                l.becares@sussex.ac.uk
                Journal
                Soc Psychiatry Psychiatr Epidemiol
                Soc Psychiatry Psychiatr Epidemiol
                Social Psychiatry and Psychiatric Epidemiology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0933-7954
                1433-9285
                4 May 2022
                4 May 2022
                : 1-8
                Affiliations
                [1 ]GRID grid.12082.39, ISNI 0000 0004 1936 7590, Department of Social Work and Social Care, , University of Sussex, ; Essex House, Falmer, Brighton, BN1 9QQ UK
                [2 ]GRID grid.83440.3b, ISNI 0000000121901201, EPPI-Centre, UCL Social Research Institute, , University College London, ; London, UK
                Author information
                http://orcid.org/0000-0002-4207-074X
                Article
                2291
                10.1007/s00127-022-02291-1
                9065661
                35507033
                aec79809-6d16-45cf-8772-d4f4e444e1a6
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 2 August 2021
                : 12 April 2022
                Categories
                Original Paper

                Clinical Psychology & Psychiatry
                sexual minority,mental health,coronavirus pandemic,social support,self-rated health

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