Population-level changes in the mental health of UK workers during the COVID-19 pandemic: A longitudinal study using Understanding Society

Objectives The COVID−19 pandemic has substantially affected workers mental health. We investigated changes in UK workers mental health by industry, social class, and occupation and differential effects by UK country of residence, gender and age. Methods We used representative Understanding Society data from 6,474 adults (41,207 observations) in paid employment who participated in pre−pandemic (2017−2020) and at least one COVID-19 survey. The outcome was psychological distress (General Health Questionnaire-12; score≥4). Exposures were industry, social class and occupation and are examined separately. Mixed−effects logistic regression was used to estimate relative (OR) and absolute (%) increases in distress before and during pandemic. Differential effects were investigated for UK countries of residence (Non−England/England), gender (Male/female), and age (Younger/Older) using 3−way interaction effects. Results Psychological distress increased in relative terms most for professional, scientific and technical (OR:3.15, 95% CI 2.17−4.59) industry in the pandemic versus pre−pandemic period. Absolute risk increased most in hospitality (+11.4%). For social class, small employers/self−employed were most affected in relative and absolute terms (OR:3.24, 95% CI 2.28− 4.63; +10.3%). Across occupations Sales and customer service (OR:3.01, 95% CI 1.61− 5.62; +10.7%) had the greatest increase. Analysis with 3−way interactions showed considerable gender differences, while for UK country of residence and age results are mixed. Conclusions Psychological distress increases during the COVID−19 pandemic were concentrated among professional and technical and hospitality industries, small employers/self−employed and sales and customers service workers. Female workers often exhibited greater differences in risk by industry and occupation. Policies supporting these industries and groups are needed.