Braving the waves: exploring capability well-being patterns in seven European countries during the COVID-19 pandemic

Abstract

The COVID-19 pandemic considerably impacted the lives of European citizens. This study aims to provide a nuanced picture of well-being patterns during the pandemic across Europe with a special focus on relevant socio-economic sub-groups. This observational study uses data from a repeated, cross-sectional, representative population survey with nine waves of data from seven European countries from April 2020 to January 2022. The analysis sample contains a total of 25,062 individuals providing 64,303 observations. Well-being is measured using the ICECAP-A, a multi-dimensional instrument for approximating capability well-being. Average levels of ICECAP-A index values and sub-dimension scores were calculated across waves, countries, and relevant sub-groups. In a fixed effects regression framework, associations of capability well-being with COVID-19 incidence, mortality, and the stringency of the imposed lockdown measures were estimated. Denmark, the Netherlands, and France experienced a U-shaped pattern in well-being (lowest point in winter 2020/21), while well-being in the UK, Germany, Portugal, and Italy followed an M-shape, with increases after April 2020, a drop in winter 2020, a recovery in the summer of 2021, and a decline in winter 2021. However, observed average well-being reductions were generally small. The largest declines were found in the well-being dimensions attachment and enjoyment and among individuals with a younger age, a financially unstable situation, and lower health. COVID-19 mortality was consistently negatively associated with capability well-being and its sub-dimensions, while stringency and incidence rate were generally not significantly associated with well-being. Further investigation is needed to understand underlying mechanisms of presented patterns.

Keywords: COVID-19; Capability well-being; ICECAP-A; Pandemic; Well-being.

Fig. 1

Mean incidence rate, mortality rate, and 14-day stringency index across the seven countries and the nine waves of data collected from April 2020 to September 2021. Incidence rate capped at 1000 (black)

Fig. 2

Mean ICECAP-A utility score across countries and waves of data collection. The utility score ranges from 0 (no capabilities) to 1 (full capabilities) and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals. Mortality data were extracted from Our World in Data [24]

Fig. 3

Mean ICECAP-A dimension scores across countries and waves of data collection. ICECAP-A dimension scores range from 1 (worst) to 4 (best). Number of observations per cell ~ 1000

Fig. 4

Mean ICECAP-A utility score across countries and waves of data collection, by age groups. The utility score ranges from 0 to 1 and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals

Fig. 5

Mean ICECAP-A utility score across countries and waves of data collection, by gender. The utility score ranges from 0 to 1 and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals

Fig. 6

Mean ICECAP-A utility score across countries and waves of data collection, by education level. Highly educated corresponds to some form of tertiary education (see Appendix 1). The utility score ranges from 0 to 1 and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals

Fig. 7

Mean ICECAP-A utility score across countries and waves of data collection, by health status using EQ-5D sum score. No health problems (5), some health problems (6–9), more severe health problems (10 +) on a theoretical range of 5 (no problems) to 25 (extreme problems on all dimensions). The utility score ranges from 0 to 1 and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals

Fig. 8

Mean ICECAP-A utility score across countries and waves of data collection, by financial security. “Insecure” defined as having some or great difficulties with making ends meet. The utility score ranges from 0 to 1 and was calculated using weights derived for the UK [32]. Shaded areas represent 95% confidence intervals