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. 2023 Jul 21;23(1):1405.
doi: 10.1186/s12889-023-16280-9.

The level of education is associated with an anxiety-depressive state among men and women - findings from France during the first quarter of the COVID-19 pandemic

Camille Joannès  1 , Niamh M Redmond  2 , Michelle Kelly-Irving  2   3 , Josephine Klinkenberg  4 , Cassandra Guillemot  4 , Florence Sordes  4 , Cyrille Delpierre  2 , Lola Neufcourt  2 ; EPIDEMIC consortium
Collaborators, Affiliations

The level of education is associated with an anxiety-depressive state among men and women - findings from France during the first quarter of the COVID-19 pandemic

Camille Joannès et al. BMC Public Health. .

Abstract

Context: It is widely recognised that the COVID-19 pandemic has negatively impacted individuals' mental health. However, little emphasis has been put on the possible influence of socio-economic factors in the relationship. In the context of the COVID-19 pandemic, our objectives were (i) to assess the relationship between education level and mental health in French adults, and (ii) to study the influence of the economic, social, health and the COVID-19-related factors in men and women respectively.

Method: Data are from 32,581 individuals representative of the French population who responded to the weekly survey "Baromètre COVID-19" between April 7th and May 31st 2020. Education level was self-reported (university degree, high school qualification, vocational certificate/qualification, no diploma). Anxiety-depressive state was derived from four items related to the frequency of occurrence of depressive and anxiety symptoms, and summarized in an overall validated anxiety-depressive score. Multivariate linear regression analyses were carried out with nested adjustments of variables related to economic, social, health and COVID-19 contexts to assess the relationship between education and anxiety-depressive state.

Results: In total, 45% of individuals reported symptoms of anxiety-depressive state (53% in women versus 36% in men). Among men, those with a vocational certificate/qualification and those with no diploma had a greater risk of having a higher anxiety-depressive state compared to those with a university degree (βVocational certificate/qualification = 0.16 [0.04; 0.27]; βNo diploma = 0.75 [0.43; 1.07]) while among women, the risk of anxiety-depressive state increased as education level decreased (βBaccalaureate = 0.37 [0.25; 0.49]; βVocational certificate/qualification = 0.41 [0.28; 0.54]; βNo diploma = 0.8 [0.49; 1.12]). For both men and women, economic, health, and COVID-19 factors partly attenuate these associations while social factors marginally modified the relationship. After accounting for confounders and intermediate variables, the absence of a diploma remained associated with anxiety-depressive state among men, while the whole educational gradient of anxiety-depressive state persisted among women.

Conclusion: In France, at the end of the first wave of COVID-19, individuals with a lower level of education had a higher risk of anxiety-depressive state. This association was more pronounced for women, highlighting a process of social inequality in health possibly related to gender. This should be considered in future prevention and public health interventions.

Keywords: Education; Mental health; SARS-CoV-2; Social health inequalities.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Causal diagram of the study
See this image and copyright information in PMC

References

    1. Kumar A, Nayar KR. COVID 19 and its mental health consequences. J Ment Health. 2021;30(1):1–2. doi: 10.1080/09638237.2020.1757052. - DOI - PubMed
    1. Witteveen D, Velthorst E. Economic hardship and mental health complaints during COVID-19. Proc Natl Acad Sci U S A. 2020;117(44):27277–27284. doi: 10.1073/pnas.2009609117. - DOI - PMC - PubMed
    1. Doré I, Caron J. Santé mentale : concepts, mesures et déterminants. smq. 2017;42(1):125–45. doi: 10.7202/1040247ar. - DOI - PubMed
    1. Mental health and COVID-19. [cited 2021 Dec 13]. Available from: https://www.euro.who.int/en/health-topics/health-emergencies/coronavirus....
    1. Holmes EA, O’Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. 2020;7(6):547–560. doi: 10.1016/S2215-0366(20)30168-1. - DOI - PMC - PubMed

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