Generalized anxiety disorder during COVID-19 in Canada: Gender-specific association of COVID-19 misinformation exposure, precarious employment, and health behavior change

Abstract

Background Growing evidence has demonstrated the mental health sequelae of the COVID-19 pandemic. Few studies have examined how pandemic-related stressors and resilience factors of anxiety affect women and men differently in Canada. Methods Population-based data from the Canadian Perspective Survey Series (CPSS-4: July 20 to 26, 2020) were analyzed to examine the relationship between Generalized Anxiety Disorder-7 scale (GAD-7) with COVID-19 misinformation exposure, precarious employment, and health behavior changes, after adjusting for socio-demographic variables. Stratified by gender, two multinomial logistic regression were conducted to calculate the likelihood of having minimal–mild anxiety (1≤ GAD score <10) and moderate–severe anxiety (GAD score ≥10), compared to no anxiety symptoms (GAD=0). Results Overall, respondents ( n = 3,779) were mainly Canadian-born (76.3%), aged >25 years (85.4%) and high school graduate (87.9%). The population prevalence of moderate–severe GAD was 13.6%, with women significantly higher than men (17.2% vs. 9.9%, p<0.001). For women ( n = 2,016), GAD was associated with being absent from work due to COVID-19 reasons (OR=3.52, 99% CI:1.12–11.04), younger age (ORs range from 2.19 to 11.01, p's<0.01), being single/widowed (OR=2.26, 99% CI 1.18–4.33), no past-week contacts outside household (OR=2.81, 99% CI:1.24–6.37), no outdoor exercise (OR=1.86, 99% CI:1.13–3.07). For men ( n = 1,753), GAD was associated with frequent fake news exposure (dose-response relations: ORs range from 3.14 to 6.55, p's<0.01), increased time of watching TV (OR=2.62, 99% CI: 1.31 – 5.27), no indoor exercise (OR=1.91, 99% CI:1.07–3.42). For both genders, GAD was associated with increased intake of alcohol, cannabis, and junk/sweet food (p's<0.01). Limitations Cross-sectional data prohibits causal inferences; self-reporting biases of GAD symptoms requires confirmation with diagnostic records. Conclusion The gendered impact of the COVID-19 pandemic was observed in the associations between clinically significant anxiety with COVID-19 misinformation exposure, job precarity, and addictive behaviors in Canada. Mental health interventions need to be gender responsive and should tackle upstream social determinants of health in this public health emergency.

COVID-19 Pandemic and Im/migrants’ Elevated Health Concerns in Canada: Vaccine Hesitancy, Anticipated Stigma, and Risk Perception of Accessing Care

“…Employment status was a variable to investigate the pandemic's impact on labour participation (defined as those who had worked at least one hour for pay, including self-employment) in the past 7 days prior to the survey (i.e., June 7 to June 13, 2020), with a specific focus to detect precarious employment/job precarity caused by the COVID-19 pandemic [24]. Consistent with prior literature [24], the response was categorized into five groups: (1) employed and at work for at least part of the week; (2) employed but absent for the entire week due to COVID-19 (e.g., business closure, layoff, or personal circumstances including COVID-19 diagnosis); (3) employed but absent for the entire week due to other reasons not related to COVID-19 (e.g., vacation, work schedule, seasonal business, maternity or parental leave, illness other than COVID-19); (4) not employed; (5) not stated. To measure the direct disruption from the COVID-19 pandemic, respondents who had a casual job with no work available at reference week were not considered as absent from work.…”

“…In addition, the inadequacy of culturally sensitive health care [22], the lack of interpretation services [15], limited health insurance eligibility [17] and the arbitrary 3-month wait period for insurance coverage [23] further exacerbate im/migrants' mistrust in the Canadian health care system. These pre-existing access problems, together with recently widespread misinformation around the pandemic [24] (i.e., the COVID-19 "infodemic"), could give rise to the vaccine hesitancy-one of the top 10 global health threats in 2019 as declared by the World Health Organization (WHO) [25]as well as stigma and fear accompanying COVID-19-"the greatest enemy" named by the United Nations [26].…”

Affective States During the First Wave of the COVID-19 Pandemic: Progression of Intensity and Relation With Public Health Compliance Behavior

“…Research has since revealed some predictors of higher compliance with public health measures during the pandemic, notably older age ( Brouard et al, 2020 ; Haischer et al, 2020 ; Solomou and Constantinidou, 2020 ) and female gender ( Clark et al, 2020 ; Galasso et al, 2020 ; Haischer et al, 2020 ; Solomou and Constantinidou, 2020 ; Nivette et al, 2021 ). Higher self-efficacy ( Clark et al, 2020 ; Hamerman et al, 2021 ; Jørgensen et al, 2021 ), higher perceived vulnerability to disease ( De Coninck et al, 2020 ; Hromatko et al, 2021 ), higher trust in science ( Hromatko et al, 2021 ; Plohl and Musil, 2021 ), prosocial personality traits ( Dinić and Bodroža, 2021 ; Nivette et al, 2021 ; Ścigała et al, 2021 ), and lower exposure to misinformation ( Roozenbeek et al, 2020 ; Simonov et al, 2020 ; Greene and Murphy, 2021 ; Lin, 2022 ) have also been linked to higher compliance with public measures. We aimed to investigate whether pandemic-related affective states also predicted compliance with public health measures.…”

Measurement invariance of the GAD-5 Generalized Anxiety Disorder Scale in a Mexican general population sample

“…Despite these considerations, the GAD-5 is a useful alternative in the general population that can be used in primary care settings, like the GAD-7 ( 11 , 12 , 27 – 31 ), and during health emergencies such as the COVID-19 pandemic. In this respect, the GAD-5 offers the practicality of web-based application in addition to the novelty of the response format used.…”