Symptoms of anxiety and depression affect 47.3% of essential workers during the Covid-19 pandemic, in Brazil and in Spain. More than half of them - and 27.4% of the total of people interviewed - suffer from both anxiety and depression simultaneously. In addition, 44.3% report alcohol abuse; 42.9% report changes in their sleep habits; and 30.9% were diagnosed with or were treated for mental illness in the year prior to a survey coordinated by Fiocruz, in partnership with other institutions.
These are the main results of the article Depression and Anxiety Among Essential Workers from Brazil and Spain During The Covid-19 Pandemic: a web survey, accepted by the Journal of Medical Internet Research.
The results refer to the web survey placed early in the pandemic in Spain (between April 15th and May 15th) and in Brazil (between April 20th and May 20th), for a total of 22,876 questionnaires filled. Of the total sample, a little more than 16% (3,745) were essential workers (the main target of the study), of which 2,842 (76%) were Brazilian and 903 (24%) were Spanish. These 3,745 responded “yes” to the question: “Are you currently an active healthcare worker, or are you currently working in other essential jobs (transportation, food, cleaning)?”
Researchers Raquel De Boni, Francisco Inácio Bastos and Jurema Mota, of the Institute of Scientific and Technological Communication and Information in Health (Icict/Fiocruz), participated in the research, that as carried out in a partnership with researchers of the University of Valencia (Spain) and the Hospital de Clinicas de Porto Alegre (HCPA)/Federal University of Rio Grande do Sul (UFRGS).
According to preliminary results, symptoms of anxiety and depression are higher among essential workers in Brazil, affecting 55% of the total number, when compared to the same workers in Spain (23%). Spain was going through its worst moment during the pandemic. “We were expecting the opposite to happen”, remembers De Boni. Bastos has some hypotheses, including unemployment: “Various papers published during the Greek economic crisis show unemployment and risk of losing a job as important factors in the generation of stress and depression. And the impact of Covid-19 on the labor market is very intense".
De Boni believes that social determinants of health, such as socioeconomic conditions and inequalities in health, also seem to explain this discrepancy. “It is necessary to double our attention to the mental health of workers in places plagued by multiple social and health issues. According to the theory of syndemics, proposed by Merrill Singer in the 1990s, the simultaneous presence of these situations works in synergy, increasing the risk of both physical and mental health issues”.
Other results of the survey show that most essential workers who answered the survey in Brazil were women (72.2%), with an average age of 39 years old, and a college degree (56.5%) or a master’s degree/doctorate (28.5%).
Bastos and De Boni highlight that in normal times science has shown that a lifestyle that is not particularly healthy tends to increase mental health problems. In a crisis such as the one we are facing with Sars-CoV-2, the virus of Covid-19, rash and unexpected changes in our lifestyle have been taking place in different ways in many countries, beginning with large-scale social distancing. It is therefore not difficult to imagine that these changes can worsen one’s mental health, causing problems such as depression and anxiety, in addition to alcohol and drug addiction. During other great crises, such as the attack on the Twin Towers in New York and the Sars epidemic in Asia, it was observed that big changes in lifestyle resulted in more mental diseases.
“Our data show, for instance, that an unhealthy lifestyle was associated with eight times more chances of an essential worker to have depression and anxiety symptoms during the beginning of the pandemic in Spain and in Brazil”, says Flavio Kapcisnzki, researcher of HCPA/UFRGS and of McMaster.
Lifestyle was assessed using a scale (Smile-C) that involves 27 questions distributed in 7 areas: Diet and nutrition; Substance abuse (alcohol, illicit drugs, pharmaceutical drugs); Physical activity; Stress management; Restoring sleep; Social support; Exposure to the external environment. According to Bastos, the Diet and Nutrition factor was especially analyzed in the research.
“In August, the Nutrinet Brasil cohort study on diet changes released the results of its survey and showed a worrying result. Although there has been a general increase in the consumption of healthier foods in Brazil after the Covid-19 pandemic began, consumption of ultra-processed foods has grown in regions with lower economic development and among people with lower education. This change in regular diet induces obesity, hypertension and diabetes in these segments, increasing risks when it comes to Covid-19”, explains Bastos.
Kapcisnzki emphasizes that in the world’s largest cities, lifestyle has been suffering from sedentarism, poor diets, use of alcohol, cigarette smoking, and loneliness. Modifying these behaviors is a great challenge for individuals as well as for public health.