Disadvantaged Canadians most affected by COVID-19 pandemic

There’s hardly a place in the world untouched by COVID-19.

In April, one month after the World Health Organization declared the novel coronavirus a global pandemic, researchers at The Royal Ottawa Mental Health Centre, the University of Ottawa Heart Institute, and several other institutions across Ontario and Quebec distributed an online longitudinal population survey to assess how Canadians were coping with the virus.

Specifically, this survey sought to examine the psychological, social, and financial impacts of the COVID-19 pandemic among health care providers, those with prior mental health conditions, and the general population at various stages of the outbreak.

The survey, uploaded to websites, disseminated via social media, and shared with organizations and hospitals across Canada, prompted respondents to evaluate their perceived stress at the acute stage of the pandemic in relation to their estimated pre-outbreak stress levels. More than 6,000 completed the survey.

Perhaps unsurprisingly, researchers found Canadians are experiencing increased levels of COVID-related stress. But preliminary analyses revealed a harsher truth as well: vulnerable subgroups (young women with children, those with mental, cognitive or physical impairments, and those already at an economic disadvantage, for example) seem to be among the hardest hit.

The survey’s findings sound a warning bell for individuals with heart disease, too, as stress and other mental health conditions are highly comorbid with heart disease.

[...] the most vulnerable in our population were the ones so dramatically impacted across multiple domains.

- Dr. Jodi Edwards, UOHI

“The study’s primary outcome found that 30% of respondents experienced clinically significant increases in their level of perceived stress,” explained Dr. Jodi Edwards, director of the Brain and Heart Nexus Research Program at the University of Ottawa Heart Institute (UOHI), and the UOHI site lead for this study. The strongest independent factors identified to be linked to increased stress were having a prior mental health condition, being female sex, younger age, having children, and noting the presence of COVID-related symptoms.

In a telephone interview with The Beat, Dr. Edwards shared how preliminary data revealed rates of job loss due to the outbreak or salary loss exceeding 35% were higher in individuals with a family income below $40,000 per year compared to those with higher family income. Similarly, loss of employment or salary was more likely among individuals without a university degree when compared to those with a university degree and was also greater in those with an existing mental health diagnosis.

“It’s really quite alarming,” said Edwards of the findings. “It shows how the most vulnerable in our population were the ones so dramatically impacted across multiple domains.”

More, Edwards said while only half of the parents with underage children reported that either they or their partner were homeschooling, most respondents indicated that the outbreak was somewhat disruptive for the management of their work/study and family life. On average, relationship ratings with both family and friends during the outbreak “significantly deteriorated compared to pre-outbreak estimates.”

“What we’re learning is that the negative impacts of the virus disproportionately affect those already disadvantaged groups,” concludes Edwards. “As we move toward economic and social recovery, these vulnerable groups must be at the forefront of our efforts.”

Edwards said the findings are particularly relevant for those with heart disease. “While everyone should be taking proactive measures to manage stress, especially during crises, such as the coronavirus pandemic, it is important for those with heart disease to continue to maintain a consistent treatment regimen, including regular exercise and stress management and regular sleep.”

Future analyses of the survey data will specifically investigate the impacts of the pandemic separately for groups of individuals with different types of chronic diseases, including heart disease. Another upcoming analysis of this survey will focus on sleep patterns during the pandemic.

This study was led by Principal Investigator Dr. Rébecca Robillard from the Royal Ottawa Mental Health Centre, and conducted in collaboration with scientists from The Ottawa Hospital, the University of Ottawa Heart Institute, the Children's Hospital of Eastern Ontario, Sunnybrook Hospital, Southlake Regional Health Centre, Centre for Addiction and Mental Health, l'Hôpital Rivière-des-Prairies, l'Hôpital du Sacré-Cœur de Montréal and centres from the CIUSSS du Centre-Sud-de-l'Île-de-Montréal who are affiliated to the University of Ottawa, University of Montreal, and University McGill.  The manuscript is currently under revision with the first in a series of publications to be available soon.