Comparing mental health trajectories of four different types of key workers with non-key workers: A 12-month follow-up observational study of 21,874 adults in England during the COVID-19 pandemic

Paul, E.; Mak, H. W.; Fancourt, D.; Bu, F.

Background: There are concerns that key workers may be at a greater risk for psychological distress than non-key workers during the COVID-19 pandemic. However, little research has included key workers outside of the healthcare sector or has disaggregated key workers into different subgroups. Aims: To examine longitudinal changes in mental health over 12 months during the COVID-19 pandemic comparing four different groups of key workers with non-key workers. Method: Longitudinal data were from 21,874 adults living in England (21 March 2020 to 22 February 2021). Latent growth modelling (LGM) was utilised to compare growth trajectories of depressive and anxiety symptoms in non-key workers and four types of key workers: i) health and social care workers, ii) teachers and childcare workers, iii) public service workers, and iv) essential services key workers (e.g., food chain or utility workers). Results: When accounting for both time-invariant and time-varying covariates, key workers in the essential services category had consistently higher levels of depressive and anxiety symptoms than non-key workers across the whole of the study period. There was little difference in mental health trajectories between health/social care, teachers/childcare and public service worker categories and non-key workers. Conclusions: Our findings suggest risk for poorer mental health during the COVID-19 pandemic varies within the broad category of key workers generally, and that those working in utility, food chain, and transport roles are especially at risk. Future research should focus on identifying which aspects of working conditions may be contributing to occupational stress in these groups.