It’s been almost five years since the end of the COVID lockdowns. Yet the world is still continuing to learn about how mental health changed during – and after – this unprecedented time.
My colleagues and I wanted to understand how mental health had changed across the life course of baby boomers and generation X – including during and beyond the pandemic.
We also wanted to understand if (and how) gender and socioeconomic inequalities had changed throughout these periods. Previous research we’d conducted had shown that large, existing gender inequalities in mental ill-health had widened during the pandemic period.
Moreover, the post-lockdown period came with a marked increase in the cost of living – making ends meet harder in a context where there had already been high levels of poverty for decades before.
We found that, on average, mental health bounced back to levels similar to those recorded before the pandemic. However, women and people from socioeconomically disadvantaged backgrounds continued to experience worse mental health across their adult lives, including after the pandemic. And those inequalities could be traced back to their early lives.
To conduct our study, we analysed data from two nationally representative British birth cohorts: the 1958 National Child Development Study and the 1970 British Cohort Study.
These ongoing studies follow the lives of all people born in Britain during one particular week in 1958 and 1970. Information is collected on each participant’s physical and mental health, as well as their social, economic and family circumstances.
These studies gave us the unique opportunity to investigate how different outcomes – including mental health – changed across the life course in baby boomers and generation X.
For our study, we looked at the same 14,182 people over up to four decades: 6,553 of whom were born in 1958 and 7,629 who were born in 1970.
We used the same measure of psychological distress (which encompasses a range of unpleasant mental states, such as feeling depressed, worried or scared) in both cohorts. This allowed us to understand how mental health had changed in the same participants throughout their adult lives – between the ages of 23-64 for baby boomers and 26-52 for generation X.
To ensure our results weren’t due to differences in measurement, we tested this tool to ensure it provided comparable measures across cohorts, genders, socioeconomic backgrounds and ages.
To examine inequalities by gender and socioeconomic background, we used information on sex assigned at birth, parental social class and housing tenure (whether their parents owned or rented their home) when participants were children (aged five-11).
We also examined the intersection of gender and socioeconomic background to understand any dual impact these inequalities may have on mental health throughout adulthood.
What we found
In both cohorts, mental health was generally at its best during a person’s 30s. But, from middle age, average levels of psychological distress began to increase.
During the pandemic, both cohorts experienced a marked increase in psychological distress. Levels reached, and in some cases surpassed, the highest distress levels they’d experienced in any other period of their lives.
In the post-lockdown period, average distress levels declined – largely returning to pre-pandemic levels. While generation X had higher average distress levels across adulthood, post-pandemic improvements were smaller for baby boomers.
Women and people who grew up in socioeconomically disadvantaged households consistently reported higher psychological distress throughout their lives compared to men and people from more advantaged backgrounds. These inequalities, which were already visible in the participants’ 20s, were still present when they were in their 50s or 60s.
Among baby boomers, socioeconomic inequalities were even larger in women – showing a dual effect.
The changing picture of mental health
We were able to track how mental health changed in the same people through different periods in their lives. This also allowed us to identify potential risk factors for poor mental health.
Our study showed further evidence of the life-long impact of gender and socioeconomic disadvantage. These factors are already known to be among the key social determinants of mental health.
Although our study didn’t investigate the specific ways in which these life-long inequalities in mental ill-health came to happen, we believe these inequalities reflect the unfair distribution of opportunities, power and privilege in society. In other words, our findings may reflect the long-term impact of sexism, classism and material deprivation – and the ways these inequalities overlap.
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Women and young girls have long been at greater risk of experiencing a number of mental health difficulties. Factors such as sexual violence, safety concerns, labour market discrimination and the unequal distribution of unpaid care work all potentially contribute to this.
Similarly, early-life socioeconomic disadvantage can limit or preclude access to certain resources, such as wealth and knowledge, which can be protective of mental health.
The finding that socioeconomic inequalities were even larger in women from the baby boomer generation may be partly explained by societal changes in the second-half of the 20th century. Changes such as the expansion of women’s education and labour-market participation and small improvements in the gender pay gap may have had a protective effect on mental health for women born in generation X.
In our view, this supports the idea that these inequalities can, indeed, be prevented.
Future of mental health
One one hand, our findings show the remarkable resilience of two British generations when faced with the challenges the pandemic brought.
But on the other hand, our findings also highlight the unfair, life-long factors that can contribute to poor mental health – factors that are largely down to chance.
Around one in three children in the UK currently living in poverty. Global gender equality is stalling – and, in some cases, even going backwards. Finding ways of addressing these inequalities will be key in improving mental health for younger generations.
Darío Moreno-Agostino receives funding from the Wellcome Trust under grant number 304283/Z/23/Z, and has received funding from the Economic and Social Research Council (ESRC) Centre for Society and Mental Health at King's College London under grant number ES/S012567/1. The views expressed here are those of the author and not necessarily those of the Wellcome Trust, ESRC, or King's College London.
