Last in line: Impacts of the COVID-19 pandemic on the health and well-being of young adults in BC

Prior to the COVID-19 pandemic, young adults age 18 to 30 years in British Columbia faced a challenging social, economic, and employment landscape due to changing norms around key life transitions, increasing income inequality, and declining housing affordability. The prevailing characterization of young adults as healthy, highly social, and irresponsible is inaccurate and detrimental to pandemic recovery planning. Emerging data forecast serious impacts of pandemic response measures on the social determinants of young adult health while intensifying existing downstream effects on their health behaviors, care, and outcomes.[1] The BCCDC COVID-19 Young Adult Task Force was commissioned in response to concerning impacts to highlight areas for action to mitigate those impacts.

Young adults in BC are experiencing a severe economic crisis: the unemployment rate has more than doubled in this age group during the pandemic and has not yet recovered to prepandemic levels.[2,3] Young adults have been more likely than others to lose their job during the pandemic and many report increased difficulty meeting household financial needs.[3] Education and job training have been disrupted or delayed for many. Students report delays in program completion and challenges securing work experience (e.g., co-op opportunities).[4] Poor housing affordability contributes to overcrowded living conditions and increased risk of COVID-19 exposure. Risk of exposure is also increased due to frontline work in grocery stores, restaurants, and retail stores, as well as being last in line for the COVID-19 vaccination. Indeed, according to the BCCDC, as of April 2021, young adults represented 31% of BC individuals infected during the pandemic but only 17% (892 543) of the BC population.

Young adults experienced peak rates of mental health and substance use disorders prior to the COVID-19 pandemic and are now experiencing substantial increases in mental health concerns and stress. In a BC survey of almost 400 000 participants in May 2020, more than half (54%) of young adults reported worsening mental health at the onset of the pandemic compared to 46% of the general BC population.[3] Many young adults with mental illness report disruptions in mental health services they had accessed prior to the pandemic.[5] Although there has been an increase during the pandemic in access to crisis-oriented virtual counseling, in-person access to continuing mental health services is limited, stigmatized, expensive, or difficult for young adults to find.[3,5]

Declining physical activity, escalating sedentary behavior, disruptions in sleep and nutrition, and increased substance use (alcohol and cannabis), with repercussions on emotional and physical well-being, have been reported by young adults during the pandemic.[3] The lack of structure created by work and education contribute to these problems, along with decreased access to settings, resources, and opportunities that promote healthy behaviors. For example, restrictions on parks and other public spaces particularly impact young adults, who are more dependent on them for socializing and recreation.[6] Social networks, daily routines, and mobility of young adults have also been significantly disrupted by the COVID-19 pandemic.[3]

There is an urgent need to monitor health trends, characterize health trajectories, and identify key determinants of health through ongoing, timely, and targeted longitudinal monitoring. Data are severely lacking for historically underserved populations (e.g., Indigenous and racialized groups; those living in rural, remote, and northern communities; and gender-diverse people). Engaging youth to speak to their needs and experiences will be critical in both guiding and evaluating policy, education, labor, and health-service interventions for this age group. A better understanding of the unique needs and impacts of the pandemic on young adults will enhance the ability for health care practitioners to support this population.
—Hasina Samji, PhD, MSc
BCCDC and Simon Fraser University
—Naomi Dove, MD, MPH, FRCPC
Office of the Provincial Health Officer of BC
—Megan Ames, PhD, RPsych
University of Victoria
—Meridith Sones, MPH
Simon Fraser University
—Bonnie Leadbeater, PhD, FRSC
University of Victoria
For the BCCDC COVID-19 Young Adult Task Force

hidden

This article is the opinion of the BC Centre for Disease Control and has not been peer reviewed by the BCMJ Editorial Board.

References

1.    Samji H, Dove N, Ames M, et al. British Columbia Centre for Disease Control Young Adult Task Force. Impacts of the COVID-19 pandemic on the health and well-being of young adults in British Columbia. 2021.

2.    Statistics Canada. Unemployment rate, participation rate, and employment rate by type of student during school months, monthly, unadjusted for seasonality. Accessed 30 April 2021. www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1410002101&pickMembers%5B0%5D=1.11&pickMembers%5B1%5D=4.1&pickMembers%5B2%5D=5.2&cubeTimeFrame.startMonth=02&cubeTimeFrame.startYear=2020&cubeTimeFrame.endMonth=03&cubeTimeFrame.endYear=2021&referencePeriods=20200201%2C20210301.

3.    BC Centre for Disease Control. BC COVID-19 R1 2020 SPEAK Survey. 2020.

4.    Toronto Science Policy Network. COVID-19 graduate student report: The early impacts of COVID-19 on graduate students across Canada. 2020. Accessed 24 February 2021. www.toscipolicynet.ca/covid19-report.

5.    Hawke LD, Barbic SP, Voineskos A, et al. Impacts of COVID-19 on youth mental health, substance use, and well-being: A rapid survey of clinical and community samples: Répercussions de la COVID-19 sur la santé mentale, l’utilisation de substances et le bien-être des adolescents : un sondage rapide d’échantillons cliniques et communautaires. Can J Psychiatry 2020;65:701-709.

6.    Dewis G. Access and use of parks and green spaces: The potential impact of COVID-19 on Canadian households. Statistics Canada; 2020. Accessed 24 February 2021. www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00031-eng.htm.