Article Text
Abstract
Background Small Island developing states (SIDS) experience frequent natural disasters and must be fastidious in their planning for these disasters, due to the prolonged impact on populations. The COVID-19 pandemic, considered a preventable disaster (by a WHO report), may not have been averted in these states due to their economic vulnerabilities, but the effects could have been lessened with holistic planning. In SIDS where tourism plays an important role in the GDP, planning for the pandemic focused on reducing viral transmission pathways, and keeping the economic markets open, but little focus was given to the mental health needs of populations. This was particularly dire for women of childbearing ages who shoulder societal burden of caring for others. This research analysis compares the impact of the early phase of the Covid-19 pandemic on women of reproductive age (18–49 years) in Barbados to their older counterparts (50 + years) to serve as a beacon for the inclusion of mental health needs in future disaster planning.
Methods An online cross-sectional survey was administered in April 2020 among Barbadians 18 years and older. Participants were mainly recruited through a text blast from a major telecom provider. The questionnaire requested sociodemographic data, knowledge of Covid 19, comorbidity data, mental health and other information. Mental health status was assessed using the Hospital Anxiety and Depression Scale. Descriptive and bivariate analyses examined differences in key outcomes across the two age group. Data were analyzed using SPSS V.28. IRB approval (UWI – Cave Hill No.200405-B.)
Results Among 1391 eligible participants, more than three-quarters (78.6%) were between 18 -49 years; median age 38.3 years. Younger women were more likely to have lost employment (p<0.05), were more dependent on others for their household needs (p <0.001), had increased the frequency (p=0.05), and quantity of alcoholic beverage use (p<0.001), and experienced abnormal levels of anxiety (p<0.001) and depression (p<0.001). They were more likely to live in people denser homes (p< 0.001).
Discussion Younger women experienced greater mental health burden during the early pandemic. Their naivety to social isolation may have reduced their coping mechanism and the increased consumption of alcoholic beverages may have been used as a coping mechanism. However, alcohol could have exacerbated their mental health distress. As mental health services were not part of the ‘essential services’ list during the pandemic, it is imperative that governments consider mental health services in disaster/public health planning for crises.