From a pandemic to a cost of living crisis. Associations between financial wellbeing, financial uncertainty and mental health in contemporary Britain

Background: Financial wellbeing is a determinant of mental health but the COVID-19 pandemic and the subsequent cost of living crisis generated by inflation have negatively impacted both aspects. Methods: Data come from Understanding Society. We address long-term (1991-2022) relationships between poor financial wellbeing (PFW), poor financial prospect (PFP) and psychological distress (GHQ-36 >= 9) using a conditional logit model as well as recent trends (2019-2022) using a Latent Growth Modelling (LGM) based on the diagonally weighted least squares (WLSMV) accounting for socio-demographic covariates and measures of deprivation. Multiple imputations were used for non-response. Results: Recent years have seen a surge in GHQ cases and PFP and consistent association between GHQ and PFW (OR=1.31; 95%CI=1.29;1.33) and PFP (OR= 1.13; 95%CI=1.12;1.15) are observed. The association between PFW and GHQ-36 slightly weakened during the pandemic [WLSMV: 0.30 (95%CI= 0.28; 0.33) in 2019; 0.27 (95%CI= 0.25; 0.30) in 2020] but strengthened for PFP [0.22 (95%CI= 0.19; 0.25) in 2019, 0.26 (95%CI= 0.23; 0.29) in 2020]. Those renting and those in the most deprived areas were more likely to report PFW whilst those in the least deprived areas and having a mortgage experiencing greater PFP, both contributing to explain psychological distress. Discussion: Policies implemented during the pandemic might have contributed to partially reduce the association between financial wellbeing and mental health but post-pandemic associations in the context of an early cost of living crisis show an increased risk with those living in the most deprived areas or not owing an accommodation more at risk. ### Competing Interest Statement The authors report no conflict of interest. Jacques Wes is a member of the Belgian Health Data Agency (HDA) user committee. ### Funding Statement JW is the PI of the Horizon Europe ERC Starting Grant UHealth (Trade Unions and Workers Health), the PI of the Negotiating Health: addressing the role of trade unions in explaining workers physical and mental health (NegHealth) Incentive Grant for Scientific Research funded by the Belgian National Scientific fund (FNRS) and the PI of the Trade unions, job satisfaction and workers health: an international comparison of panel data Joint Usage and Research Center Program at the Institute of Economic Research, Hitotsubashi University, Japan. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study uses Understanding Society data that can be accessed through the UK data archive portal: https://www.data-archive.ac.uk. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The study uses Understanding Society data that can be accessed through the UK data archive portal: https://www.data-archive.ac.uk.