Israeli Behaviors under Lockdown Found to be Less Healthy
Adults ate 43% more, children 56% more, with quality of sleep often worse
Israelis reported large increases in food consumption and time spent in front of screens during the COVID-19 lockdown, while one-third of adults said their quality of sleep declined, a recent study by the Myers-JDC-Brookdale Institute found.
The Jerusalem-based social-policy research institute conducted two internet surveys with 1,500 people in March, asking about eating habits, screen time, sleep, exercise and loneliness. Respondents were told to select one of the following responses: much less than usual, less than usual, usual, a little more than usual, much more than usual.
Adults aged 20-64 were also asked about their children under the age of 18 who lived in their home. Adults and children often had different habits.
For example, 43% of the adults ate more than before coronavirus pandemic, while another 43% ate more snacks and sweets. However, 56% of their children ate more during the lockdown, while 64% ate more snacks and sweets than previously.
“I’m not sure the fact that people ate more during COVID was groundbreaking news; but what is, is putting a number on it. Some people had a sort of gut feeling that maybe they were standing in front of their refrigerator more than usual,” the institute’s executive director, Prof. Michael Hartal, told The Media Line.
I’m not sure the fact that people ate more during COVID was groundbreaking news; but what is, is putting a number on it. Some people had a sort of gut feeling that maybe they were standing in front of their refrigerator more than usual
“Scientifically, being able to put a number on it and see how many people were reporting this allows [us] to see what happens in prolonged lockdowns, and [to see] that not everyone in the household behaves in the same way,” he added.
Children also differed from adults in changes in the amount of time they spent in front of screens and how much they slept.
Some 75% of children and 67% of adults watched screens for a longer period of time, including for work and school, as well as pleasure.
Adult sleep changes were diametrically opposed to those of children, with 17% of adults sleeping less than usual and most children sleeping the same amount as usual or more. About 33% of adults said their quality of sleep was worse.
“From a public health viewpoint, it’s a tremendous [change] to have one-third of the [adult] population responding that their quality of sleep was reduced,” Hartal said, “even if a similar number were reporting that the number of [sleep] hours increased.”
Of the children, 49% slept more and 35% slept the same amount, with 19% having better quality sleep and 65% experiencing no change in sleep quality.
The behavioral differences between adult and children have potential policy implications.
“The reason why we find this so interesting is that we have to tailor public messages. It’s not enough to tell people: manage your screen time, manage your eating habits, manage your physical fitness,” Hartal said.
“Some of those messages may have to be targeted differently for adults and the children living in the same home, which is something that we haven’t seen reported before and seems to be pretty novel and unique in this report,” he continued.
Physical activity was the one area where levels were somewhat similar throughout the household.
Some 61% of the adult respondents exercised less than usual, while 57% put less effort into their exercise. Among children, 66% exercised less than before and 62% put in less effort.
The similarities are significant for public health decisions.
“Decision-makers should target a whole household as one unit and try to encourage them to exercise more because there is a connection between the two,” Dr. Michal Laron, senior research scholar and health-policy team leader at the institute, told The Media Line.
She conducted the research along with Hartal and Rachel Goldwag, a researcher on the health-policy team.
Mental health issues increased during the lockdown, said Nadav Davidovitch, director of the School of Public Health at Ben-Gurion University of the Negev. Mental health affects public health more than most people realize, he told The Media Line.
“From a public-health perspective, there is unfortunately less appreciation for mental health problems even though the burden of mental health issues is quite heavy,” he said. “It leads to co-morbidities; it can exacerbate physical conditions, chronic conditions, such as diabetes and heart disease. Mental-health problems can cause a decline your physical condition.”
About 66% of the respondents said they felt they missed companionship more than usual, and 46% reported feeling depressed and lacking hope for the future. Some 51% reported feeling lonely more often.
The researchers have asked the same question every year in a national survey and found the percentage had more than doubled from the usual 19%. While the survey questioned adults under 65, those who were older tended to be more lonely.
This finding may be exacerbated by the fact that young people have more economic anxiety than people who are older.
“We know from other studies and our study at Ben-Gurion University, that young people were especially upset about their economic situation and being unemployed.” Davidovitch said. “This was stronger among people who were forced to go on unpaid leave, more than people who were unemployed before, because they changed their status and the uncertainty was very hard.”
In addition, the Myers-JDC-Brookdale Institute study found that three times more people, or 12%, reported that in times of trouble, they won’t have anyone to turn to for help as opposed to 4% pre-coronavirus.
“The power of the findings [on loneliness and having no one to turn to] is that we asked commonly used, validated questions that appear in national surveys all the time. So we have good, strong data to compare it to,” Hartal said.
The study also had some positive findings.
Half of the respondents reported eating more family meals together than before. Some 47% smoked less in the presence of others than before even while 36% smoked more than usual. And 28% drank less than before while 5% drank more than usual.
“In times like these, a lot of the studies tend to be alarmist. As you see, a lot of our findings are not very encouraging, but there are some findings that are encouraging and show the effect of being at home with your family,” Hartal said.
“It is something we want to take note of and use in the future,” he continued. “Maybe we were underestimating the effect that family members have on individuals’ behaviors.”
For the future, Laron says, people in charge should note that the respondents were generally open to receiving health advice.
“We wanted to provide decision-makers with some suggestions for preserving good health habits under the restrictions. People are willing to get help,” she said.
For example, 50% wanted to receive tips on exercise at home, and 36% were interested in recipes for healthy cooking and baking.
A person’s economic prospects, physical well-being and gender play important roles in the tendency to have worse health in these times.
“People who are expecting their financial situation to worsen were more likely to experience worsened quality of sleep, eat more, be depressed and exercise less,” Laron said. “People whose perceived physical health is poorer are prone to sleeping less and eating more. Women were more vulnerable to changes in the amount of food they consume, and tended to have poorer sleep quality and feel more depressed….”
The study by Ben-Gurion University found that women were more prone to anxiety during the lockdown.
“Women were more anxious,” Davidovitch said. They often also “had the burden of taking care of the family’s health.”
Hartal says that because all members of society are not impacted in the same way, public health officials should take a multi-layered approach.
“What we see is that there is no one-size-fits-all response. People are affected differently, and the responses have to be tailored,” he said.
What we see is that there is no one-size-fits-all response. People are affected differently, and the responses have to be tailored
Anxiety over finances, however, is the one of the largest determinants of poor health outcomes.
“Economic concern is a strong independent predictor of negative health behaviors. The concerns that people have overshadow everything else and remain a strong predictor of negative health behaviors,” Hartal said.
This has further implications for the future.
“Although people are returning to work and the unemployment numbers seem to be better than they were several weeks ago, I think it’s safe to say that we are still far from a place where people are saying their economic outlook is positive,” he said.
“Although the restrictions definitely affect people’s ability to exercise and what they eat,” he stated, “the larger public health effects will be dictated by the long view of people’s economic outlook.”