Gender inequalities in the disruption of long-term life satisfaction trajectories during the COVID-19 pandemic and the role of time use: evidence from a prospective cohort study.

Background: The COVID-19 pandemic has disproportionately affected women's mental health. However, most evidence has focused on mental illbeing outcomes, and there is little evidence on the mechanisms underlying this unequal impact.

Aims: To investigate gender differences in the long-term trajectories of life satisfaction, how these were affected during the pandemic and the role of time-use differences in explaining gender inequalities.

Method: We used data from 6766 (56.2% women) members of the 1970 British Cohort Study (BCS70). Life satisfaction was prospectively assessed between the ages of 26 (1996) and 51 (2021) years, using a single question with responses ranging from 0 (lowest) to 10 (highest). We analysed life satisfaction trajectories with piecewise latent growth curve models, and investigated whether gender differences in the change in the life satisfaction trajectories with the pandemic were explained by self-reported time spent doing different paid and unpaid activities.

Results: Women had consistently higher life satisfaction than men before the pandemic (Δ_{intercept,unadjusted} = 0.213, 95% CI 0.087-0.340; P = 0.001) and experienced a more accelerated decline with the pandemic onset (Δ_{quad2,unadjusted} = -0.018, 95% CI -0.026 to -0.011; P < 0.001). Time-use differences did not account for the more accelerated decrease in women's life satisfaction levels with the pandemic (Δ_{quad2,adjusted} = -0.016, 95% CI -0.031 to -0.001; P = 0.035).

Conclusions: Our study shows pronounced gender inequalities in the impact of the pandemic on the long-term life satisfaction trajectories of adults in their 50s, with women losing their pre-pandemic advantage over men. Self-reported time-use differences did not account for these inequalities. More research is needed to tackle gender inequalities in population mental health.