Living conditions, lifestyle habits and health among adults before and after the COVID-19 pandemic outbreak in Sweden - results from a cross-sectional population-based study

Background: Studies on the public health consequences of COVID-19 pandemic showing data based on robustmethods are scarce. The aim of this study was to investigate mental and physical health as well as living conditionsand lifestyle habits in the general population before and after the COVID-19 outbreak in Sweden. Methods: The study is based on 2273 persons 16-84 years who responded to the national public health surveyin February-May 2020 in Värmland county (overall response rate 45%). The differences between early respondents(before the outbreak, n = 1711) and late respondents (after the outbreak, n = 562) were studied using multivariatelogistic regression, adjusting for background characteristics: age, gender, educational level, and country of birth. Thesame analyses were also completed in the corresponding survey carried out in February-June 2018. Results: Statistically significant differences between the groups were obtained for economic difficulties and worryabout losing one’s job, which were more common among late respondents, and for sleeping difficulties, which weremore common among early respondents after adjusting for background characteristics. There were no differencesin other living conditions nor in lifestyle factors. Prevalence of good self-rated health, high blood pressure, aches inshoulders or neck, anxiety or worry and stress did not differ between the groups. In 2018, the only statistically signifi-cant difference between early and late respondents concerned economic difficulties. Conclusions: Very few differences in living conditions, lifestyle factors and health were observed in the study popula-tion before and after the COVID-19 outbreak. The results suggest that, in addition to a possible decrease in sleepingdifficulties, the prevalence of being worried about losing one’s job increased among the employed after the outbreak