# Health behaviour and wellbeing trends among Australian adults before and during the COVID-19 pandemic (2017–2022): An interrupted time-series analysis

## TL;DR

This study examined health behaviors and wellbeing in Australian adults from 2017 to 2022, finding limited overall impact from the pandemic but rising e-cigarette use.

## Contribution

The study provides population-level insights into health behavior and wellbeing changes during the pandemic using interrupted time-series analysis.

## Key findings

- E-cigarette use increased significantly from 2017 to 2022 (OR 8.25).
- Self-rated health initially declined during the pandemic but returned to pre-pandemic levels by 2022.
- Most health behaviors and BMI trends remained largely unchanged during the pandemic.

## Abstract

•We explored health behaviour and wellbeing trends in NSW, Australia, 2017–2022.•Our analysis found limited population-level impacts of the COVID-19 pandemic.•Continued monitoring should investigate potential delayed or ongoing effects.•Socioeconomic disparities must remain a priority for preventive health measures.

We explored health behaviour and wellbeing trends in NSW, Australia, 2017–2022.

Our analysis found limited population-level impacts of the COVID-19 pandemic.

Continued monitoring should investigate potential delayed or ongoing effects.

Socioeconomic disparities must remain a priority for preventive health measures.

To explore population-level trends in health behaviours and wellbeing indicators from before (2017–2019) to during (2020–2022) the COVID-19 pandemic in Australia.

Using cross-sectional data from New South Wales Adult Population Health Surveys (2017–2022, n = 73,680 responses), we calculated weighted prevalence estimates and interrupted time-series logit models to investigate trends in health behavioural risk factors (vegetable and fruit intake, physical activity, alcohol consumption, smoking, e-cigarette use), Body Mass Index (BMI) (overweight and obesity), and wellbeing indicators (psychological distress, self-rated health) among adults aged ≥ 16 years before and during the pandemic.

From 2017 to 2022, the behavioural risk factors and BMI trends were mostly unchanged. Similarly, wellbeing indicator trends showed only minor variations according to age. The interrupted time-series models found marked changes from before to during the COVID-19 pandemic for e-cigarette use and self-rated health. E-cigarette use showed an overall increasing trend, with significant increases from 2017 to 2022 (OR 8.25, 95 %CI 6.10–11.16). Poor self-rated health showed a stable trend before COVID-19, but decreased in 2020 (OR 0.68, 95 %CI 0.58–0.80) and 2021 (OR 0.70, 95 %CI 0.60–0.81), returning to pre-COVID levels in 2022 (OR 1.23, 95 %CI 1.07–1.41). During the pandemic (2020–2022), there were few statistically significant observed changes in prevalence trends according to SES indicators.

Among Australian adults, relatively small population-level impacts of the COVID-19 pandemic on health behaviours and wellbeing trends were observed. Continued surveillance and sub-group analyses are essential for investigating potential time-lagged effects and regional or sociodemographic differences in health behaviours and wellbeing.