Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown

Baowen Xue; Anne McMunn

doi:10.1371/journal.pone.0247959

Peer Review History

Original SubmissionNovember 8, 2020
11 Jan 2021 Decision Letter - Thach Duc Tran, Editor PONE-D-20-35127 Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown PLOS ONE Dear Dr. Xue, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Feb 25 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes Reviewer #2: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes Reviewer #2: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: This article tackles important questions about the impact of Covid-19-related lockdowns on the ways household and childcare labor is handled within households and the effects of that division of labor on the mental health of women and men. Although they do not set out specifically to test a theory, the authors frame their research using role strain theory, arguing that it reasonable to assume that the necessity for parents to devote more time to domestic work, childcare, and remote learning while often also working from home may lead to increased role overload and inter-role conflict. These may lead, in turn, to increased psychological distress. The study relies on a large sample of respondents from an established nationally representative survey (Understanding Society) who were followed up using online questionnaires during April and May of 2019. The sample of respondents is broken down into subsamples: all participants, couples, parents, couple parents, working, parents, and working couple parents. This is an appropriate and useful data set, although, as noted in the article’s discussion of limitations, it may be that some people who were most strongly impacted by the changes enforced by the pandemic did not have easy internet access, and so may have been least likely to respond. The authors provide a good description of the measures used and of their limitations. They note, for example, that they could not measure changes in hours of unpaid work from pre- to post- the onset of the pandemic, because the last pre-Covid survey was done in 2016/18. They also note that hours of work are measure via self-report, which, besides general accuracy issues, presents something of a problem for the measurement of gender differences, in that men tend to overestimate their hours of work. However, since their findings indicate much higher reported hours of unpaid work for women than for men, the latter issue does not appear to undercut their results. The descriptive findings show that, during the lockdown, women spent much more time on unpaid care work than men did, and that women were considerably more likely than men to adjust their employment hours to meet the demands of childcare. The gender differences in these descriptive results are not adjusted for other differences between women and men in the sample: men were older, more likely to live with a partner, slightly less likely to have a child in their household, and much more likely than women to work full-time or full-time with long hours. While the male-female differences in hours of unpaid work are quite strikingly large, it would be interesting to see the extent to which such differences are tempered by these demographic differences, and the paper makes no attempt to do this. On the other hand, in the linear regression analyses conducted to examine the links between unpaid care work and psychological distress, as measured by the GHQ, are appropriately adjusted for these possible confounding variables. These analyses show that for women, but not men, there is an association between hours of care work and psychological distress, and that working parents who adapted their work patterns showed more distress than those who did not—especially if the other partner did not make such an adjustment. There are several issues that I think deserve more extensive treatment in the Discussion section of this paper. Why might working parents who adjusted their work hours feel more distressed than those who did not? Is it because those who did not adjust had other sources of support that allowed them to keep their original schedules? Why did lone mothers who adapted their work patterns show bigger increases in distress than did couple mothers who did the same? What impact may perceived equity within couples have had on psychological distress? The latter issue is raised in the Introduction and is mentioned briefly and unsatisfyingly in the Discussion, but is not actually explored. It is true that there is no data in this study that has direct bearing on these questions. However, the questions deserve exploration in the service of developing future research based on these interesting findings. Reviewer #2: The authors are seeking to examine the role of unpaid care work on psychological distress during the COVID lockdown in the UK. This is clearly a timely and important topic. I think that the manuscript has a lot of positive features and with some revisions could make a substantial impact on the field. First, the Introduction is well written – however, rather than emphasizing the role strain theory, I think that role spillover might be more relevant. The lockdown brings the work and home roles together as never before; thus, the spillover is obvious and immediate. I understand the authors are not focusing on any specific theoretical framework but rather seek to address research questions; however, the literature and theories on these issues is plentiful. I think it would behoove them to pose specific hypotheses as opposed to questions. I was glad to see that the authors used a baseline measure of distress, working hours and employment pre-COVID; however, they did not use a baseline pre-COVID measure of childcare. I understand their limitation with this issue and appreciate their acknowledging it. I was expecting to see partner effect analyses based on the discussion of crossover effects in the Introduction. I see that women’s housework share was entered into the couple-level analyses. However, I think it would be interesting to see if at the individual level partner’s housework hours/week and childcare hours/week were related to the individual’s distress in addition to the actor effects. In the Discussion, the authors focus on the role strain theory but I am wondering if spillover might be more relevant here. Additionally, the authors should discuss long-term impacts of COVID lockdowns as the fall and winter have seen a resurgence of cases and social restrictions. It is one thing if this was an acute couple of months, but this has become chronic - how might the relationships with these constructs change? Overall, I feel that the manuscript is timely but the authors need to do more in their analyses to examine the actor-partner effects. ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. 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Revision 1
7 Feb 2021 Author Response Response to reviewers’ comments Reviewer #1: This article tackles important questions about the impact of Covid-19-related lockdowns on the ways household and childcare labor is handled within households and the effects of that division of labor on the mental health of women and men. Although they do not set out specifically to test a theory, the authors frame their research using role strain theory, arguing that it reasonable to assume that the necessity for parents to devote more time to domestic work, childcare, and remote learning while often also working from home may lead to increased role overload and inter-role conflict. These may lead, in turn, to increased psychological distress. The study relies on a large sample of respondents from an established nationally representative survey (Understanding Society) who were followed up using online questionnaires during April and May of 2019. The sample of respondents is broken down into subsamples: all participants, couples, parents, couple parents, working, parents, and working couple parents. This is an appropriate and useful data set, although, as noted in the article’s discussion of limitations, it may be that some people who were most strongly impacted by the changes enforced by the pandemic did not have easy internet access, and so may have been least likely to respond.The authors provide a good description of the measures used and of their limitations. They note, for example, that they could not measure changes in hours of unpaid work from pre- to post- the onset of the pandemic, because the last pre-Covid survey was done in 2016/18. They also note that hours of work are measure via self-report, which, besides general accuracy issues, presents something of a problem for the measurement of gender differences, in that men tend to overestimate their hours of work. However, since their findings indicate much higher reported hours of unpaid work for women than for men, the latter issue does not appear to undercut their results. Our response: We thank the reviewer for the positive comments. The descriptive findings show that, during the lockdown, women spent much more time on unpaid care work than men did, and that women were considerably more likely than men to adjust their employment hours to meet the demands of childcare. The gender differences in these descriptive results are not adjusted for other differences between women and men in the sample: men were older, more likely to live with a partner, slightly less likely to have a child in their household, and much more likely than women to work full-time or full-time with long hours. While the male-female differences in hours of unpaid work are quite strikingly large, it would be interesting to see the extent to which such differences are tempered by these demographic differences, and the paper makes no attempt to do this. On the other hand, in the linear regression analyses conducted to examine the links between unpaid care work and psychological distress, as measured by the GHQ, are appropriately adjusted for these possible confounding variables. These analyses show that for women, but not men, there is an association between hours of care work and psychological distress, and that working parents who adapted their work patterns showed more distress than those who did not—especially if the other partner did not make such an adjustment. Our response: We have now investigated gender differences in unpaid care work after adjusting for demographic differences. Results are shown in S2 Table and S3 Table in the Supporting information. Three models are presented: an unadjusted model, a model adjusted for covariates but without baseline work hours (because we felt this may be an over adjustment as the ‘causal’ direction between employment and unpaid care work could go in both directions), and a fully adjusted model (same covariates as in the main analyses.) Both the coefficient for gender differences in the number of hours and the average marginal values for hours spent doing unpaid care work in the past week for men and women are shown in the tables. After accounting for the demographic differences, the gender difference in childcare/homeschooling hours remains but is reduced (changed from a 9-hour difference in the unadjusted model to a 6-hour difference in the fully adjusted model for April and May). However, the gender differences in housework hours or work adaptation of working hours were not attenuated after accounting for demographic differences or baseline working hours. Therefore, the results show that even after accounting for the demographic differences, women still spent much more time on unpaid care work than men during the first lockdown in the UK, and it was more likely to be the mother than the father who reduced working hours or changed employment schedules due to increased time on childcare. Relevant texts have been added to the Method (p 10 Sensitivity analyses) and Results sections (p 25 Results from sensitivity analyses). There are several issues that I think deserve more extensive treatment in the Discussion section of this paper. Why might working parents who adjusted their work hours feel more distressed than those who did not? Is it because those who did not adjust had other sources of support that allowed them to keep their original schedules? Why did lone mothers who adapted their work patterns show bigger increases in distress than did couple mothers who did the same? Our response: We thank the reviewer for the useful comments on how to improve the discussion section. We have added text emphasising that parents who did not adjust their work patterns may have other sources of support that allowed them to keep their original schedules (p27 lines 385-388). We also have added text to explain possible reasons of why lone mothers who adapted their work patterns show bigger increases in distress than couple mothers who did the same (p28 lines 410-417), such as lone mothers have conflicts in meeting several needs at the same time without a partner’s support to buffer the stress of combining work and work adaption with childcare. What impact may perceived equity within couples have had on psychological distress? The latter issue is raised in the Introduction and is mentioned briefly and unsatisfyingly in the Discussion, but is not actually explored. It is true that there is no data in this study that has direct bearing on these questions. However, the questions deserve exploration in the service of developing future research based on these interesting findings. Our response: We thank the reviewer for the useful suggestion to address perceptions of equity within couples more thoroughly. We have added text on how perceived equity within couples may potentially impact psychological distress (p 27 lines 390-393), and highlight the need for future research on this topic (p27 line 398-401). Reviewer #2: The authors are seeking to examine the role of unpaid care work on psychological distress during the COVID lockdown in the UK. This is clearly a timely and important topic. I think that the manuscript has a lot of positive features and with some revisions could make a substantial impact on the field. First, the Introduction is well written – however, rather than emphasizing the role strain theory, I think that role spillover might be more relevant. The lockdown brings the work and home roles together as never before; thus, the spillover is obvious and immediate. I understand the authors are not focusing on any specific theoretical framework but rather seek to address research questions; however, the literature and theories on these issues is plentiful. I think it would behoove them to pose specific hypotheses as opposed to questions. Our response: We thank the reviewer for the useful suggestions for our theoretical background and the use of hypotheses. We have added the role spillover theory in the Introduction (p 4, lines 84-94), and have posed specific hypotheses as opposed to questions (p6). In the discussion section, research questions have been replaced with hypotheses accordingly (p25-28). I was glad to see that the authors used a baseline measure of distress, working hours and employment pre-COVID; however, they did not use a baseline pre-COVID measure of childcare. I understand their limitation with this issue and appreciate their acknowledging it. Our response: We thank the reviewer for the positive comments. I was expecting to see partner effect analyses based on the discussion of crossover effects in the Introduction. I see that women’s housework share was entered into the couple-level analyses. However, I think it would be interesting to see if at the individual level partner’s housework hours/week and childcare hours/week were related to the individual’s distress in addition to the actor effects. Our response: We have conducted a sensitivity analysis to investigate the actor-partner effect as suggested by the reviewer. Results are shown in S4 Table in the Supporting information. Women’s own high childcare/ homeschooling hours were associated with increased psychological distress in May, but no significant association with partner’s unpaid work hours was seen for women or men. Relevant texts were added to the Method (p 10 Sensitivity analyses) and Results sections (p 25 Results from sensitivity analyses). In the Discussion, the authors focus on the role strain theory but I am wondering if spillover might be more relevant here. Additionally, the authors should discuss long-term impacts of COVID lockdowns as the fall and winter have seen a resurgence of cases and social restrictions. It is one thing if this was an acute couple of months, but this has become chronic - how might the relationships with these constructs change? Overall, I feel that the manuscript is timely but the authors need to do more in their analyses to examine the actor-partner effects. Our response: We have added discussion of the spillover effect between family and work, both negative spillover (p27, lines 380-385) and positive spillover (p28, lines 414-417). We thank the reviewer for the important point regarding the long-term impacts of lockdowns which has indeed become the case with even greater restrictions in the UK currently. We have added text on p30 (lines 464-469) and hope to study the longer term experiences of lockdown going forward. Response to journal requirements 1. Please ensure that your manuscript meets PLOS ONE's style requirements, including those for file naming. The PLOS ONE style templates can be found at https://journals.plos.org/plosone/s/file?id=wjVg/PLOSOne_formatting_sample_main_body.pdf and https://journals.plos.org/plosone/s/file?id=ba62/PLOSOne_formatting_sample_title_authors_affiliations.pdf Our response: We have carefully read the links and have made sure our manuscript meets PLOS ONE’s style requirements. 2. Please provide additional details regarding participant consent. In the ethics statement in the Methods and online submission information, please ensure that you have specified (1) whether consent was informed and (2) what type you obtained (for instance, written or verbal, and if verbal, how it was documented and witnessed). If your study included minors, state whether you obtained consent from parents or guardians. If the need for consent was waived by the ethics committee, please include this information. If you are reporting a retrospective study of medical records or archived samples, please ensure that you have discussed whether all data were fully anonymized before you accessed them and/or whether the IRB or ethics committee waived the requirement for informed consent. If patients provided informed written consent to have data from their medical records used in research, please include this information. 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More information: https://www.understandingsociety.ac.uk/documentation/access-data In your revised cover letter, please address the following prompts: a) If there are ethical or legal restrictions on sharing a de-identified data set, please explain them in detail (e.g., data contain potentially sensitive information, data are owned by a third-party organization, etc.) and who has imposed them (e.g., an ethics committee). Please also provide contact information for a data access committee, ethics committee, or other institutional body to which data requests may be sent. b) If there are no restrictions, please upload the minimal anonymized data set necessary to replicate your study findings as either Supporting Information files or to a stable, public repository and provide us with the relevant URLs, DOIs, or accession numbers. For a list of acceptable repositories, please see http://journals.plos.org/plosone/s/data-availability#loc-recommended-repositories. We will update your Data Availability statement on your behalf to reflect the information you provide. Our response: We have added the Data Availability statement in the cover letter. 4. Please include captions for your Supporting Information files at the end of your manuscript, and update any in-text citations to match accordingly. Please see our Supporting Information guidelines for more information: http://journals.plos.org/plosone/s/supporting-information. Our response: We have included captions for Supporting Information files at the end of our manuscript, and have updated in-text citations to match accordingly. Attachments Attachment Submitted filename: Response to Reviewers.docx https://doi.org/10.1371/journal.pone.0247959.r002
17 Feb 2021 Decision Letter - Thach Duc Tran, Editor Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown PONE-D-20-35127R1 Dear Dr. Xue, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. If you have any billing related questions, please contact our Author Billing department directly at authorbilling@plos.org. If your institution or institutions have a press office, please notify them about your upcoming paper to help maximize its impact. If they’ll be preparing press materials, please inform our press team as soon as possible -- no later than 48 hours after receiving the formal acceptance. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information, please contact onepress@plos.org. Kind regards, Thach Duc Tran, M.Sc., Ph.D. Academic Editor PLOS ONE Additional Editor Comments (optional): Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: No https://doi.org/10.1371/journal.pone.0247959.r003
Formally Accepted
23 Feb 2021 Acceptance Letter - Thach Duc Tran, Editor PONE-D-20-35127R1 Gender differences in unpaid care work and psychological distress in the UK Covid-19 lockdown Dear Dr. Xue: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Thach Duc Tran Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0247959.r004

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