Impact of School Closures on the Health and Well-Being of Primary School Children in Wales UK; A Routine Data Linkage Study Using the HAPPEN Survey (2018-2020)

Background: In response to the COVID-19 pandemic, school closures were implemented across the United Kingdom. This study aimed to explore the impact of school closures on children’s health by comparing health and wellbeing outcomes collected during school closures (April – June 2020) with data from the same period in 2019 and 2018.Methods: Data were collected online via the ‘HAPPEN At Home’ survey, which captured the typical health behaviours of children aged 8 – 11 years between April - June 2020. These data were compared with data in 2018 and 2019 also collected between April-June, from HAPPEN. Free school meal (FSM) status was used as a proxy for socio-economic deprivation. Analyses were repeated stratifying by FSM.Findings: Comparing responses between April – June in 2020 (n=1068), 2019 (n=1150) and 2018 (n=475), there were improvements in physical activity levels, sleep time, happiness and general wellbeing for children during school closures compared to previous years. However, children on FSM ate less fruit and vegetables (21% (95%CI (5·7% to 37%)) and had lower self-assessed school competence compared to 2019. Compared to those not on FSM they also spent less time doing physical activity (13·03% (95%CI: 3·3% to 21·7%) and consumed more takeaways (16·3% (95%CI: 2%-30%)) during school closures.Interpretation: This study suggests that schools play an important role in reducing inequalities in physical health. The physical health (e.g. physical activity and diet) of children eligible for FSM may be impacted by prolonged school closures.Funding: This work was supported by the National Centre for Population Health and Wellbeing Research (NCPHWR).Declaration of Interests: All authors declare no competing interest including no financial and personal relationships with other people or organisations that might have an interest in the submitted work and no other relationships or activities that could appear to have influenced the submitted work.Ethics Approval Statement: The survey was granted ethical approval by Swansea University’s Medical School on 15/04/2020 (Reference: 2017-0033B).