key: cord-0697845-puzh4sik
authors: Bayın Donar, Gamze; Aydan, Seda
title: Association of COVID‐19 with lifestyle behaviours and socio‐economic variables in Turkey: An analysis of Google Trends
date: 2021-09-22
journal: Int J Health Plann Manage
DOI: 10.1002/hpm.3342
sha: 29a3867d24487c3ef63475b8202ef07258224f12
doc_id: 697845
cord_uid: puzh4sik

This study aims to examine the relationship between COVID‐19 cases/deaths and Google data on lifestyle behaviours and socio‐economic variables in Turkey. The data of the research are composed of Google Trends search volume for various words related to socio‐economic conditions, nutritional attitudes, indoor behaviour, outdoor activities and confirmed COVID‐19 case and death data from the Ministry of Health from 31 December 2019 to 31 January 2021. Spearman correlation analysis was conducted to evaluate the relationship between the Google search volumes of selected keywords and COVID‐19 case and deaths. In addition, repeated ANOVA and Bonferroni post‐hoc tests were performed to compare the differences in search volumes of selected keywords before and during the COVID‐19 outbreak. Correlation analysis showed that the strongest variables in each category were vitamin C, zinc, Zoom, online shopping, hotel, market, gym, unemployment and unemployment benefit. Compared to previous years, during the pandemic, there was a significant increase or decrease in the search volumes of almost all words. These results showed that the COVID‐19 significantly changed people's online interests regarding lifestyle behaviours and socio‐economic conditions. It is thought that the findings can guide health policies to be followed in reducing the effects of both behavioural changes and negative socio‐economic consequences.

Cases of pneumonia of unknown aetiology appeared at 31 December 2019 in Wuhan, China. Further analysis revealed the involvement of a novel strain of virus named 'severe acute respiratory syndrome coronavirus 2' obtained from samples of the infected patients. 1 The disease caused by this virus, initially expressed as 2019-nCoV, was later named COVID-19 on 11 February 2020. 2 As a result of the worldwide increase in the number of cases, it was declared as a global pandemic by the World Health Organization (WHO) on 11 March 2020. 3 It was announced that the first case of COVID-19 had been detected by the Ministry of Health in Turkey, on 11 March 2020. In Turkey as of 9 February 2021, the total number of cases reached to 2, 548, 195 ; while the total number of deaths has reached to 26,998. 4 The COVID-19 pandemic has caused serious problems in many countries including in Turkey. It has profoundly affected economic and social life as well as public health. 5 The pandemic has adversely affected the global economy and is estimated to continue to affect. It is thought that the economic stagnation and shrinkage that would arise with this situation will affect many sectors to a great extent and may cause many social problems. Subran et al. 6 stated that global corporate bankruptcies are expected to increase by an estimated 14% in 2020. Considering that the epidemic continues, many people may lose their jobs as a result of these bankruptcies. It is also stated that especially developing countries will need financial support in the pandemic process. 6, 7 The Turkish economy, like many other countries, had to struggle with negative economic growth and underemployment problems during the COVID-19 process. Bulut and Pınar 8 compared the employment data for the period between April, when the COVID-19 measures peaked in Turkey, and September, the period when the latest TURK-STAT employment data were announced. According to TURKSTAT data, the unemployment rate was 13.2% in the July-August-September period of 2020, but this rate was 12.8% in March-April-May period, when the pandemic has the most impact on economic activities. 8 Some measures have been taken in order to have a positive effect on the economic course in Turkey. Incentive packages for employment were prepared, the labour market was supported by the recruitment of personnel to the public sector, and limitations were imposed on dismissals. In this way, efforts were made to prevent the increase in unemployment rate. Although all these measures tried to curb the decline in employment rates, the unemployment rate increased by 0.4 points in the April-August 2020 period, and the number of unemployed increased by 419,000. 8 COVID-19 has significantly affected not only economies and working life, but also lifestyle behaviours of individuals such as sleeping, dietary habits and physical activities. Many habits that have been acquired for many years may change or end due to COVID-19. 8 During the pandemic, changes have occurred in the needs, activities and consumption behaviours. 9 In a study in Turkey conducted with 433 participants, the majority of the respondents stated that they had restricted the expenditures deemed unnecessary during the pandemic period, postponed their future plans, increased Internet usage and changed their social lives. 10 In another study, which aimed to examine the change in nutrition and lifestyle habits of Turkish people during the COVID-19 outbreak with a total of 432 volunteers, it was revealed that body weight, sleep time and social media use increased and activity level decreased during the initial stage of the pandemic. 11 Similarly, the results of another study

show that there are changes in the diet, sleep and physical activity patterns of individuals after COVID-19 in Turkey. 12 In another study in Turkey conducted with among 3000 people, 56% of the participants stated that eating habits and sleeping patterns changed during the coronavirus period. According to the same study, people in Turkey have focused on family relationships, used social media, watched TV series/movies, cleaned up their homes and baked in the pandemic process. On the contrary, the least common activities were sleeping, reading books and doing sports. 13 Moreover, the restrictive bans imposed by the governments and the measures to increase the social distance taken by public and private sector organizations to prevent the spread of the COVID-19 pandemic cause people to work from home. In order to prevent people from coming together, it was necessary to encourage or make it mandatory for people to work from home. Emerging literature tries to identify jobs that can be done from home in different economies and to calculate the proportion of the workforce that can work from home. 14 In a similar study conducted for Turkey, it was calculated that nearly 70% of professional professionals can work from home, but this rate is below 10% in professions based on muscle strength and heavy workload. 15 On the other hand, in a study in Turkey conducted with among 3000 people, 65% of the participants have to go out due to work, health problems, family care or general responsibilities. 13 The effects of COVID-19 may arise after some time and determining the effects on both socio-economic and lifestyle behaviours may require longer term studies. However, the online search behaviour of individuals can provide an insight to evaluate these effects. Google Trends is one of the most efficient trend analysis tools focusing on the most searched keywords by individuals and it can be used to examine and estimate individuals' interests and behaviours. 1, 16 Various studies about impacts of COVID-19 on food security and diet-related lifestyle behaviours, 16, 17 and unemployment, 18-23 using Google Trends data, have been conducted. To our knowledge, no study has examined the impacts of COVID-19 on socio-economic variables and lifestyle behaviours, by using Google Trends data, comprehensively in Turkey. In this study, it was aimed to demonstrate the impacts of COVID-19 on some socio-economic variables and lifestyle behaviours in Turkey, by using Google Trends data.

The rapidly spreading COVID-19 has caused many restrictions in economic and social life. Individuals are required to stay at home as much as possible and to maintain social distance that will prevent transmission of the disease. Many governments restrict access to restaurants, accommodation facilities, theatres, shopping centres and other non-essential businesses to reduce people's contact with each other. Some businesses close voluntarily to protect their employees and the public health. However, the closure of workplaces brings rapid and serious difficulties in the economic activities of businesses, bringing them to the brink of bankruptcy. 14 In addition to the restrictions, many sectors have suffered due to the adverse conditions caused by factors such as significant decrease in demands, decrease in economic activities, problems in the supply chain, labour force absenteeism. 24, 25 Many workplaces in the service sector, especially in industry, trade and tourism, had to stop their activities. Along with the transportation and logistics, there have been disruptions in the agricultural sector, too. In this process, only businesses that provide basic services such as health, food, communication and produce basic products, provide online remote services and service to homes were able to continue their activities. All these developments have significantly affected the world and countries in terms of growth, foreign trade and employment on a global scale. 26 The economic difficulties experienced by countries and sectors due to the pandemic have reflected in the working and social lives of individuals. With the COVID-19 pandemic, the whole society and working life have entered an adaptation process. 24 Work patterns change during this period, but more importantly, labour markets are significantly affected. According to recent studies, especially those employed in sectors whose production activities were affected by the crisis face risks such as losing their jobs, being on unpaid leave and decreasing weekly working hours. 14 In this period, states are trying to mitigate the harmful effects of the COVID-19 crisis on the overall economy and the labour market by taking various measures. Kara 14 revealed that, although may differ from country to country, the measures taken for employment at the global level concentrates on seven categories. These categories are support for informal or self-employed workers, unemployment benefits, wage subsidies, new working schemes, subsidies for employee sick leave, cap on layoffs and increased labour training subsidies. COVID-19, which began to be spoken since December 2019, severely affects life and causes changes that may be permanent in a long term, in Turkey as well as all over the world. With the measures taken to control the spread of the pandemic, international supply chains, supply-demand balances, producer

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Association of COVID-19 with lifestyle behaviours and socio-economic variables in Turkey: An analysis of Google Trends