Poor Social Well-Being Tied to Worse Mental Health Among Americans

As the COVID-19 pandemic continues to threaten the physical health of millions of people worldwide, a mental health crisis looms around the corner. 

Necessary public health efforts to slow the spread of the novel coronavirus, including social distancing practices, stay-at-home mandates and quarantines as well as the closures of schools and businesses, have resulted in poor mental health outcomes. 

The public health strategies used to control the pandemic highlight the unintended consequences of social disconnectedness and isolation.

Social well-being is one of five interrelated elements of well-being in the Sharecare Community Well-Being Index (CWBI), along with purpose, community, financial and physical well-being. A person’s social health has to do with feeling loved and supported on a daily basis. CWBI data suggests that poor social well-being can significantly affect a person’s overall health, as well as other domains of well-being. 

“Sharecare, alongside partners, such as Gallup and Boston University’s School of Public Health, have been studying the role that social well-being plays in overarching health for more than a decade, including complex relationships between social well-being and other well-being domains,” says Elizabeth Colyer, SVP, Community Well-Being Index at Sharecare. “Prior research has revealed a strong link between social relationships and financial well-being. One example of these findings includes 87% of individuals who are thriving in financial well-being indicating the relationship that they have with their spouse, partner or closest friend is stronger than ever. By comparison, the same is true for only 61% of individuals who are suffering in financial well-being. This is just one example of the role social relationships play in our overarching health.” 

Symptoms of Depression Tied to Poor Social Well-Being

In a September 2020 Sharecare survey, Americans who strongly disagreed that their friends and family give them positive energy every day were three times more likely to report “feeling down, depressed, or hopeless nearly every day in the last two weeks.” In other words, those with aspects of poor social well-being were more likely to report symptoms of depression.

For the 35.7 million Americans who live alone, limited face-to-face contact due to COVID-19 is especially concerning. 

Complicating matters, the survey found that 14% of respondents with an annual household income of less than $10,000 reported aspects of worse social well-being compared to 0.5% of those with an annual household income of $50,000 to $74,999. The rapid rise in unemployment rates since the pandemic began and the established link between economic security and overall well-being may help explain why those in the lower income groups were more than twice as likely to report symptoms of depression. 

Research conducted by Ettman and colleagues underscore these findings. The September 2020 study published in JAMA Network Open found that depression symptoms have increased threefold among U.S. adults since the start of the pandemic. The researchers found that depression symptoms increased across the board but those with more COVID-19 related stressors, such as job loss, were the most likely to report probable depression. Those with fewer financial and social resources before the COVID-19 outbreak also reported a greater burden of depression symptoms.

The authors argued that post-pandemic recovery strategies should take into account the likely surge in mental illnesses, particularly among high risk groups.

Pandemic May Contribute to More ‘Deaths of Despair’

As people around the world have been forced into various degrees of social isolation and many are struggling with increased anxiety and financial insecurity, a report from the United Nations (UN) urges world leaders to prepare for a mental health crisis.

Among those at particularly high risk are frontline healthcare workers, older people, teens and children as well as those with pre-existing mental health conditions, according to UN Secretary-General António Guterres. The UN report adds that many people who were able to manage anxiety before COVID-19 are less able to cope due to “multiple stressors generated by the pandemic.”

Research suggests that now, as the pandemic persists, more people may have thoughts of suicide or self-harm and potentially act upon them. A May 2020 study released by Well Being Trust and the Robert Graham Center for Policy Research in Primary Care and Family Medicine estimates that sluggish U.S. economic recovery combined with high unemployment could contribute up to 150,000 deaths of despair over a 10-year period.  

An April 2020 article in JAMA Psychiatry argues that the unprecedented steps taken to “flatten the curve,” particularly the call for social distancing, has the potential to contribute to a spike in suicide risk.

Mitigating the Pandemic’s Negative Mental Health Effects 

These trends illuminate inequities that have long existed across the nation and call for initiatives that mitigate the mental health effects of the pandemic through equitable policies and outreach. 

In an April 2020 article published in JAMA, Reger and colleagues emphasize the need for mental health crisis screening as COVID-19 precautions in healthcare setting may serve as a barrier to care for certain individuals. They point out that some effective strategies to help prevent self-harm may be implemented in a socially distant way. For example, studies have shown that outreach by phone and mailing letters to at-risk loved ones (Caring Letters intervention) have helped reduce suicide rates.

Optimistically, the researchers note a potential silver lining of the pandemic that has been studied after other large-scale disasters, such as the September 11, 2001 terrorist attacks: greater unity. 

The authors state, “the so-called pulling-together effect, whereby individuals undergoing a shared experience might support one another, thus strengthening connectedness.” They added that global health crises, such as the COVID-19 pandemic, could effectively alter people’s views on health and mortality, “making life more precious.” 

Know When to Seek Help

If you believe that you or someone you know is at risk for suicide, reach out for help. Anyone considering suicide can contact the Crisis Text Line by texting ‘HELLO’, ‘HOME’, START’ or ‘NAMI’ to 741741. They will be connected with a person who will listen to their concerns without judgement. They can also call the National Suicide Prevention Lifeline at 1-800-273-8255.

If you’re with someone who is actively considering suicide, do not leave that person alone. Call 911 right away or go to the nearest emergency room.