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COVID-19 Mental, Economic Stresses Worse for US Public than for Those in Other Wealthy Countries

  • 1Consulting Editor, JAMA Health Forum and JAMA

More US adults are facing mental health and economic challenges related to the coronavirus disease 2019 (COVID-19) pandemic compared with their counterparts in 8 other high-income nations, a new survey of more than 8000 adults shows.

The findings, from the Commonwealth Fund’s 2020 Commonwealth International Health Survey, also show that that US adults have relatively less trust in their national leadership in handling the dual crises compared with respondents living in other wealthy countries.

“As our country struggles with the surging number of cases and the economic havoc that the pandemic is wreaking, people in other countries are living a different, better, reality,” said David Blumenthal, MD, Commonwealth Fund President, in a statement.

The survey of 8259 adults 18 years or older, conducted by the survey research firm SSRS from March 30 to May 25, 2020, provides a snapshot of respondents’ experiences during a period when US cumulative cases increased from more than 160 000 to more than 1.6 million. One-third of US adults reported they were experiencing stress, anxiety, and great sadness that was difficult for them to cope with on their own—a significantly higher proportion than in other countries, where 10% (in Norway) to 26% (Canada) of adults reported similar distress.

Furthermore, only 1 in 3 adults in the United States or the United Kingdom who needed and wanted to get professional help to cope with their distress reported being able to do so, compared with about half of Australians and Canadians.

“The negative impact of COVID-19 on mental health has been immediate, and the pandemic is certain to have long-term effects in every country it has touched,” the report’s authors noted. “These ill effects have been exacerbated by uncertainty associated with the spread of the disease, information and misinformation overload, and feelings of isolation created by social distancing.”

In the United States, the cumulative numbers of both US cases and deaths have continued to soar since the survey period ended on May 25, to more than 5 million confirmed US cases and more than 160 000 deaths as of August 8.

Unsurprisingly, the shuttering of businesses, loss of income, and other economic effects of the pandemic have added to the emotional distress of many millions of people globally. More than 30% of US adults—a significantly higher proportion than in other high-income countries—reported they had experienced negative economic effects of the pandemic. In addition to being unable to pay for necessities such as food, rent, or heat, these effects include depleting most of their personal savings, borrowing money, or taking out a loan.

Other countries reporting economic worries by a substantial percentage of their populations included Canada, where about 1 in 4 survey respondents reported economic hardships, and Australia, where about 1 in 5 did so. In contrast, only 6% of German respondents and 7% of Dutch respondents reported similar financial difficulties.

Job loss or loss of a source of income was more common among respondents in the United States (27%), Australia (26%), and Canada (23%), compared with only 7% to 8% of respondents in France, Germany, and the Netherlands.

The authors note that previous research findings indicate that even before the COVID-19 pandemic, US residents were already among the most likely to experience emotional distress. In 2016, 26% of US adults reported that in the past 2 years they had experienced emotional distress that was difficult to cope with on their own, a rate similar to that of Canada (27%) and Sweden (24%) but considerably higher than reported by adults in Germany (7%) and France (12%).

Another key finding of the survey was that US respondents were less likely than those in other countries to have a positive opinion of the government’s pandemic response. Only one-third of US adults said that President Trump had done a “good” or “very good” job of handling the pandemic, whereas 49% to 95% of respondents from other countries approved of how their president, prime minister, or central government has responded.

As cases and deaths have continued to climb in the United States, overall opinion of President Trump’s handling of the coronavirus pandemic has declined further. A poll by the Associated Press-NORC Center for Public Affairs Research released on July 26 revealed that approval of the president’s handling of the pandemic reached a new low, with just 32% of the US public saying they support his approach.

“As the number of confirmed COVID-19 cases and deaths in the US continues to increase, policymakers—at all levels of government—should look abroad for innovative solutions,” Reginald D. Williams II, lead author of the study and Commonwealth Fund Vice President for International Health Policy and Practice Innovations, said in a statement. “There are valuable lessons we can learn, particularly around improving access to mental health services, and addressing socioeconomic needs exacerbated by the pandemic.”

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