Since the coronavirus pandemic was declared in mid-March, many Americans have suffered job losses. As of this writing, the national unemployment rate stands at 11.1%, and some 17,750,000 people are unemployed. This paints a bleak economic picture as a whole, but individually, it could have far reaching health impacts too.
“The National Institutes of Health has conducted several studies over the years confirming that unemployment can have a negative effect on both mental and physical health,” says Dr. Richard Seidman, chief medical officer of L.A. Care Health Plan, the largest publicly operated health plan in the U.S.
“Unemployment initially begins by affecting mental health, but it can manifest in physical health changes over time,” says Darby Fox, a child and adolescent family therapist based in the greater New York City area. Though we often try to separate the mental from the physical, in truth, the two are closely integrated.
In terms of mental health, being employed and earning enough money to support yourself and your family can provide a powerful sense of control, as well as an identity, a routine and self-esteem, all of which are important for maintaining good overall health.
“Worry over how to support yourself and your family coupled with a loss of identity that often goes with working can create stress,” Fox says, and this stress can lead to a range of health problems that go well beyond the brain and into the rest of the body.
And this stress can transition into physical issues over time, says Melissa Neathery, clinical associate professor at the Louise Herrington School of Nursing at Baylor University in Dallas, Texas. Mental health issues are so thoroughly intertwined that “you can’t have physical or mental health without the other.”
From Mental to Physical Problems
Losing the sense of identity and control that having steady employment often provides, especially when compounded by a loss of income, can be an enormous physical and mental challenge for many people. As such, unemployment has also been associated with the development or exacerbation of a range of health issues including:
— Insomnia and other sleep disorders.
— Back pain.
“Unemployment as a stressor can lead to more visits to the doctor, greater use of medications and spending more days ‘sick in bed,'” says Dr. K. Luan Phan, chair of the department of psychiatry and behavioral health at the Ohio State University Wexner Medical Center in Columbus.
However, because many people get their health insurance through their jobs, a loss of employment may reduce their ability to access health care, Phan adds. “There’s a risk that folks with less money in their budgets will cut corners and spend less time seeking medical care because of cost.” Canceling that annual physical or other annual screenings and check-ups might make sense in the moment to save some money, but could set you up for more expensive health issues later.
Similarly, trimming the monthly gym membership and other health-boosting expenditures from a crunched household budget might help you make rent next month, but preventive measures typically pay big dividends down the line.
It’s also true that in many cases, eating healthy whole foods can be pricier than choosing processed or ready-made options. When money is tight, skimping on fresh produce may seem like a wise cost-cutting decision, but it can have long-term health implications.
For some, unemployment and the challenges it brings also leads to high-risk coping behaviors such as increased alcohol consumption and smoking. “Stress or anxiety alone, but certainly combined with risky behaviors, can have a negative impact on physical health,” Seidman says. “If you combine high alcohol use and smoking, individuals can be at risk of other conditions like cancer and liver disease.”
Being Poor is Bad for Health
Even in the best of times, being poor is detrimental to health. Seidman notes that “a researcher at the University of California San Francisco says socioeconomic status is the most powerful predictor of disease and mortality. The lower the income, the greater the risk of poor health outcomes.”
The effects have been quantified, he adds. “The Health Inequality Project says the richest Americans live 15 years longer than the poorest. With COVID-19 here in Los Angeles County, we have seen similar disparities. As of July 8, the mortality rate for the entire county was 33 per 100,000. But, for those living in areas of extreme poverty, the rate was 74 in 100,000.”
During this pandemic, many low-income workers and those living under or near the poverty line are likely to lose their jobs at higher rates than more affluent Americans, and that means many more people will likely suffer long-term health consequences of job loss and financial insecurity.
Tips for Limiting the Health Impacts of Unemployment
Clearly, losing a job can become a major health issue, but there are some things you can do to limit its impact on your health while you look for your next job opportunity.
— Carefully review your financial situation. “Understanding your spending habits and finding ways to ‘declutter’ your budget, knowing where and how money is coming out of your bank account can help someone make adjustments,” Phan says. And if getting rid of a few monthly subscriptions can help you keep up with exercise or health care needs, so much the better. Prioritizing health and healthy activities might seem difficult in the moment when you’re struggling to sort it all out, but supporting good health now is always likely to be cheaper in the long run.
— Think about what you want to do most. Neathery recommends thinking carefully about whether this period of unemployment is actually an opportunity in disguise and a chance to learn a new skill or go in a different direction. Maybe it’s time to go back to school and pursue another career you’ve always wanted to try. You may be able to find scholarships and loans that make the financial challenge of such a big change more manageable. Plus, as a student, you’ll have access to health insurance. “Not everyone can make a huge career change, but for some it’s an option,” and is one that shouldn’t be simply dismissed out of hand, she says.
— Keep moving. “When you’re feeling down, it’s always a good idea to get some exercise. Even a gentle walk lets the brain down-regulate,” and relax, Fox says. So, find an exercise that you enjoy and set up a regular routine. The loss of a consistent routine after losing a job is part of the problem, so make your daily walk, run, swim, cycle, dance class or whatever other activity you prefer a focal point of every day to keep that sense of routine. When money’s tight, remember that going for a walk or run is free. If you live in a place where walking might be dangerous, look to see if there’s an indoor space, such as a shopping mall, where it might be safer to get moving. And avail yourself of any of the dozens of free exercise videos online or fitness apps that can help you figure out how to create an at-home or in-the-park workout using objects you have on hand or body weight resistance moves to build strength and support health.
— Meditate. Developing a daily mindfulness or meditation practice can help you keep things in perspective and alleviate the stress of unemployment. Meditating for just five or 10 minutes a day has been shown to reduce stress levels, which may reduce your risk of negative health outcomes. Again, there are dozens of free resources — training videos, apps, journaling resources and so forth — available online that can help you get started if you’re new to meditation.
— Make social connections. While it might be difficult right now to meet with others in person because of the coronavirus, make an effort to reach out to old friends and colleagues for social contact and moral support, as well as for potential networking opportunities. You never know who knows whom and which conversation may lead to a job.
— Find a purpose. Even if it’s part-time work in a different industry than you intend for your career, sometimes simply having work of any kind is enough to help you reestablish a routine to stay motivated and moving forward. And it doesn’t have to be work. Perhaps volunteering at an organization you support is a way to find connection, purpose and routine — all for a good cause.
— Make healthy eating a priority. Yes, eating fresh foods can be more expensive than their processed counterparts. But put the emphasis on quality rather than quantity when meal planning, and don’t hesitate to access a food pantry if you need to.
— Avoid alcohol and drugs. When you no longer have to be up early for work the next morning, that can make it easier to drink more each night or abuse drugs. But Seidman recommends avoiding this temptation as much as possible and sticking to a routine of self-care and health management.
— Take a break. Though you’ll want to keep a routine as much as possible, Seidman also notes that now and again, you do need some down time and to take a break. “Stepping back from the job hunt at times is important for one’s mental health and stress levels,” which can in turn pay health dividends. So, when it gets to be too much, give yourself some grace and a day off. “Give yourself permission to grieve for an appropriate amount of time, then move on,” Neathery says.
— Keep an open mind. The world and economy are changing rapidly, and the type of job you had before might not become available again, so Phan recommends staying “on top of your resume and thinking of creative ways of how you can contribute to the workforce. Stay engaged in seeking employment and work on expanding your framework for what jobs are available and what you would be willing to do in the short-term.”
— Ask for help. “With the economy being what it is, it could take much longer for people to find work, so the risk of poor health outcomes is high,” Seidman says. “People are going to have to reach out for help,” and many are. Feeding America reports that about 40% of the people vising food banks are first-time recipients of food assistance, and they’re not subsisting on just canned goods and pasta. These days, food pantries can provide everything you need for high-quality, nutritious and fresh meals. You can also reach out to friends, a counselor or maybe a spiritual leader to share your struggles, and discuss how to develop healthy coping skills.
— Keep your eye on the future. It’s important to stay healthy during a period of unemployment, because as soon as you get hired again, you’re going to need to be ready to hit the ground running. “Even in these uncertain times, work to remain hopeful and grateful for the positive things your life,” Phan says.
— Call or text a help line. If you’re in crisis, don’t hesitate to call a free mental health hotline. These resources are available to anyone at any time and exist to help you connect with the right support when you need help. If you’re thinking about harming yourself, please don’t hesitate to call the National Suicide Prevention Lifeline at 1-800-273-8255 (which is also the Veterans Crisis Line). If drugs or alcohol are becoming an issue, call the Substance Abuse and Mental Health Services Administration’s National Helpline at 1-800-662-HELP (4357). There are also many other local services available in communities across the country you can connect with when it all seems too much to bear. If you prefer texting, you can text TALK to the Crisis Text Line 24/7 at 741-741 for confidential support via text message.
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