On March 11, 2020, the World Health Organization declared COVID-19 a global pandemic. Within a week, millions went home to shelter in place for what they thought would be a few weeks, hoping that their sacrifice would stop the spread of the coronavirus. One year later, more than 500,000 U.S. residents have died from the coronavirus, while the nation also has grappled with racial injustice, a brutal election cycle and civil unrest. In our October 2020 report, Stress in AmericaTM 2020: A National Mental Health Crisis, the American Psychological Association issued a warning about the impact of these stressful events on long-term physical and mental health. We warned that Americans faced a second pandemic — one that would persist even after the physical threat of the virus has been addressed. Our most recent survey of U.S. adults, conducted in late February 2021 by The Harris Poll, indicates that this is coming to fruition. Survey responses reveal that physical health may be declining due to an inability to cope in healthy ways with the stresses of the pandemic. Many reported they have gained or lost an undesired amount of weight, are drinking more alcohol to cope with stress and are not getting their desired amount of sleep. This is particularly true of parents, essential workers, young people and people of color. These reported health impacts signal many adults may be having difficulties managing stressors, including grief and trauma, and are likely to lead to significant, long-term individual and societal consequences, including chronic illness and additional strain on the nation’s health care system. Key survey findings include A majority of adults (61%) reported experiencing undesired weight changes since the start of the pandemic, with more than 2 in 5 (42%) saying they gained more weight than they intended. Of this group, adults reported gaining an average of 29 pounds (with a typical gain of 15 pounds, which is the median). Two in 3 Americans (67%) said they are sleeping more or less than they wanted to since the pandemic started. Similar proportions reported less (35%) and more (31%) sleep than desired. Nearly 1 in 4 adults (23%) reported drinking more alcohol to cope with their stress during the coronavirus pandemic. Nearly half of Americans (47%) said they delayed or canceled health care servicessince the pandemic started. Nearly half of parents (48%) said the level of stress in their life has increased compared with before the pandemic. More than 3 in 5 parents with children who are still home for remote learning (62%) said the same. Essential workers were more than twice as likely as those who are not to have received treatment from a mental health professional (34% vs. 12%)and to have been diagnosed with a mental health disorder since the coronavirus pandemic started (25% vs. 9%). Black Americans were most likely to report feelings of concern about the future. More than half said they feel uneasy about adjusting to in-person interaction once the pandemic ends (57% vs. 51% Asian, 50% Hispanic and 47% white). Gen Z adults (46%) were the most likely generation to say that their mental health has worsenedcompared with before the pandemic, followed by Xers (33%), Millennials (31%), Boomers (28%) and older adults (9%). This report elaborates on these findings and proposes strategies to help us navigate this secondary crisis. APA is committed to helping people emerge from this challenging time poised to embrace and shape a brighter future together. Pandemic-related stress comes with serious health consequences The prolonged stress experienced by adults, especially the high levels of stress reported by Americans directly linked to the pandemic, is seriously affecting mental and physical health, including changes to weight, sleep and alcohol use. Weight change is a common symptom when people are having difficulty coping with mental health challenges. A majority of adults (61%) reported experiencing undesired weight changes, since the start of the pandemic, with more than 2 in 5 (42%) saying they gained more weight than they intended. Of this group, adults reported gaining an average of 29 pounds (with a median gain of 15 pounds), and 1 in 10 (10%) said they gained more than 50 pounds. For the 18% of Americans who said they lost more weight than they wanted to, the average amount of weight lost was 26 pounds (median of 12 pounds). Significant weight gain poses long-term health risks. According to the National Institutes of Health, people who gain more than 11 pounds are at higher risk of developing Type II diabetes mellitus and coronary heart disease, and people who gain more than 24 pounds are at higher risk of developing ischemic stroke. And according to the Centers for Disease Control and Prevention, people who are overweight are more likely to develop serious illness from the coronavirus. Adults also reported changes in sleep and increased alcohol consumption. Two in 3 Americans (67%) said they are sleeping more or less than they wanted to since the pandemic started. Similar proportions reported less (35%) and more (31%) sleep than desired. Nearly 1 in 4 adults1 (23%) reported drinking more alcohol to cope with their stress during the coronavirus pandemic. This proportion jumps to more than half of adults (52%) who are parents with early elementary school-age children (5-7 years old). Overall, physical health has taken a back seat. Nearly half of Americans (47%) said they delayed or canceled health care services since the pandemic started. Additionally, more than half of U.S. adults (53%) said they have been less physically active than they wanted to be since the pandemic started. Three in 4 adults who reported a high stress level (rating of 8 – 10 on a scale where 1 means “little or no stress” and 10 means “a great deal of stress”) during the past year related to the pandemic (75%) reported undesired weight changes since the start of the pandemic, compared with 43% of those who reported a low stress level (rating of a 1–3). They also were more likely to report sleeping more or less than they wanted to since the start of the pandemic (84% vs. 42% for low stress) and drinking more alcohol to cope with stress (38% vs. 10% for low stress). Further, more than 3 in 5 of those who reported high stress (63%) said they have been less physically active than they wanted to be since the start of the pandemic, compared with 42% of those who reported a low stress level. A majority of adults (82%) said they never imagined the COVID-19 pandemic would last this long. Nearly 7 in 10 Americans (67%) said that living through the coronavirus pandemic has been a rollercoaster of emotions. Nearly 1 in 4 U.S. adults (24%) said they or a household member were laid off from a job during the coronavirus pandemic, while 22% started working from home, and 16% of all U.S. adults had a child or children age 18 or younger at home for remote learning. Among parents who had a child home for remote learning, the majority (85%) still had at least one child remote learning from home as of February 2021. Additionally, 2 in 3 Americans (67%) reported less in-person social interaction since the start of the coronavirus pandemic, but a similar proportion (67%) have had online social interactions (e.g., social media, online chat rooms or video calls) during this time. The majority of those who have had online social interactions since the coronavirus pandemic started (84%) said these engagements have helped them cope with stress. When asked how the level of stress in their life has changed compared with before the pandemic, nearly half of U.S. adults (47%) said the level of stress in their life has increased. Regardless of vaccination status, Americans feel uneasy about in-person interactions in the future Looking ahead, Americans are hesitant about the future regard- less of their vaccination status. Nearly half of Americans (49%) said they feel uneasy about adjusting to in-person interaction once the pandemic ends. Adults who received a COVID-19 vaccine were just as likely as those who have not received a vaccine to say this (48% vs. 49%, respectively). Similarly, 46% of adults said they do not feel comfortable going back to living life like they used to before the pandemic. Here, too, similar proportions of Americans agreed with this statement regardless of whether they had received a COVID-19 vaccine (44% of those who received a vaccine vs. 46% of those who did not receive a vaccine). APA provides guidance: Calls on policymakers to address severe health consequences While the situation is critical, it is not hopeless. This report contains small steps Americans can take to stay active, positive and connected on a daily basis. But the U.S. response to this crisis also requires large, systemic changes by health leaders and policymakers. We need to facilitate access to mental health services during and after the pandemic, including an expansion of congressional pandemic relief efforts that include substantial funding for mental health services and support. This also should include investing in prevention and treatment, continuing support for and expansion of telehealth services, and increasing funding to better support school mental health services. Even before the COVID-19 pandemic turns the corner, we need to invest in helping Americans recover mentally and physically, making us stronger for the future. A special thank you to our member psychologists specializing in child development, parenting, racial disparities, education, substance use, eating disorders and employment who contributed actionable advice to this report: Emma Adam, PhD; Mary Alvord, PhD; Leslie Hammer, PhD; Byron McClure, PhD; James Murphy, PhD; Tracy Sbrocco, PhD; Mia Smith-Bynum, PhD; and Erlanger “Earl” Turner, PhD. A special thanks also to our staff who provided insights on this report: Senior Director, Practice Transformation and Quality Lynn Bufka, PhD; APA Deputy CEO Jim Diaz- Granados, PhD; and Senior Director of Health Care Innovation Vaile Wright, PhD. Source
