Survey of Health and Wellbeing –Monitoring the Impact of COVID-19

Lead Institution: Iverson Health Innovation Research InstituteContact: shaw@swin.edu.au

Dr Michelle Lim, Prof Gavin Lambert, Ms Lily Thurston, Ms Taylah Argent, Dr Robert EresSwinburne University of Technology

Prof Johanna BadcockUniversity of Western Australia

Prof Pamela Qualter, Dr Margarita Panayiotou, Dr Alexandra HennesseyUniversity of Manchester

Prof Julianne Holt-LunstadBrigham Young University

Brief background and study aim

• One in four Australians (12-89) report problematic levels of loneliness in two national Australian surveys run in 2018 and 20191 2.

• In the UK, in 2018, the Office of National Statistics reported comparable high levels of loneliness at a population level3.

• COVID-19 pandemic has further magnified social and economic vulnerabilities in our community. Public health measures taken to flatten the curve is likely to increase loneliness, social isolation, poor mental health, and lower quality of life.

• The overall study aim is to understand the impact of the COVID-19 pandemic on relationships, health, and quality of life.

1 Australian Loneliness Report (2018) Australian Psychological Society2 Young Australian Loneliness Survey (2019) VicHealth 3 Office for National Statistics (2018)

What do we measure?

Part 1 – Who is the individual? • Age, gender, nationality, work status, income, household and carer status, education and income level,

and postcode.

Part 2 – How do they feel, live, and relate to others?• Mental health – depression and social anxiety.• Relationships – loneliness, social isolation risk, perceived social support.• Stress, positive and negative affect, coping styles.• Quality of life.

Part 3 – How has COVID-19 impacted the individual? • Assessing level of social restrictions at time of survey.• Measuring changes to loneliness, social isolation risk, worry, work status, social media use, health

status.

Study design

Prospective cohort study involving 3 surveys over a 6-month period:

Baseline survey 30 MINS

6-8 weeks follow-up20 MINS

6-8 weeks follow up 20 MINS

• Ethics approval from the Swinburne Human Research Ethics Committee HREC 20200728-4307. • Recruitment activities commenced via social media channels and partners.• Data collection currently occurring via internet-based survey.• 2,666 participants consented to date.

Wave 1 details

• Wave 1 data collection from April 3rd to June 18th 2020.

• Wave 1 findings are intended to display cross-sectional trends only.

• Data analysis is ongoing. Additional analyses are required to fully understand the impact of COVID-19 on loneliness, social contact, mental health, and physical health.

• Not all data measured are presented in this summary.

• No causal claims can be made at this stage of data collection.

• While findings are global, we conduct subgroup analyses for residents living in Australia, United Kingdom, and the United States.

Take Home Messages

Wave 1 Summary Findings

Loneliness was associated with more mental health symptoms, less social contact, and more physical health concerns.

Living with family during COVID-19 seems to be most beneficial for protecting against feelings of loneliness, depression, social anxiety, and stress.

Social contact was similar across all ages and countries, with respondents having the least contact with their neighbours.

Wave 1 Summary Findings

1 in 2 Australians report feeling more lonely since COVID-19.

2 in 3 American/British residents report feeling more lonely since COVID-19.

Young adults report more loneliness, depression, anxiety, and stress than other adults.

Those who reported feeling more lonely because of COVID-19also reported more mental health concerns.

Sample Characteristics

Number of participants, age, gender, education level, marital status, carer status, parental status

Participants

2,666

Australia: 701

Britain: 483

United States: 378

Gender Identity

Male: 16.7%

Female: 81.4%

Other*: 2%

Average Age

47.31 Years

Range:

18 to 101 years

Sample characteristics

*Other includes people who identified as non-binary, agender, gender fluid, or transgender without additional detail of their preferred gender profile

Sample characteristics

Parental Status

Parent: 27.5%

Non-Parent: 72.5%

Highest Education

High School: 20%

Bachelor Degree: 38%

Master’s Degree: 30.6%

Doctoral Degree: 11.3%

Marital Status

Single: 21.1%In a relationship: 18.8%

Married: 42%Separated: 2.9%Divorced: 10.4%Widowed: 3.6%

Other: 1.3%

Carer Status

Carer: 18.2%

Non-Carer: 81.8%

Who has participated?

Location of Respondents

NUMBER OF RESPONDENTS1 701

Loneliness & Social Contact

Loneliness – UCLA-LS; UCLA loneliness scaleSocial contact – LSNS; Lubben social network scale

Loneliness during COVID-19

Over 1 in 6 people reported problematic levels of loneliness (17.34%).

Young adults aged 18-25 years reported the highest levels of loneliness compared with other age groups.

40

42

44

46

48

50

18 to 25(n = 196)

26 to 35(n = 479)

36 to 45(n = 492)

46 to 55(n = 557)

56 to 65(n = 579)

66 to 100(n = 317)

Lone

lines

s Sco

re

Age Groups

Mean Loneliness Scores by Age Group

Note: Problematic levels of loneliness were calculated based on 1 standard deviation above the mean. Higher scores indicate more loneliness

4041424344454647484950

18-2

5 ( n

= 5

7)

26-3

5 ( n

= 1

73)

36-4

5 ( n

= 1

52)

46-5

5 ( n

= 1

49)

56-6

5 ( n

= 1

14)

66-1

00 (

n =

52)

18-2

5 ( n

= 2

2)

26-3

5 ( n

= 5

2)

36-4

5 ( n

= 7

6)

46-5

5 ( n

= 9

8)

56-6

5 ( n

= 1

48)

66-1

00 (

n =

87)

18-2

5 ( n

= 2

4)

26-3

5 ( n

= 3

7)

36-4

5 ( n

= 5

1)

46-5

5 ( n

= 7

6)

56-6

5 ( n

= 1

05)

66-1

00 (

n =

85)

AUS UK US

Lone

lines

s Sco

re

Region

Mean Loneliness Scores by Region

Loneliness during COVID-19

Loneliness appears to be differentially represented across age groups within each region.

Note: There are discrepant numbers of participants in each age group within each region. These findings should be taken with caution and only tentative conclusion can be made

Loneliness during COVID-19

1 in 2 Australian residents reported feeling lonelier since COVID-19 (54%).

2 in 3 British residents reported feeling lonelier since COVID-19 (61%).

2 in 3 American residents reported feeling lonelier since COVID-19 (66%). 0

10

20

30

40

50

60

70

Australia UK US

Perc

enta

ge o

f Sam

ple

Region

Change in Loneliness by Region

Less Lonely Equally Lonely More Lonely

Loneliness during COVID-19

Those who reported feeling more lonely since the start of the pandemic also reported higher social anxiety.

0

1

2

3

4

5

AUS UK US

Min

i-SPI

N Sc

ore

Region

Mean Social Anxiety by Region and Change in Loneliness

Less Lonely Equally Lonely More Lonely

Note: A score of 6 on the Mini-SPIN is indicative of problematic social anxiety (Connor et al. 2001)

Loneliness during COVID-19

Those who reported feeling more lonely since the start of the pandemic also reported more depression.

0

2

4

6

8

10

12

AUS UK USPH

Q-8

Sco

re

Region

Mean Depression Scores by Region and Change in Loneliness Status

Less Lonely Equally Lonely More Lonely

Note: A score of 10 on the PHQ-8 is indicative of problematic levels of depression (Kroenke et al., 2009)

Loneliness by household status

Most respondents (72.5%)

lived with family during the

pandemic and reported the

lowest level of loneliness.

People living alone reported

the highest level of loneliness.

42

43

44

45

46

47

48

49

50

Living alone

(n = 568)

Living with family

(n = 1877)

Living with non-family

(n = 160)

Lon

eli

ne

ss S

core

Household Status

Loneliness by Household Status

Social contact during COVID-19

Social contact was similar across all age groups.

Contact with neighbours was consistently low across all age groups.

02468

101214161820

18 - 25(n = 194)

26 - 35(n = 481)

36 - 45(n = 492)

46 - 55(n = 559)

56 - 65(n = 579)

66 - 100(n = 317)

LSNS

Sco

re

Age Group

Mean Social Contact by Age Group

Family Friends Neighbours

Social contact during COVID-19

Social contact was similar across all three regions.

Social contact with neighbourswas consistently low.

02468

1012141618

AUS (n = 690) UK (n = 482) US (n = 377)

LSNS

Sco

re

Region

Mean Social Contact by Region

Family Friends Neighbours

Mental Health

Depression – PHQ-9; Patient health questionnaire - only 8 items administeredSocial Anxiety – Mini SPIN; Mini-social phobia inventoryPerceived Stress – PSS; Perceived stress scaleQuality of Life – EUROHIS; European health interview survey

Depression across age during COVID-19

Approximately 1 in 3 people (36.1%) reported problematic levels of depression.

Young adults (18-25 years) report the highest levels of depression.

0

2

4

6

8

10

12

14

18 to 25(n = 196)

26 to 35(n = 481)

36 to 45(n = 494)

46 to 55(n = 559)

56 to 65(n = 580)

66 to 100(n = 319)

PHQ

-8 S

core

Age Group

Depression by Age Group

Note: A score of 10 on the PHQ-8 is indicative of problematic levels of depression (Kroenke et al., 2009)

Social anxiety across age during COVID-19

Approximately 1 in 4 people (28.4%) reported problematic levels of social anxiety.

Young adults (18-25 years) reported the highest levels of social anxiety.

Note: A score of 6 on the Mini-SPIN is indicative of problematic levels of social anxiety (Connor et al. 2001)

0

1

2

3

4

5

6

18 to 25(n = 195)

26 to 35(n = 481)

36 to 45(n = 493)

46 to 55(n = 560)

56 to 65(n = 581)

66 to 100(n = 319)

Min

i-SPI

N Sc

ore

Age Group

Mean Social Anxiety Scores by Age Group

Perceived stress across age during COVID-19

Young adults reported the highest levels of stress.

0123456789

10

18 - 25(n = 189)

26 - 35(n = 476)

36 - 45(n = 490)

46 - 55(n = 557)

56 - 65(n = 578)

66 - 100(n = 318)

PSS

Scor

e

Age Groups

Mean Stress Scores by Age Groups

Quality of life across age during COVID-19

Older adults (66-100 years) reported the highest quality of life of all participants.

2525.5

2626.5

2727.5

2828.5

2929.5

30

18 to 25(n = 195)

26 to 35(n = 482)

36 to 45(n = 492)

46 to 55(n = 559)

56 to 65(n = 580)

66 to 100(n = 319)

EURO

HIS

Scor

e

Age Group

Mean Quality of Life Ratings by Age Group

Note: Higher scores represents higher quality of life

Depression in each region during COVID-19

Australians reported having the least severe depression scores.

Note: Higher scores indicate more depression. A score of 10 or more is indicative of problematic depression (Kroenke et al., 2009)

7.2

7.4

7.6

7.8

8

8.2

8.4

8.6

8.8

AUS (n = 690) UK (n = 482) US (n = 377)

PHQ

-8 S

core

Region

Mean Depression Scores by Region

Social anxiety in each region during COVID-19

All regions reported similar levels of social anxiety symptoms.

Note: Higher scores indicate more social anxiety severity. A score of 6 or more is indicative of problematic social anxiety (Connor et al. 2001)

00.5

11.5

22.5

33.5

44.5

AUS (n = 690) UK (n = 482) US (n = 377)

Min

i-SPI

N Sc

ore

Region

Mean Social Anxiety Score by Region

Perceived stress in each region during COVID-19

All regions reported similar levels of perceived stress.

Note: Higher scores indicate more perceived stress

6.6

6.8

7

7.2

7.4

7.6

7.8

AUS (n = 690) UK (n = 482) US (n = 377)

PSS

Scor

e

Region

Mean Stress Scores by Region

Quality of life in each region during COVID-19

Australians reported higher quality of life compared with people in the US and UK.

Note: Higher scores indicate better quality of life

26.5

27

27.5

28

28.5

29

29.5

30

AUS (n = 690) UK (n = 482) US (n = 377)

EURO

HIS

Scor

e

Region

Mean Quality of Life Scores by Region

Living situation and depression during COVID-19

Those living with non-family members during the COVID-19 pandemic reported having the most severe depression symptoms.

Note: Higher scores indicate more depression. A score of 10 or more is indicative of problematic depression (Kroenke et al., 2009)

7

7.5

8

8.5

9

9.5

10

Living alone(n = 568)

Living with family(n = 1877)

Living with non-family(n = 160)

PHQ

-8 S

core

Household Status

Mean Depression Scores by Household Status

Living situation and social anxiety during COVID-19

Those living with non-family members during the COVID-19 pandemic reported having the most severe depression symptoms.

Note: Higher scores indicate more social anxiety severity. A score of 6 or more is indicative of social anxiety disorder (Connor et al. 2001)

3.33.43.53.63.73.83.9

44.14.24.34.4

Living alone(n = 568)

Living with family(n = 1877)

Living with non-family(n = 160)

Min

i-SPI

N S

core

Household Status

Mean Social Anxiety by Household Status

Living situation and perceived stress during COVID-19

Those living with non-family members during the pandemic reported having the highest perceived stress score.

77.27.47.67.8

88.28.48.6

Living alone(n = 568)

Living with family(n = 1877)

Living with non-family(n = 160)

PSS

Scor

e

Household status

Mean Stress Scores by Household Status

Living situation and quality of life during COVID-19

Those living with family members during the COVID-19 pandemic reported having the highest quality of life.

26

26.5

27

27.5

28

28.5

29

Living alone(n = 568)

Living with family(n = 1877)

Living with non-family(n = 160)

EURO

HIS

Scor

e

Household Status

Mean Quality of Life Scores by Household Status

Physical Health

Physical Health Questionnaire – PHQ-14; Physical health questionnaire – 14 itemsNumber of physical health conditions

Physical health concerns across age group

Each age group reported similarpatterns of physical health concerns.

Note: Higher scores indicate more somatic physical health concerns

02468

1012141618

18 - 25(n = 189)

26 - 35(n = 476)

36 - 45(n = 490)

46 - 55(n = 557)

56 - 65(n = 578)

66 - 100(n = 318)

PHQ

-14

scor

e

Age Group

Mean Physical Health Concerns by Age Group

Sleep Concerns Headaches Gastrointestinal concerns Respiratory concerns

Total Number of Health Conditions

Older adults (66-100 years) reported twice as many health conditions as young adults (18-25 years).

0

0.5

1

1.5

2

2.5

3

18 - 25(n = 199)

26 - 35(n = 486)

36 - 45(n = 501)

46 - 55(n = 560)

56 - 65(n = 580)

66 - 100(n = 319)

Num

ber o

f Hea

lth C

ondi

tions

Age Group

Mean Number of Health Conditions by Age Group

Occupational Status

Change in workhours

Change in work hours by age

1 in 5 young adults (18 –25 years) reported a decrease in in work hours.

1 in 4 adults (26 – 65 years) reported a decrease in work hours.

0

10

20

30

40

50

60

18-25 26-35 36-45 46-55 56-65 66-100

% o

f Peo

ple

with

Cha

nge

in W

ork

Hour

s

Age Group

Change in Work Hours by Age

No Change Increase Decrease

Change in work hours by region

1 in 5 people reported a reduction in work hours during COVID-19 across all regions.

0

10

20

30

40

50

60

70

AUS UK US

% o

f Peo

ple

Who

Hav

e Ha

d a

Chan

ge in

Wor

k Ho

urs

Region

Change in Work Hours by Region

No Change Increase Decrease

Relationships Between Variables

Relationships Between Variables

Note: Relationships between variables were assessed using Pearson correlation coefficients for the whole dataset. Each region of interest displayed the same relationships with comparable strengths. Relationships are significant against p <.001

Higher levels of loneliness are associated with: Strength of relationship Pearson’s r

Higher levels of social anxiety Large .48

Higher levels of depression symptoms Large .55

Less contact with friends Large -.57

Less contact with family Moderate -.33

Less contact with neighbours Large -.52

Fewer approach coping strategies Moderate -.38

More avoidant coping strategies Moderate .34

Living alone Small .15

Lower quality of life Large -.65

More perceived stress Large .54

More physical health conditions Small .18

More sleep related problems Moderate .33

More headaches Moderate .26

More gastro-intestinal problems Moderate .27

More respiratory problems Small .11

List of Measures

Measure Acronym Description

UCLA Loneliness Scale UCLA-LS A 20-item measure of loneliness

Mini-Social Phobia Inventory Mini-SPIN A 3-item measure of social anxiety

Patient Health Questionnaire PHQ-8 An 8-item measure of depression

Lubben Social Network Scale LSNS-18 An 18-item measure of social contact

Perceived Stress Scale PSS A 4-item measure of perceived stress

European Health Interview Survey of Quality of Life EUROHIS An 8-item measure of quality of life

Physical Health Questionnaire PHQ-14 A 14-item measure of somatic physical health complaints

References

Carver, C.S. (1997). You want to measure coping but your protocol’s too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(92).

Cohen, S., Kamarck, T., & Mermelstein, R., (1983). A global measure of perceived stress. Journal of health and social behaviour, 24(4), 385-396.

Connor, K. M., Kobak, K. A., Churchill, L. E., Katzelnick, D., & Davidson, J. R. (2001). Mini-SPIN: A brief screening assessment for

generalized social anxiety disorder. Depression and anxiety, 14(2), 137-140.

Kroenke K, Strine TW, Spitzer RL, Williams JBW, Berry JT, & Mokdad AH. (2009). The PHQ-8 as a measure of current depression in

the general population. Journal Affective Disorders,114:163-173.

Lim, M.H., Australian Psychological Society. (2018). Australian Loneliness Report: a survey exploring the loneliness levels of Australians and the impact on their health and wellbeing. Australian Psychological Society, Psychology Week 2018, 'The Power of

Human Connection' campaign. https://psychweek.org.au/wp/wp-content/uploads/2018/11/Psychology-Week-2018-Australian-

Loneliness-Report.pdf. Accessed 15 July 2020

Lim M.H., Eres, R., & Peck, C. (2019). The Young Australian Loneliness Survey: understanding loneliness in adolescents and young adults. https://www.vichealth.vic.gov.au/loneliness-survey. Accessed 15 July 2020

References

Lubben, J.E. (1988). Assessing social networks among elderly populations. Family and Counselling Health: The journal of health promotion and maintenance, 11(3), 43-52.

Office for National Statistics. (2018). National Measurement of Loneliness: 2018. London, United Kingdom: Office for National Statistics.

Russell, D., Peplau, L.A., & Cutrona, C.E. (1980). The revised UCLA Loneliness Scale: concurrent and discriminant validity evidence. Journal of Personality and Social Psychology, 39(3), 472.

Schat, A.C.H., Kelloway, E.K., & Desmarais, S. (2005). The Physical Health Questionnaire (PHQ): Construct validation of a self-report scale of somatic symptoms. Journal of Occupational Health Psychology, 10(4), 363-381.

Schmidt, S., Muhlan, H., & Power, M. (2006). The EUROHIS-QOL 8-item index: psychometric results of a cross-cultural field study. European Journal of Public Health, 16(4), 420-428.