Economic hardship and mental health complaints during COVID-19

Dirk Witteveen, Eva Velthorst

Research output: Contribution to journalArticlepeer-review

190 Scopus citations


The COVID-19 economic crash is idiosyncratic because of its virtual standstill of economic activity. We therefore ask how individual labor market experiences are related to the development of mental health complaints in the spring of 2020. As clinical data collection was compromised during the lockdowns, standardized surveys of the European labor force provide an opportunity to observe mental health complaints as the crisis unfolded. Data are representative of active members of the labor force of six European nations that contained varying levels of COVID-19 burdens in terms of mortality and lockdown measures. We document a steep occupational prestige level gradient on the probability of facing economic hardship during the lockdowns—looming job loss, income loss, and workload decline—which evidently exacerbate socioeconomic inequalities. Analyses indicate a striking positive relationship between instantaneous economic hardships during the COVID-19 lockdown and expressing feelings of depression and health anxiety. Importantly, the magnitude of the association between such hardships and indicators of mental health deterioration is highly dependent on workers’ occupational standing, revealing a second layer of exacerbating inequality.

Original languageEnglish
Pages (from-to)27277-27284
Number of pages8
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number44
StatePublished - 3 Nov 2020


  • COVID-19
  • Depressive symptoms
  • Health anxiety
  • Labor market inequality
  • Recession


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