Impact of COVID-19 on Women’s Mental Health and What It Taught Us | Categories Mental Health

by Rebekah Clark↓, Kari Pedersen↓ & Lisa H. Gren, PhD, MSPH↓

The COVID-19 pandemic presented new and unique challenges in many areas of life. Women in the US were impacted differently than men in some of these areas, including work-life changes, home and family changes, and responsibility for problem-solving. The purpose of this section is to explore how these changes affected women’s mental health. We focus on young and middle-aged adults because the literature supports that this group faced multiple significant changes during the pandemic, and there is a significant quantity of research about this age group.

Various reports have suggested increased mental health challenges during the pandemic. Though they disagree about the extent of this change, sources agree that changes were most significant within specific subgroups of the population.^1-3 Specifically, studies report a modest worsening of overall mental health, anxiety, and depression for women, older adults, parents, sexual minority groups, and college students. Those with pre-existing illnesses were also found to be at an increased risk for worsened mental health during the pandemic.³

Though women and non-binary individuals had a higher prevalence of mental health needs and insufficient care prior to the pandemic, these gender-based disparities became particularly evident during this time. Non-binary and other-gender individuals reported the most significant increase in adverse mental health outcomes compared to men, followed by women (Figure 1).² Women also experienced a plethora of other changes as a result of the pandemic, including an increase in overall stress and intimate partner violence, increased responsibilities and stress at home, and changes in the workplace and to work-life balance.^4-6

The relationships between mental health, stress, social factors, physical health, and other factors are often quite complex. This complexity can be further increased during unanticipated adverse events such as a global pandemic, as conditions change rapidly and dramatically, and many people struggle to adapt to and manage these changes. For young and middle-aged women, responsibilities at work and home changed, and this had a major impact on their mental health as they worked to balance the new demands. Effective strategies and interventions employed in these areas can positively impact the mental health of women in this age group.⁷

Connections to Work

As a function of existing gender constructs and the historical roles of women in society, (1) women were more likely to be employed in occupations that were significantly impacted by the pandemic, (2) women were more likely to work in low-paying jobs and take on unpaid labor both inside and outside the home, and (3) the pandemic exacerbated existing gender-based disparities in the workforce.^6,8 Many couples had to decide which partner would quit their job to stay home with children or elderly family members, and the lower earner (usually the woman in a heterosexual couple) often had to reduce hours or quit altogether.⁸ These choices produced long-term losses for women, such as reduced opportunities for career advancement and wage growth throughout their careers, and lessened contributions to retirement and Social Security.⁹ These losses are concerning since reduced financial security has been shown to negatively affect mental health.¹⁰

Many companies have been hesitant to allow employees to work remotely, but the pandemic forced companies to consider new ways of working. Three and a half years after the start of the pandemic, 58% of Americans are now able to work from home at least one day a week, and many of them are. In fact, 87% of those offered the chance to work remotely choose to do so.⁶ Most studies conclude that remote work improves work-life balance and benefits both the employer and employees.¹¹ The benefits are especially strong for women and for racial and ethnic minorities (Figure 2), which may be because these groups experience fewer microaggressions and other negative experiences online compared to in the office.¹² Remote work also has the possibility to alleviate the “identity labor” required by women and racial and ethnic minorities to fit into a world created by White men. Remote work could support efforts toward equity, diversity, and inclusion.¹¹ On the other hand, some women experienced increased exposure to domestic violence during the pandemic because more people were at home while the ability to report these occurrences privately was hampered.¹³

While flexible work arrangements can enhance gender equity for women who take advantage of the flexibility to further their career goals – as is typical for men – women often face societal pressures to use this flexibility for increased housework and childcare. Women who choose the latter path may find that increased flexibility decreases gender equity rather than increasing it .¹⁴ An effective strategy might allow women to choose whether and how much to work remotely.

Given that the majority of employees have a preference for at least some remote work, care must be taken not to create new inequalities for those whose jobs cannot be performed remotely.⁶ One strategy is to allow employees who must work in person other types of flexibility in their job, such as flexible work hours, as schedule control can be particularly useful in creating work-life balance.¹⁴ When considering lessons learned from the pandemic, companies should be cognizant of individual differences, the unique needs of female employees, opportunities for choice, and work-life balance. Flexible work has never been more possible or available than it is now, and attention to these practices can allow for better support of employees’ mental health.

Connections to Home, Family, and Social Supports

Women in the US spend almost double the amount of time caring for children compared to their male counterparts.¹⁵ When the pandemic began, children were sent home from school for what was anticipated to be only a few weeks, but in many cases, stretched to over a year. Already experiencing disproportionate caregiving responsibilities, women were further burdened with the additional physical and emotional requirements of adapting to the pandemic, as well as providing emotional support for family members.¹⁶ The increased burden of acting as a teacher, parent, employee, and support person affected parents regardless of gender, but women were disproportionately burdened by these tasks.¹⁷ An April 2020 poll of more than 1,200 American adults reported that mental health was significantly worse for mothers compared to fathers (Figure 3).¹⁸

While the pandemic increased family and home life burdens for women, what we learn as a result has the potential to decrease burdens long-term. The pandemic demonstrated our continued societal reliance on the unpaid work of women in caring for children and older adults.¹⁹ The best chance for positive societal change is to purposefully and proactively put in place changes that improve women’s mental health at home. For instance, researchers have shown that child tax credits reduce poverty, prevent developmental disruptions for children, and protect women’s health.²⁰ Utilizing lessons learned during the pandemic may present benefits that include healthier families, men being more involved in their children’s lives, a more egalitarian society, and improved mental health outcomes for women.¹⁹

While young and middle-aged adults faced increasing demands on their time and energy during the pandemic, some of the most significant struggles for older adults’ mental health were isolation and loneliness. For many, this was true even before the pandemic and was only intensified by these adverse events, shifts in social interactions, and a lack of access to resources.²¹ Researchers have emphasized the significant influence of social interaction and support on the outcomes of older adults, particularly during hardships like the pandemic.²² Because this group was also at a higher risk of COVID-19, it was difficult at times to find the balance between minimizing exposure risk and maximizing the health benefits of social interaction.²³ Improved use of telecommunications is one way that social interactions were successfully maintained during the pandemic, and their continued use can provide social support in times when in-person connection is more difficult.⁶

Conclusions

Women were among the groups who had relatively worse mental health impacts during the COVID-19 pandemic. This life-changing event we experienced, both as individuals and as a society, has served to highlight and reinforce social inequities and demonstrate why we must address them. A number of lessons learned about mental health during the pandemic can be encouraged as ongoing best practices, while others are perhaps unique to the disruptive setting of an emergency. In the former category, remote work and flexible work hours have the potential to improve work-life balance for women, as well as minimize the stressor of “identity labor.”¹¹ Still, more work is needed to understand how women can negotiate toward a more equitable distribution of unpaid labor at home.⁸

With regard to emergency situations, the pandemic highlighted how acute stressors can impact mental health, with worsening anxiety and depression more pronounced among women and sex and gender minorities relative to men.² Furthermore, while women reported more negative mental health impacts than men, the underlying reasons were often related to life stage. Children, adolescents, and older adults experienced challenges related to isolation, while young and middle-aged adults experienced the challenges of taking on more responsibility for both daily life activities and the social, emotional, and mental health of people in their immediate and extended social networks.^1,21,16  Enhanced communication platforms that were developed in response to the pandemic can be utilized in future emergencies to improve mental health surveillance, health education, and treatment options, as well as to provide remote treatment options and opportunities to socially connect isolated individuals. However, concerns raised about reporting and intervention for exposure to domestic violence have demonstrated that additional work is needed to consider ways to respect individual privacy in the setting where home, school, and work are co-mingled.¹³ Finally, it is important to consider the impact of unique combinations of risk and protective factors that different women may experience, as women with multiple risk factors had an increased risk of mental health challenges during the pandemic. Women’s mental health is also inextricably linked to the other domains of health, and lessons from the pandemic can inform strategies for improving women’s health across the 7 Domains of Health.

References

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Citation

Clark R, Pedersen K, & Gren LH. (2024). Impact of COVID-19 on Women’s Mental Health and What it Taught us. Utah Women’s Health Review.

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Impact of COVID-19 on Women’s Mental Health and What It Taught Us by Rebekah Clark, Kari Pedersen & Lisa H. Gren, PhD, MSPH