Those getting jobless benefits had fewer symptoms of depression and lower anxiety, according to a new study. But losing that aid could result in deaths that are not directly from the coronavirus.



Americans who lose unemployment insurance are risking more than their personal finances. They also risk their health. New research focused on people who lost their jobs this year shows that many suffered effects that tend to be linked to worse health outcomes, like a loss of food or of stable housing. Dr. Seth Berkowitz of the University of North Carolina co-authored the research.

SETH BERKOWITZ: What we found is that amongst people who reported having a pandemic-related income disruption, those who were receiving unemployment insurance had much lower risk of food insufficiency, much lower risk of missing housing payments, lower depressive symptoms, lower anxiety symptoms, were less likely to delay care.

INSKEEP: That all sounds good, but what if you're not getting unemployment relief anymore? We spoke with Berkowitz as Congress negotiates over long-delayed extra relief.

As a physician, how does it affect people's health when they have some disruption in housing, have to suddenly move, vacate an apartment or have some other event that leads to depression? How does that affect their health?

BERKOWITZ: It's incredibly disruptive for people. I mean, if you think of - many of the illnesses that we have in the U.S. are chronic illnesses - diabetes, high blood pressure, high cholesterol. And what those require is a lot of management over time. So if you have diabetes, you're constantly trying to keep your blood sugar under control. You're constantly trying to reduce your cardiovascular risk. That requires taking, you know, medications every day, which you have to fill, and there's an expense to that.

And all of those get disruptive if you start having to worry about, you know, the most basic needs. How do you put food on the table for you and your children? How do you keep a roof over your head if you're so stressed out and anxious and have a lot of depressive symptoms? Are you thinking about, you know, well, I'm going to - am I going to try to prevent a stroke 20 years from now or if I'm just going to make it through the next day?

So all of these things have a really profound effect on people's health, both in their own right and also through their effects on people's ability to manage chronic conditions and stay healthy.

INSKEEP: How serious was the difference between the people who received the benefits and the people who didn't?

BERKOWITZ: It was a fairly large difference, and it's one that I would describe as clinically meaningful. But I think it's also important to note just how common these symptoms are amongst people who have been experiencing this pandemic income disruption.

So, you know, we used a measure of clinically meaningful depressive symptoms. And overall, across all groups, about 40% of people reported that. And for anxiety, it was over half, so 50% of people. So these are really common symptoms, not unexpected when you're undergoing such a stressful circumstance. But I think that highlights the fact that the lower risk we see in the group receiving unemployment insurance - you know, this isn't a small difference like 1% versus 2%. This is a large group of people affected. And given that we're talking about, you know, 10 million or 20 million people, I think this really means that a lot of Americans are in this category right now.

INSKEEP: Millions - millions of people.


INSKEEP: So what are the implications of that as Congress debates more relief for the country but hasn't quite agreed on anything?

BERKOWITZ: Well, that I think is - that really gets at the heart of why we wanted to do this study. Key changes as part of the CARES Act were the more generous benefits and then something called Pandemic Unemployment Assistance, which expanded eligibility to people like gig economy workers or the self-employed who are not typically eligible for traditional state unemployment insurance. And then it also expanded the duration of benefits. The extra $600 a week is what expired at the end of July, but the other two legs of that - the broadened eligibility and the extended duration - are currently still active, although they expire at the end of December.

I think findings like ones from our studies and other studies that have been done that suggest that these programs may be having their intended effect, that they're doing what we want them to do - we hope that informs the discussion both for ongoing pandemic relief because I think the economic effects of the pandemic will be with us for a while, but also just for long-term unemployment insurance reform, not in the numbers that we've seen during the pandemic, but people lose their jobs through no fault of their own all the time. And so unemployment insurance is really an important part of social insurance.

INSKEEP: Can the loss of unemployment insurance kill people?

BERKOWITZ: I think it's very likely that if you're not able to manage your chronic conditions, that if you're not able to put food on your table, if you're evicted or forced out of your home, that could result in worsening health. And as an extreme, people could die as a result of not having the resources needed to stay healthy and stay alive.

INSKEEP: Meaning that there could be people who are dead because of the pandemic, even if they never got coronavirus?

BERKOWITZ: I think that's absolutely possible.

INSKEEP: Dr. Seth Berkowitz, thanks so much.

BERKOWITZ: Thank you. I really appreciate it. Transcript provided by NPR, Copyright NPR.