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Double Burden of Distress: Exploring the Joint Associations of Loneliness and Financial Strain with Suicidal Ideation During the COVID-19 Pandemic in Canada

Author

Listed:
  • Fahima Hassan

    (Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada)

  • Lihui Liu

    (Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada)

  • Cindy Feng

    (Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H 1V7, Canada)

Abstract

Background: The COVID-19 pandemic, coupled with social distancing measures and economic disruptions, has been associated with increased experiences of loneliness and financial strain. While prior research has examined their separate associations with suicidal ideation, limited attention has been given to their joint relationship. Methods: We used data from the 2022 Mental Health and Access to Care Survey (MHACS) (n = 9861; ages 15+ in Canada) to assess whether financial strain modifies the association between loneliness or emotional distress and suicidal ideation. Multivariable survey-weighted logistic regression was conducted, adjusting for sociodemographic, economic, psychosocial, and health-related characteristics, including mental health and substance use conditions. Results: Among the 9743 respondents who answered the question on suicidal ideation, 355 (3.65%) reported suicidal ideation. Compared to individuals with neither stressor, those who experienced loneliness or emotional distress alone had 1.54 times higher odds of suicidal ideation (aOR = 1.54, 95% CI: 1.29–1.84, p < 0.001), while those who reported financial strain alone had 0.58 times the odds (aOR = 0.58, 95% CI: 0.43–0.80, p = 0.001). The highest odds were observed among individuals who experienced both loneliness/emotional distress and financial strain, with an adjusted odds ratio of 2.05 (95% CI: 1.71–2.45, p < 0.001), indicating an interaction between these stressors. Conclusion: The co-occurrence of loneliness or emotional distress and financial strain was associated with higher odds of suicidal ideation during the COVID-19 pandemic, compared to individuals experiencing neither stressor. These findings highlight the importance of considering both social and economic stressors when assessing mental health risks. Given the cross-sectional nature of this study, further longitudinal research is needed to explore the temporal relationships and potential causal pathways linking these experiences to suicidal ideation.

Suggested Citation

  • Fahima Hassan & Lihui Liu & Cindy Feng, 2025. "Double Burden of Distress: Exploring the Joint Associations of Loneliness and Financial Strain with Suicidal Ideation During the COVID-19 Pandemic in Canada," IJERPH, MDPI, vol. 22(5), pages 1-17, April.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:682-:d:1642619
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