Grief After COVID-19 Elevates Substance Use Risk in Men, Not Women

Abstract

Background: Stressful life events (SLEs), such as the loss of a family member, predict mental health problems and substance use. However, knowledge remains limited regarding how these associations vary by sex or gender in global populations. Objectives: In a global sample drawn from 22 countries, this study aimed to examine whether the long-term impact of losing a family member to COVID-19 predicts subsequent substance use differently in men and women. Methods: We conducted a secondary analysis of Waves 1 and 2 of the Global Flourishing Study (GFS), a longitudinal panel survey conducted in 22 countries. The sample included 109, women and 97,761 men. Variables included the loss of a family member due to COVID-19 (yes/no), substance use (drinking and smoking) at baseline and follow-up, sex/gender, and covariates (age, education, and employment). Structural equation modeling (SEM) was used for data analysis. Results: Among men, the loss of a family member due to COVID-19 was associated with a statistically significant increase in substance use from Wave 1 to Wave 2. Among women, the loss of a family member due to COVID-19 was associated with a reduction in subsequent substance use. Conclusions: The mental health consequences of losing a family member to COVID-19, as reflected in substance use, differ between men and women, and the effect may be disproportionately greater in men. The observed sex/gender differences may reflect differences in coping patterns and social roles.