Journal of General Internal Medicine

Journal Information
ISSN / EISSN : 0884-8734 / 1525-1497
Current Publisher: Springer Science and Business Media LLC (10.1007)
Former Publisher: Wiley (10.1046) , Wiley (10.1111)
Total articles ≅ 10,763
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Yvonne Okaka, Duaa Abdelhameid, Rose McKeon Olson, Miriam Kwarteng-Siaw, Nicholas Spanos, Valerie E. Stone
Journal of General Internal Medicine pp 1-3; doi:10.1007/s11606-020-06291-2

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Hanna Vollbrecht, Vineet M. Arora, Sebastian Otero, Kyle A. Carey, David O. Meltzer, Valerie G. Press
Journal of General Internal Medicine pp 1-3; doi:10.1007/s11606-020-06309-9

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Ali Almasi, Shahram Saeidi, Alireza Zangeneh, Mehdi Khezeli, Yahya Salimi, Moslem Soofi, Nader Rajajbi Gilan
Journal of General Internal Medicine pp 1-3; doi:10.1007/s11606-020-06289-w

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Sarah Burm, Saad Chahine, Mark Goldszmidt
Journal of General Internal Medicine pp 1-7; doi:10.1007/s11606-020-06284-1

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Jeffrey L. Jackson, Carol K. Bates, Steven M. Asch
Journal of General Internal Medicine pp 1-9; doi:10.1007/s11606-020-06270-7

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Vanessa L. Kronzer, Emily L. Leasure, Andrew J. Halvorsen, Amy S. Oxentenko, Sara L. Bonnes
Journal of General Internal Medicine pp 1-7; doi:10.1007/s11606-020-06296-x

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Jonathan Kusner, Andreas Mitchell, Bevin Kenney, Sheridan F. Reiger
Journal of General Internal Medicine pp 1-3; doi:10.1007/s11606-020-06286-z

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Tyler J. VanderWeele, Jeffery Fulks, John F. Plake, Matthew T. Lee
Journal of General Internal Medicine pp 1-3; doi:10.1007/s11606-020-06274-3

Abstract:
The COVID-19 pandemic has affected people’s lives in countless ways. The impact may extend to physical and mental health; their social relationships; their sense of meaning, identity, and happiness; and their financial stability. Using a stratified online national sample, representative of the USA on geographic region, gender, generation/age, and race/ethnicity, we report on means of well-being scores in the USA across these various domains of human flourishing1,2 both prior to (January 2020) and following (June 2020) the WHO declaration of pandemic. In January and June 2020, participants were recruited and surveyed through online Qualtrics national consumer panels (Lucid). The January study employed a 15-minute questionnaire. Data were collected from January 2 through 13, 2020 resulting in 1010 completed responses (completed-surveys-to-qualified-respondents rate, 90%) using a stratified national sample of adults 18 and older within all 50 states and the District of Columbia. Based on US Census data, quotas were designed to ensure that the final group of respondents reflected the distribution of adults nationwide and adequately represented the racial and ethnic diversity of the USA. Quotas limited responses by geographic region, gender, generation/age, and race/Hispanic-origin. No other screening criteria were applied. Post hoc weighting ensured the sample was representative of US adults in each quota area plus educational attainment and religious self-identification. Similar representative recruitment and online data collection was carried out in June 2020, from May 28 through June 10, 2020, resulting in 3020 completed responses (completed-surveys-to-qualified-respondents rate, 76%). Among the survey items, participants responded to 12 well-being items in six flourishing domains (happiness, health, meaning, character, relationships, financial; two indicators per domain) as part of an overall validated flourishing measure.1,2 Items were self-reported scored from zero to ten. Means at both time periods were reported across the six domains (Table 1), and t tests were used to assess changes in scores over time. Means for individual indicator scores at both time periods, and precise item wording, are reported in Table 2. In January 2020, mean scores were approximately seven in each domain, except for financial stability which was lower (Table 1). From January to June 2020, means in flourishing declined overall (− 0.49, 95% CI − 0.61, − 0.37, p < 0.001) and in every domain, except character. The declines were larger for self-reported health (− 0.64, 95% CI − 0.78, − 0.49, p < 0.001), happiness (− 0.74, 95% CI − 0.89, − 0.58, p < 0.001), and financial stability (− 0.95, 95% CI − 1.15, − 0.75, p < 0.001) than for social relationships (− 0.19, 95% CI − 0.36, − 0.02, p = 0.02), meaning and purpose (− 0.39, 95% CI − 0.55, − 0.23, p < 0.001), or character strengths (− 0.03, 95% CI − 0.16, 0.11, p = 0.68). Well-being has declined in the USA during the COVID-19 pandemic, but not all aspects have been affected equally. The health, happiness, and financial stability means each declined by about one-third of a standard deviation (e.g., a change from the 50th-percentile to 37th percentile of the original distribution). The modest declines in social connectedness scores, but more substantial declines in happiness and mental health corroborate recent evidence of only modest increases in loneliness but larger increases in psychological distress between 2018 and 2020.3 Compared with that prior data, the results here concern a much tighter time frame around the pandemic, and additional domains of well-being. The modest changes in meaning and character may be indicative of the human capacity to find growth amidst difficulty. That the financial stability scores manifested the largest decline likely mirrors the dramatic increase in unemployment and in employment insecurity, and may have subsequent health consequences.4 The study is limited by the sampling methodology, the online assessment requiring internet access and literacy, potential seasonality of well-being, and the possibility of selection bias since respondents in June were less likely to participate than in January. However, if less well-off individuals were less likely to respond in June, the declines in well-being may be even larger than those reported here.5 Likewise, while seasonality of subjective well-being sometimes indicates slightly lower levels in colder months, this too would then imply that the actual declines in well-being may be larger than those reported in Table 1. Assessment of these flourishing domains has recently been proposed for use in clinical settings.1 The data here provide the first national benchmarks for these flourishing domains. These benchmarks may be of interest in clinical and public health assessment, and may also be of use in determining when the USA has returned to its prior levels of well-being. VanderWeele TJ, McNeely E, Koh HK. Reimagining health: flourishing. JAMA, 2019; 321(17):1667-1668. Article Google Scholar VanderWeele TJ. On the promotion of human flourishing. Proceedings of the National Academy of Sciences of the United States of America, 2017; 31:8148-8156. Article Google Scholar McGinty EE, Presskreischer R, Han H, Barry CL. Psychological Distress and Loneliness Reported by US Adults in 2018 and April 2020. JAMA, 2020; 324(1):93-94. CAS Article Google Scholar VanderWeele TJ. Challenges estimating total lives lost in COVID-19 decisions: consideration of mortality related to unemployment, social isolation, and depression. JAMA, July 8, 2020. doi:https://doi.org/10.1001/jama.2020.12187. Smith LH, VanderWeele TJ. Bounding bias due to selection. Epidemiology. 2019 30(4):509-516. Article Google Scholar Download references Some of the results have been presented at the American...
Annie M. Racine, Douglas Tommet, Madeline L. D’Aquila, Tamara G. Fong, Yun Gou, Patricia A. Tabloski, Eran D. Metzger, Tammy T. Hshieh, Eva M. Schmitt, Sarinnapha M. Vasunilashorn, et al.
Journal of General Internal Medicine pp 1-9; doi:10.1007/s11606-020-06238-7

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Mubeen Shakir, Sarah Wakeman
Journal of General Internal Medicine pp 1-2; doi:10.1007/s11606-020-06299-8

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