What’s New in Psychology?

The Hidden Cost of Grief    

Jim Windell

             Time heals all wounds the old maxim says. And in the words of Cicero, “There is no grief which time does not lessen and soften.” And while people seemingly recover from grief and loss over time, perhaps they pay a steep cost while waiting for the passage of time to do its job.

            A new study, recently discussed by one of the researchers who conducted the study on National Public Radio, suggests that grief, whether caused by COVID-19 or other deaths, comes with significant medical costs.

            Toni Miles, professor at the University of Georgia’s College of Public Health, and a team of researchers completed the first-ever state-wide survey of recent bereavement in Georgia. Data was collected between 2018 and 2019 – before the pandemic.

            Miles was motivated to look at bereavement after she and a friend had a conversation in 2012 about the public health consequences of losing a loved one. They realized that the impacts of bereavement were vastly understudied. However, Miles has been passionate about understanding what bereavement following death does to people since her time as a medical resident during the AIDS epidemic in the ‘80s.

           “I saw young men die who were my age every day for six months,” Miles said in the  NPR interview. “And that process was just so damaging. It took me a while to get my humanity back.”

           Looking at the results of the survey she and her team did in Georgia, she says that they found that 45% of the population aged 18 and over were newly bereaved in that two-year window. “That’s nearly one in two people in the state,” she said, “and the data doesn’t take into account kids under 18.”

          For those people who were in their 50s or older, they found that bereavement increases one’s risk of dying two-fold – and that risk never decreases. For the same cohort, bereavement also elevates one’s risk of needing an overnight hospital stay. In general, Miles said, “People who are bereaved are one and a half times more likely to visit a doctor 20 or more times in the two-year period after bereavement.”

           The age group most likely to report bereavement are people between 30 and 55 years old, she said. Large scale health costs associated with bereavement can pose a huge challenge to this age group. Lack of sleep could cause a car accident, or an old smoking habit could reemerge, she added.

           Miles pointed out that statistically people who experience bereavement do not get sick all at once. One or two habits may change over time that can lead to poor health outcomes. For instance, she said, in Georgia, binge drinking increased in grieving young men. If she were screening a young man after the death of someone close, she said, she would ask about shifts in alcohol consumption. Heavy drinking can influence hospitalization, death and “all kinds of outcomes that you might not believe are related to bereavement but are.”

          In effect, Miles emphasized, grief can also sway behaviors so that new behaviors and habits kick in. Besides drinking more, she said, people may not sleep as much, may neglect top wear seat belts, go back to smoking or even stop taking care of themselves medically. One example, she noted, was an asthmatic person might cease to treat their asthma after the death of a loved one.

          Noting that since the pandemic began we have lost 700,000 people in the U.S. That means, Miles said, that millions of people are now grieving. That grief will be linked to higher blood pressure, shorter lives, depression and sleeping problems.

            To address these hidden costs of bereavement, Miles said that society needs to readjust how we view loss. For example, the death of a friend is just as traumatic as losing a family member.  And she said that “We really do need to have more empathy recognizing that if someone says ‘someone died that I'm really close to,’ we need to take a moment and find out what they have lost in addition to losing that person.”

           Calling the grief experienced by millions since the pandemic a crisis, Miles stated that she is urging individual states to include an annual survey on bereavement with their other yearly questionnaires on topics like seatbelt use and smoking. Collecting this kind of data, she contends, can in turn inform policy and allow communities to figure out costs associated with the need.

           She concluded that “If we don't, as a culture, understand that people suffer when they lose someone and not just make disparaging remarks about what killed them, we're not going to solve this problem.”

           The report of this study is entitled “A New Measure of Population Health in a Complex Sampling Survey: The 2019 Georgia Behavioral Risk Factor Surveillance Survey – Unweighted, Weighted, and Imputed Weighted Data.” The authors are Changle Li, Toni Miles, Ye Shen, Rana Bayakly, Moses Ido, & M. Mahmoud Khan. It is under consideration for publishing in BMC Medical Research Methodology.