# Social support, financial status, and depression among French healthcare workers one year after the onset of the COVID-19 pandemic

## TL;DR

One year into the pandemic, French healthcare workers with poor social support and financial struggles were more likely to experience depression, highlighting the need to address these factors in mental health interventions.

## Contribution

This study identifies social and financial factors as key predictors of depression in healthcare workers a year into the pandemic, shifting focus from earlier emphasis on work-related stressors.

## Key findings

- 21% of healthcare workers reported moderate to severe depressive symptoms.
- Loneliness, lack of workplace social support, and worsening financial outcomes were significantly associated with depression.
- Mental health comorbidities and living alone remained linked to depression after adjusting for other factors.

## Abstract

Early studies on factors associated with depressive symptoms among healthcare workers (HCWs) during the COVID-19 pandemic were primarily related to working conditions and exposure to the pandemic. Despite the socio-economic impact of the pandemic, research focusing on factors related to social support and financial situation was scarce.

This study investigated the association between HCWs’ financial and social support, and the presence of depressive symptoms in France one year after the pandemic’s onset.

This study used data from a cross-sectional, online, voluntary survey conducted in France between April and October 2021 among a diverse, non-probability sample of HCWs. Data were calibrated according to the French Census of HCWs. Depressive symptoms (moderate to severe) were assessed using the 9-item Patient Health Questionnaire (score > 9). Four log-binomial regression models estimated prevalence ratios (PR) and their 95% confidence intervals (95%CI), taking into account working conditions, sociodemographics, and mental health comorbidities (post-traumatic stress disorder, anxiety, burnout).

Among the 655 respondents, 21% had moderate to severe depressive symptoms. Adjusted for working conditions and sociodemographics found significant associations between loneliness, lack of social support at work and worsening financial outcomes over the past year, with depression. After introducing mental health comorbidities, not only were they all associated with depression, but worsening financial outcomes and living alone remained associated with depression (PR = 1.23; 95%CI [1.04–1.45] and PR = 1.33; 95%CI [1.13–1.57], respectively).

This study suggests that one year after the start of the pandemic, factors associated with depressive symptoms were related to social support and financial situation, unlike at the beginning of the pandemic when working conditions and exposure to COVID-19 were more studied and emphasized. These findings highlight the importance of considering the social determinants of health in studies and interventions aimed at improving the mental health of HCWs, and not just their working conditions.

The online version contains supplementary material available at 10.1186/s12889-025-24066-4.