The Pulse

Burnout And Poor Mental Health Put Pressure On Global Vitality

Intellectual and emotional health ranked higher than physical health

Latest research from Cigna Healthcare reveals employers play a crucial role in boosting workforce vitality. Download the complete Cigna Vitality Study here.

ANTWERP, Belgium and HONG KONG, Oct. 26, 2023 /PRNewswire/ — High levels of burnout and poor mental health are hindering global well-being and vitality, according to the latest research from Cigna Healthcare.

The Cigna Healthcare Vitality Study 2023, released today with survey results from more than 10,800 respondents across 12 markets, shows only one in five people has a high level of vitality, with mental health being the critical factor.

Stress and burnout are major contributors to this. Those with low vitality suffer more stress (9 in 10) compared to those with high vitality (7 in 10). Although these levels have declined a little since the peak of the pandemic, they remain high, with eight in 10 people suffering. Burnout remains at endemic levels, with 94% of respondents reporting at least one symptom over the past year.

The global cost-of-living crisis is a major driver of this, with nearly half of all survey respondents listing it as a key source of stress, closely followed by “uncertainty about the future”.

Jason Sadler, President, International Health, Cigna Healthcare, said the Vitality Study demonstrates how the worsening well-being crisis is challenging people worldwide.

“Our latest research shows overall health is the sum of numerous factors. Many external stressors are severely affecting our mental well-being, leading to worrying rates of stress and burnout,” Mr. Sadler said.

“With significant global challenges such as conflict, illness, and the cost-of-living crisis affecting the day-to-day lives of billions of people, we can no longer measure well-being using narrow health metrics such as diet, exercise, and disease alone.

“Meaningful well-being assessments must honestly consider the bigger picture: intellectual and emotional stimulation, cultural and social connections, financial and physical security, and of course health. Our Vitality Study does exactly that.”

Over nine years, Cigna Healthcare has monitored the changing dynamics of well-being across the globe. The Vitality Study 2023 brings together insights on how social, occupational, financial, intellectual, physical, spiritual, emotional, and environmental factors are interrelated and reframing our concept of health.

Vitality Goes Beyond Common Notions Of Health

Only one in five of our respondents displayed a high level of vitality. Perhaps reflecting the modern knowledge economy with its focus on upskilling and personal development, Cigna also observed that people see broader aspects of vitality, such as intellectual health, as being of greater importance than physical health.

When Cigna asked people to score how well they are doing across various aspects of vitality, over half said they ‘value learning new things’ and ‘have a place where they can feel safe and well’. Both are higher than prioritization of physical health and having ‘the skills and tools necessary to live a healthy life’. Social health was also ranked amongst the top three aspects of vitality, but with less than half agreeing they can build connections with others, there’s room for improvement.

Mental Health Is Critical

Although the ability to manage one’s emotions was ranked fifth among all the dimensions of health, emotional or mental health remains the most important indicator of overall vitality. When asked to rate their mental well-being, responses diverged greatly between those with high and low vitality scores: 84% of those with high vitality said they have strong mental well-being compared to only 10% of those in the low vitality group.

Those with low vitality also tend to be more stressed (9 in 10) compared to those with high vitality (7 in 10). Stress has declined since the peak of the pandemic, from 82% of people experiencing stress in 2022 to 80% in this year’s study. Burnout, which Cigna reported as being at almost universal levels in 2022 persists, with 94% still reporting at least one burnout symptom over the course of the past year.

Money Worries Exacerbating Stress

The ‘cost of living crisis’, caused by global inflation, is the leading cause of stress, as mentioned by nearly half of the people we spoke to. This was closely followed by the linked issues of ‘uncertainty about the future’ and ‘personal finance’. With global interest rates set to continue to remain high in the months ahead, people’s financial concerns are likely to remain high for the foreseeable future.

Work Culture Is Improving

Despite the ongoing stress levels, we do see an overall improvement in some of the scores associated with work. Working patterns have stabilized, with 56% of people now working full-time back in the office and the remainder working predominately in a hybrid manner.

The return to a regular office routine appears to be recognized as delivering productivity benefits, with 44% saying they felt it was the most productive environment. Among those who have returned to the office full-time or adopted a hybrid model, one-third indicated that they have closer relationships with coworkers, and three in ten say they can concentrate better at work.

Perhaps unexpectedly, this appears to have helped bring down stress levels associated with work, with 67% saying they feel constantly connected to work and unable to switch off, compared to 72% in 2022. We also see an overall reduction in the number of people working outside of normal working hours, down to 65% from 69% last year.

Work is a central part of people's vitality and well-being. It provides the social settings, resources, and benefits that are critical to positive health. It is therefore essential that every employer considers this as part of their workplace health plan...

However, there are still disparities between regions, with people in Europe less likely to work beyond office hours (16%), while in the Middle East nearly a third (32%) work after hours. Despite this, we also see the Middle East reporting a higher benefit from in-office working, with 45% saying they have improved concentration in the office, compared to 
only 14% in Europe.

Top Vitality Indicators:

  • I really value learning new things and understanding more and more (53%)
  • I know places I can always go in which I feel safe and well (50%)
  • I choose to prioritize my physical health (43%)
  • I can successfully build connections with others (43%)
  • I feel capable of managing my emotions (42%)
  • I look forward to each new day (42%)

The study shows that vital workplace skills, such as building knowledge, having a safe and secure environment, and being able to manage emotions are among the highest indicators of overall vitality.

Mr. Sadler said the results deliver a strong message to employers around the world to work quickly to address the vitality gap.

“Work is a central part of people’s vitality and well-being. It provides the social settings, resources, and benefits that are critical to positive health. It is therefore essential that every employer considers this as part of their workplace health plan.”

Dr Stella George, Chief Medical Officer, International Health, Cigna Healthcare, added that employers have a responsibility to create workplaces that help individuals thrive.

“Well-being is the sum of our choices, the quality of our relationships, and the health of our communities. As such, the modern definition of health also extends beyond absence of illness. It’s about thriving in all aspects of life – physically, mentally, socially, and environmentally.”

How Employers Can Help

There is a clear role for employers to step in and support people, as the cost-of-living crisis is having a direct impact on health. 67% of people say that inflation is making it too expensive to stay healthy, and 59% of employees say they wish they had more support from their employer to live a healthier life.

This is where our vitality approach fits in. When asked their top three preferences in terms of a robust health and well-being program, the number one was a private health insurance plan. However, this was followed by ‘flexible time off or work arrangements’, mentioned by nearly half of everyone we spoke with, and mental health support, raised by over a third.

Interestingly, subsidized gym memberships, perhaps the most traditional form of health support from employers, was only mentioned by a quarter of people worldwide, and by as few as one fifth in North America.

Why We Should Embrace Vitality

With global well-being remaining fragile in the face of continued macroeconomic challenges and geopolitical uncertainly, the vitality approach is critical to protect and enhance people’s health.

By encompassing crucial aspects of well-being, energy level, and attitude towards life, vitality offers us a more accurate sense of health in modern society.




About the Cigna Healthcare Vitality Study
The Cigna Healthcare Vitality Study surveyed 10,800 respondents in the US, UK, Netherlands, Spain, Belgium, Switzerland, Kenya, the UAE, Saudi Arabia, China, Singapore, and the Hong Kong SAR between May and June 2023.
The survey asked 35 questions to gauge respondents’ sense of social, occupational, financial, intellectual, physical, spiritual, emotional, and environmental well-being – providing Cigna Healthcare with a comprehensive picture of people’s ability to thrive in an organizational setting and to pursue life with health, strength, and energy.
The study was based on the Evernorth Vitality Index©, developed in partnership with leading clinical psychologist and author Dr. Richard Ryan using his Self-Determination Theory and Subjective Vitality Scales (SVS). The index measures eight dimensions of well-being as well as three components of the SVS.
About Cigna Healthcare
Cigna Healthcare is a health benefits provider that advocates for better health through every stage of life. We guide our customers through the health care system, empowering them with the information and insight they need to make the best choices for improving their health and vitality. Products and services are provided exclusively by or through operating subsidiaries of The Cigna Group (NYSE:CI), including Cigna Health and Life Insurance Company, Connecticut General Life Insurance Company, Evernorth Health companies or their affiliates and Express Scripts companies or their affiliates. Such products and services include an integrated suite of health services, such as medical, dental, behavioral health, pharmacy, vision, supplemental benefits, and others.
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