Social health

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1. Key messages

On Sciensano’s epidemiological dashboard, you can explore dynamic data visualisations about mental and social health during the COVID-19 crisis up to June 2022, with data coming from the COVID-19 Health cross-sectional Survey.
Additionally, an interactive app provides updated data on mental and social health from the BELHEALTH cohort since October 2022. After this date, the same group of people were followed in the BELHEALTH survey to assess the evolution of the indicators in time and the potential risk and protective factors involved. 

2. Social dissatisfaction from 2020 onwards

The prevalence of social dissatisfaction increased, particularly during the COVID-19 lockdowns

Social dissatisfaction rates were high throughout the COVID-19 crisis and rose significantly during each infection peak, and were linked to the enforcement of strict containment measures (between 52% and 64%, depending on which peak).
However, at the beginning of 2022, social dissatisfaction rates declined, impacting less than 25% of the population.
After 2022 (with the change of survey type in September 2022), the prevalence of social dissatisfaction remained stable, hovering around 20%.

There were no major sex differences in social dissatisfaction throughout the entire period.

Since 2022, young people have been the most affected by social dissatisfaction

In 2020 and 2021, men and women in the middle-aged category (30–64 years) reported higher social dissatisfaction. Nevertheless, after June 2022, the younger age group (18–29 years) showed the highest prevalence of social dissatisfaction, albeit with some fluctuations. Since early 2022 social dissatisfaction percentage had begun to stabilize. This stabilization may also be linked to the end of COVID-19 restrictions. 

3. Social dissatisfaction in 2018

The proportion of people reporting social dissatisfaction does not show a consistent pattern across different age groups

Before the COVID-19 pandemic, social dissatisfaction varied by age group and did not follow a linear trend. Women (8.4%) and men (8.3%) experienced nearly the same level of social dissatisfaction. A notable difference was observed between the 65-74 age group and those aged 75 and older, likely due to increased health challenges, social isolation, and reduced mobility among the oldest individuals.

The Walloon Region and Brussels-Capital Region have a higher prevalence of social dissatisfaction compared to the Flemish Region

Social dissatisfaction increased in 2013 among men in the Flemish Region and women in the Walloon Region, but no other significant changes occurred between 2013 and 2018. There were no regional disparities, as social dissatisfaction levels remained similar across all regions.

People with lower level of education experience social dissatisfaction more frequently

A socio-economic gradient existed in the prevalence of social dissatisfaction. After adjusting for age, people in the lowest educational group were 1.8 times more likely to experience social dissatisfaction than those in the highest educational group.

4. Perceived weak social support from 2020 onwards

More people reported weak social support during the lockdowns of the COVID-19 pandemic

During the COVID-19 crisis, the number of people reporting weak social support increased during peak infection periods. After March 2022, the percentage of perceived weak social support has stabilised at around 28%.

There were no major sex differences in social dissatisfaction throughout the entire period.

People aged 50-64 are the most likely to perceive their social support as weak

Among men, those aged 50-64 reported the lowest levels of perceived social support throughout the entire survey period. The least to report low perceived support was the 65+ age group. In October 2022, the difference between the 50-64 age group and the other categories became greater.

Among women, the group which reported the strongest social support was the 50-64 age group. After October 2022, the 18-29 age group became the group perceiving the best social support, and the gap between them and the other age categories widened until February 2023.

5. Perceived weak social support in 2018

Perceived weak social support remains consistent across age and sex

Overall, there was little difference in weak support by sex. In 2018, 15% of men and 16% of women reported experiencing weak support.

People in the Flemish Region report the lowest level of weak social support

The Walloon Region and the Brussels-Capital Region had a higher prevalence of weak social support compared to the Flemish Region. No clear trend over time is observed.

A socio-economic gradient exists for weak social support

After adjusting for age, people in the lowest educational group were 2.0 times more likely to experience weak social support than those in the highest educational group.

6. Loneliness from 2021 onwards

Loneliness affects both sexes similarly

We observed peaks in loneliness corresponding to the lockdowns during the COVID-19 pandemic. Since June 2023, following the change in survey type, feelings of loneliness stabilized at 57%.

There were no major sex differences in loneliness throughout the entire period.

Young adults aged 18-29 are the most affected by loneliness

Among men, loneliness remained high most of the period in the 18–29 age group. However, following the change in survey type in June 2023, this group had the lowest prevalence compared to other age categories. From that point onward, men aged 50 to 64 appeared to be the most affected.

Among women, loneliness remained high in the 18–29 age group, while the 65+ age group was generally the least affected. However, with the launch of the BELHEALTH survey in June 2023, loneliness prevalence among women aged 65+ increased, making them the second most affected group.

7. Read more

View the metadata for this indicator

HISIA: Interactive Analysis of the Belgian Health Interview Survey

COVID-19 survey interactive app

BELHEALTH interactive tool

Background

According to the World Health Organization, health is a state of complete physical, mental, and social well-being, shaped by a complex set of factors. Both health and mental illness extend beyond biological and psychological aspects, encompassing interconnected social dimensions. Social factors play a crucial role in shaping, maintaining, and promoting health and in influencing the incidence, prevalence and persistence of diseases [17]. Given their impact, it is essential to consider key social determinants of mental and physical health, including social satisfaction, social support and loneliness.

Social health is a broad term that generally refers to two related but distinct concepts. On one hand, it can refer to the overall health of a society; on the other, it describes how individuals within that society coexist and interact. Additionally, social health can refer to an individual’s ability to engage with others and function within a social environment. In this sense, it reflects the quality of social connections and the extent to which people can interact and build relationships. [18] Although the COVID-19 pandemic is becoming less of a threat, new challenges with profound social and economic consequences for the population continue to emerge [19].

In Belgium, the Health Interview Survey (HIS) is one of the primary sources of systematic data on social health indicators in the general population. During the COVID-19 crisis, online health surveys were conducted at regular intervals to monitor the evolution of social health. Data was collected between April 2020 and June 2022. Since October 2022, the BELHEALTH cohort has been tracking mental health and well-being in the population every four months. While the COVID-19 Health Survey used a mixed longitudinal and cross-sectional approach— following the same participants over time while recruiting new ones at each data collection point— BELHEALTH relies on a longitudinal design, following the same cohort of participants throughout the study. To ensure representativeness of the general population, data is weighted for age. However, it is important to note that neither the COVID-19 nor the BELHEALTH survey were designed to be fully representative of the Belgian population; rather their goal is to track trends in mental health disorders within the study population.

Among the various dimensions of social health monitored in these surveys, we focus on the following three disorders:

• Prevalence of social dissatisfaction
• Prevalence of perceived weak social support
• Prevalence of loneliness

Definitions

Social dissatisfaction

COVID-19 health survey and Belhealth survey
Percentage of the population (aged 18 and over) who are dissatisfied with their social contacts, based on responses to the question about their social contacts in the past two weeks. Participants could choose from the following answers: 1 = Very unsatisfying, 2 = Rather unsatisfying, 3 = Rather satisfying, and 4 = Very satisfying. Social dissatisfaction is defined as the percentage of people who answered “very unsatisfying” or “rather unsatisfying.”

Health Interview Survey
Percentage of the population (aged 15 and over) who are dissatisfied with their social contacts, based on responses to the question “How do you find your social contacts?”. Social dissatisfaction corresponds to the percentage of people who answered “rather dissatisfied” or “really dissatisfied”.

Perceived weak social support

Participants from the COVID-19 and BELHEALTH survey (aged 18 and over), as well as from the HIS (aged 15 and over), were asked to assess their perceived level of support from those around them using the Oslo Social Support Scale (OSSS-3). The total score serves as an assessment of social support.

Loneliness

COVID-19 health survey and Belhealth survey Participants (aged 18 and over) were asked to assess their level of loneliness by using the 6-item DeJong Gierveld Loneliness Scale [20]. This loneliness score was then categorized into three levels: not lonely (score of 0 or 1), moderately lonely (score of 2, 3 or 4) and severely lonely (a score of 5 or 6). Loneliness was defined as feeling moderately or severely lonely.

References

1. First COVID-19 health survey: preliminary results. Deposit number D/2020/14.440/50. Brussels: Sciensano; 2020. doi: 10.25608/ydnc-dk63
2. Second COVID-19 health survey: preliminary results. Deposit number D/2020/14.440/52. Brussels: Sciensano; 2020. doi: 10.25608/rkna-ee65
3. Third COVID-19 health survey: preliminary results. Deposit number D/2020/14.440/54. Brussels: Sciensano; 2020. doi: 10.25608/xkg3-xz50
4. Fourth COVID-19 health survey: preliminary results. Deposit number D/2020/14.440/80. Brussels: Sciensano; 2020. doi: 10.25608/jmgf-2028
5. Fifth COVID-19 health survey: preliminary results. Deposit number D/2020/14.440/96. Brussels: Sciensano; 2020. doi: 10.25608/xcxd-7784
6. Sixth COVID-19 health survey: preliminary results. Deposit number D/2021/14.440/30. Brussels: Sciensano; 2021. doi: 10.25608/j877-kf56
7. Seventh COVID-19 health survey: preliminary results. Deposit number D/2021/14.440/50. Brussels: Sciensano; 2021. doi: 10.25608/ht7a-8923
8. Eighth COVID-19 health survey: preliminary results. Deposit number D/2021/14.440/82. Brussels: Sciensano; 2021. doi: 10.25608/hqy9-m065
9. Ninth COVID-19 health survey: preliminary results. Deposit number D/2022/14.440/3. Brussels: Sciensano; 2022. doi: 10.25608/evrs-je22
10. Tenth COVID-19 health survey: preliminary results. Deposit number D/2022/14.440/18. Brussels: Sciensano; 2022. doi: 10.25608/mve9-bk51
11. Belgian Health and Well-being Cohort (BELHEALTH) - Bulletin 1, Brussels: Sciensano; 2023. https://www.sciensano.be/en/biblio/bulletin-ndeg-1-belhealth-fr 
12. Belgian Health and Well-being Cohort (BELHEALTH) - Bulletin 2, Brussels: Sciensano; 2023. https://www.sciensano.be/en/biblio/bulletin-ndeg-2-belhealth-fr 
13. Belgian Health and Well-being Cohort (BELHEALTH) - Bulletin 3, Brussels: Sciensano; 2023. https://www.sciensano.be/en/biblio/bulletin-ndeg3-belhealth-fr 
14. Belgian Health and Well-being Cohort (BELHEALTH) - Bulletin 4, Brussels: Sciensano; 2024. https://www.sciensano.be/en/biblio/bulletin-ndeg4-belhealth-fr 
15. Belgian Health and Well-being Cohort (BELHEALTH) - Bulletin 5, Brussels: Sciensano; 2024. https://www.sciensano.be/en/biblio/bulletin-ndeg5-belhealth-fr 
16. Health Interview Survey, Sciensano, 1997-2018. https://www.sciensano.be/en/projects/health-interview-survey
17. Harandi TF, Taghinasab MM, Nayeri TD. The correlation of social support with mental health: A meta-analysis. Electronic Physician. 2017 Sep 25;9(9):5212.
18. Sciensano. Enquête de santé 2018 : Santé sociale. https://www.sciensano.be/en/biblio/enquete-de-sante-2018-sante-sociale
19. Sciensano. Belgian Health and Well-being Cohort. https://www.sciensano.be/en/projects/belgian-health-and-well-being-cohort
20. De Jong Gierveld J, Van Tilburg T. A 6-Item Scale for Overall, Emotional, and Social Loneliness: Confirmatory Tests on Survey Data. Research on Aging. 2006;28(5):582–98.

Please cite this page as: Sciensano. Mental and Social Health: Social health, Health Status Report, 6 May 2025, Brussels, Belgium, https://www.healthybelgium.be/en/health-status/mental-and-social-health/social-health