A survey of expats has explored the effect of the COVID-19 pandemic on expat family health and well-being. It investigates how expats managed both their own and their children’s health and well-being during the pandemic and subsequent lockdowns and reveals that 60% are rethinking whether they want to continue living abroad.

The ‘Expat Family Wellness Survey 2020: The Impact of COVID-19’, a survey of expats in the U.K., U.S., Singapore and the UAE by Aetna International, found that 60% of expats are rethinking whether they want to continue living abroad due to the COVID-19 pandemic, and 44% say the reason for this is to have access to better health care. Adding to this:

• 40% of expats are rethinking living abroad to be closer with friends and family
• A quarter of expats are rethinking living abroad over concerns about future air travel and overall travel restrictions.

Expats with younger children are more concerned about living abroad, suggesting that families with small children may want/need more support:

• 65% of expats with children aged 7-12 years say that they are rethinking their living abroad status
• 45% who have children that are 18 or older say that the pandemic has not made them rethink their life abroad

Regional differences

In terms of region, expats in the U.S. are the most likely to rethink their life abroad in order to access better health care. In fact:

• 70% of expats in the U.S. say that the COVID-19 pandemic has made them rethink their living abroad status
  • 53% say the reason for rethinking their country of residence is to have access to better health care
• 58% of expats in the UK say the COVID-19 pandemic has made them rethink their living abroad status
  • Only 34% say the reason for rethinking their country of residence is to have access to better health care
• Expats in the UAE (56%) and Singapore (56%) are slightly less likely to rethink their living abroad status than those in the UK and the U.S.

Health care a deciding factor for living abroad

77% of expats who agreed with the statement “the quality of health care is better in my country of residence than it is in my home country”, said that health care was originally a deciding factor in the choice to live abroad.

Interestingly, older expats are less likely to report that health care was a deciding factor when originally moving abroad:

• 83% of 18-24-year-olds reveal that health care was a deciding factor
• 63% of over-65s said it was not a deciding factor.

Fears around access to health care

The survey also reveals that 40% of expats have fears around accessing health services due to COVID-19 pandemic:

• 36% say that they fear attending doctor/hospital appointments due to the pandemic
• 35% say that they have fears around ability to care for elderly relatives/vulnerable people due to the pandemic
• 22% fear late/delayed diagnosis while 20% fear late/delayed treatment due to the pandemic.

Regionally, expats in the U.S. are the most fearful about accessing health services due to COVID-19 pandemic (50%) – much higher than the global average (39.8%). Expats in Singapore are the most fearful about late diagnosis (24%) and late treatment (26%).

Dr Hemal Desai, Global Medical Director, Aetna International says: 

“There’s no doubt, the COVID-19 pandemic impacted health care systems around the world, but they are returning to normal in many parts of the world. It seems that factors such as travel restrictions, the quality of local health care and the effect of the pandemic on access to health services have all caused expats to question their decision to live and work abroad. Access to high quality health care is an important consideration for expats and this survey shows the uncertainty the pandemic has created in this regard and the impact this is having on the decision for expats living overseas.

“These findings are important for employers to note so that successful international assignments can be achieved in the future. The pandemic has highlighted the need for employers to highlight the health care benefits and additional health care options available to those considering international assignments. At a minimum, these should include access to digital health services, employee assistance programs, virtual primary care and 24/7 assistance in case of medical emergencies.“

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