Surviving Mars – Health, Comfort and Sanity Guide

Health, Comfort and Sanity Guide Preliminaries High and Low Stats A stat is high if it […]

Health, Comfort and Sanity Guide


High and Low Stats

  • A stat is high if it is 70 or higher
  • A stat is low if it is 29 or lower

These are game constants and are used to determine what color a stat displays as and whether bonuses or penalties are applied. For example Whiner trait causes sanity penalties at low comfort, that means comfort less than 30.

Breakthroughs, Events and Traits

For the most part I’m not going to be mentioning the effects from Breakthroughs and Events, for they are many and often aren’t encountered in any given game. Also I won’t mention all colonist traits, but I try to mention the more important for gameplay ones.


Comfort Bonuses

A colonist can gain comfort from the following sources:

  • Visiting a service building regardless of reason (daily interest, daily meal, medical care, etc), comfort is only awarded if the colonist’s comfort is less than the Service Comfort rating of the building. The bonus is normally +10 but can be higher if the building has a high Service Comfort relative to the colonist’s comfort.
  • Resting at home. Typically this is +4 to +6 depending on service comfort and is only applied if the residence service comfort is higher than the colonist’s comfort.
  • Traits like Vegan, Party Animal can award comfort boosts, these bonuses don’t have any kind of service comfort condition.

Comfort Penalties
A colonist can lose comfort for the following reasons:

-10 for failing to fulfill a daily interest. This penalty is not applied if the colonist sought out a service for a reason other than the daily interest, for example if a colonist wants medical care but no infirmary is available, they do not suffer a comfort penalty.
-20 for homelessness.
-3 for eating an unprepared meal.
Some traits apply comfort penalties, like Loner applies -4 comfort every sol if the colonist is in a dome with over 30 colonists.

No comfort penalties

There are some things which don’t apply comfort penalties even though you might expect them to:

  • No food. Even though a colonist gets a -3 penalty for eating an unprepared meal, there is no comfort penalty for no meal being available at all.
  • Missing life support: as with food, there is no comfort penalty for power, water or oxygen being missing.
  • Very poor service. A colonist can never get a comfort penalty for a low Service Comfort, even if a colonist has 100 comfort and sleeps in an Apartment with a Service Comfort of 30, they don’t suffer a comfort penalty for the poor service. They just get no bonus.

The effects of high and low comfort:

  • High comfort awards a +5 morale bonus which is also a +5 work performance bonus.
  • Low comfort afflicts a -10 morale bonus which is also a -10 work performance bonus.

Colonists never deliberately seek out to raise their comfort, even being in low comfort doesn’t motivate them. They only raise comfort by randomly seeking an interest or as a side effect of seeking food or medical care.

When an Earthborn colonist reaches 0 comfort they become Earthsick which renders them unable to work and they will board the next rocket that lands nearby. If they reach high comfort (70+) the Earthsick status is removed. Martianborns don’t seem to suffer any special ill effect from being on 0 comfort beyond the -10 morale penalty.

Comfort in Practise

Many players mistakenly believe the way to manage comfort is to check what services colonists are complaining about in the dome comfort overview and provide them. Don’t do this. Colonists don’t know what is good for them, they complain about things that aren’t important like Gambling and fail to complain about things that are important like quality food. It’s almost realistic.

The most important service is Food

Food service is provided by Diners and Grocers. It is very useful to provide this service for two reasons: Firstly, it avoids the -3 comfort penalty for eating an unprepared meal. Secondly and perhaps more importantly, everyone has to eat, so everyone visits a Grocer or Diner once per sol, this visit will award them (at least) 10 comfort if their comfort is low. In general you should build a Grocer and Diner per 50 colonists.

Since the average Grocer has a service comfort of 50, and Diner 60, as long as colonists can eat a daily meal their comfort will hover around 50 to 60, even if they consistently fail to fulfill their daily interest and get a -10 comfort penalty, they’ll get the +10 comfort back from eating a meal. Since the low comfort threshold is 30 providing meals almost entirely prevents low comfort.

This colonist is pretty annoyed at the lack of luxury and shopping, but the meals sure are good!

Unfortunately the dome overview doesn’t tell you if colonists are eating unprepared meals, you need to personally inspect the comfort of individual colonists (you can use the colony overview to find colonists with low comfort).

Given the choice between Diners and Grocers it’s usually best to provide both, so colonists can fulfill Shopping, Dining and Social. Shopping and Social are both very popular and are economically provided by Grocers and Diners.

It is acceptable to only use Grocers, the only real advantage of this is forcing colonists with Social interest to attend Open Air Gyms while pleasing shoppers (Dining is uncommon interest). You can use Heavy Workload to boost the service comfort to about 60 which is good for breeding.

Diners are generally superior as food providers as they provide 2 extra capacity and 10 higher service comfort. If all you care about is maintaining average comfort you can run Diners at 1 worker per shift getting 2 extra capacity over a Grocer and about the same Service Comfort. Alternatively you can run full shifts plus Heavy Workload, this boosts the Service Comfort to about 70 which can easily put colonists into High Comfort, for that tasty +5 performance boost plus increased breeding potential.

The other most important service is Rest

Rest is provided by a home and like Food every colonist wants it every sol. The main thing is to avoid the -20 Comfort Penalty for homelessness, that comfort penalty is so large that only a few things like The Hanging Gardens can provide enough comfort to keep homeless colonists out of low comfort.

The daily comfort boost is also useful in combination with the daily meal. Say a colonist is a Gamer and a Loner (like absolutely nobody I know) living in a well populated dome. In a day they can lose 10 comfort for failing to game, and 4 comfort for overcrowding. But they gain 10 comfort from eating a meal, and 6 comfort from resting, and thus remain at around 50 comfort.

For the most part you don’t have to be worried about the Service Comfort of residences. It is undesirable if they are only 30, as that makes it easier for colonists to get into low comfort, but 40 is fine (i.e. Apartment with Vista). And it’s nice if you can get them up to 60-70 to help get colonists into high comfort. Between 40 and 60 is all much the same.

It’s useful to provide cheap services

Cheap services are those with a low cost to construct and low or no ongoing cost. It is worth noting that cheap services have low service comforts, and as such they rarely ever award a comfort bonus unless your colonists have very poor comfort (which might be the case if a Colonist has multiple comfort-harming traits).

For the most part the reason you provide these services is to avoid the -10 comfort penalty for the service being missing. Since you aren’t using them for the comfort bonus, it’s just fine to put them in a passage connected dome, the passage penalty matters not in the slightest when there is no bonus anyway.

  • Decorations: Cheap to build, free to maintain but take up a lot of space. Provide the very popular Relaxation interest which is otherwise hard to provide early in the game, along with the less popular Exercise and Playing. It’s not a bad idea to fill any unused slices with decorations, you can always remove them later when you need the space. Also putting them in a passage-connected dome can be a good idea.
  • Open Air Gym: A combination Comfort and Health building, it provides the popular Social interest, though in practise Socialites will prefer Diners and if you want them to exercise you should turn off Diners! It also of course provides the not very popular Exercise interest. The Open Air Gym takes up a lot of space but it’s free to maintain. Best put in a passage-connected dome.
  • Playground: A combination comfort, sanity and character-building service, the Playground is only used by children, but it’s amazing for them, with a massive service comfort of 80 and basically maxing out their comfort and sanity. It is highly recommended to provide enough Playgrounds for your children as everything it provides is incredibly useful, including awarding random useful traits like Sexy and Party Animal, and nearly entirely eliminating undesirable traits like Idiot. Putting playgrounds in a passage connected dome is fine.

It’s mostly pointless to provide expensive services

Expensive services are those which are expensive to build, maintain and employ the workforce for. Often they also have low capacity per tile and per worker.

Previously I noted that you can get high comfort simply by running Diners with Heavy Workload, Diners have excellent capacity per tile and appeal to everyone, while only consuming food. This being the case, and due to the somewhat marginal benefits of high comfort, it’s not really worthwhile investing in expensive services unless you very specifically want to increase breeding rate even beyond that of the ~70 comfort provided by Diners and cheap services.

If you do want high comfort it’s most efficiently provided by The Hanging Gardens spire, or in Space Race the Church-specific Temple spire or China-specific Tai-Chi Garden. Medical buildings with Rejuvenation Treatment are also extremely effective at boosting comfort through the roof and like food services everyone needs medical care, especially if you’re a ruthless slave-driver.


Sanity Bonuses

Colonists can gain sanity from the following sources:

  • Resting at home. Usually +5 sanity.
  • Visiting a medical building. Usually +10-30 sanity depending on the building performance.
  • Visiting a playground, usually +10 or a Temple spire, usually like +150 (which is completely bizarre).
  • Recovering from the Stressed Out status +50 sanity.
  • Living in a Geoscape dome or with a certain breakthrough (applied when resting).
  • The Gamer trait awards sanity when gaming.

Sanity Penalties

There are three main classes of sanity penalties:

Sanity abusing work practises

  • -10 Heavy Workload (overtime)
  • -10 Nightshift
  • -10 Working outside a Dome


Cold Waves and Dust Storms inflict regular small sanity penalties, usually about 10 per sol in total. This occurs regardless of how well you are managing the disaster.

Missing Life Support

Also known as management disasters, when an aspect of life support is missing even very briefly colonists suffer a randomized sanity penalty. They will not receive another sanity penalty for that particular aspect of life support until the next sol, this is defined as midnight, so if life support cuts off just before midnight they can get two sanity penalties in rapid succession.

Also when a colonist dies, other colonists in the dome suffer a -15 sanity penalty.


Certain traits afflict sanity penalties under certain conditions. Those conditions are usually very easy to avoid.

The effects of high and low sanity

  • High sanity awards +5 Morale.
  • Low sanity inflicts a -10 Morale penalty and the colonist will aggressively seek Medical Checks for so long as they are in low sanity.

When a colonist falls to 0 sanity a series of things happen:

  • First they have a 1% chance of committing suicide. Basically they roll a d100 and if it comes up 1, they swallow it and choke to death.
  • If they are still alive, they have a 30% chance of developing a new flaw (reduced to 9% with Supportive Community).
  • Whether or not they gain a flaw, they gain the Stressed Out status which prevents them from working and lasts 3 sols, when it ends they gain +50 sanity.
  • The Stressed Out status completely protects against gaining new flaws, but does not protect against suicide.
  • As long as sanity remains at 0 the colonist has a 1% chance to commit suicide every time they idle (decide what to do next), this won’t occur more than 24 times per sol, but usually much less as the colonist will spend large periods of time in a service building or resting and not rolling the d100.

Sanity in Practise

Sanity management involves balancing sanity abuse with sanity healing.

Medical Care vs Sanity Abuse

It is important to provide medical care to all working colonists, there is no real need to provide medical care for colonists who don’t work, such as Elders and Tourists as by not working they take very few sanity penalties and they still regain +5 sanity per rest.

The need for medical care depends on how much you use sanity abusing work practises. Colonists naturally regain 5 sanity per night when they rest, and they lose 10 sanity per sol when doing sanity abusing work. This means that effectively the first sanity abusing practise causes a loss of 5 sanity per sol. After 20 sols without medical care the colonist will have a breakdown. 2 sanity abusing practises cause the loss of 15 sanity per sol, and 3 practises the loss of 25 sanity per sol.

Medical buildings tend to award 8 to 30 sanity per visit. A basic infirmary employing wrong-specs will award about 10 sanity per visit, with medics it’ll award about 15. Medical Center can easily award 30 per visit. A colonist can visit multiple times in a row (in fact without even leaving the building) and will in fact do this if they are still at low sanity after the first visit.

This colonist suffered a series of sanity abuses, once they fell to low sanity they sought medical care. Then they got hit by -30 sanity at work, they visited the infirmary repeatedly to restore their sanity to above 30.

We can crudely estimate how many medical buildings we need. If the infirmaries have medics, a colonist doing one sanity abusing practise will need to visit the infirmary every 4 sols. An infirmary can see about 30 colonists per sol, so at a low level of sanity abuse an infirmary could service around 120 colonists.

When two sanity abuses are combined, colonists lose sanity 3 times faster and need to visit the infirmary nearly every day, as such the Infirmary would only be able to keep about 40 colonists sane.

When three sanity abuses are combined, now colonists have to visit the infirmary every sol or even multiple times per sol, and a single infirmary will only handle about 25 colonists. Because colonists don’t seek sanity-healing until their sanity is already low, losing up to 25 sanity in a day means that colonists are living on a knife’s edge in terms of sanity, while a low sanity colonist WILL very aggressively seek medical checks, if the infirmary is permanently full that colonist will have a breakdown the next sol. Also these severely abused colonists will almost certainly have breakdowns if they suffer an extra +10 sanity penalty from disasters.

The proper amount of sanity abuse

If you don’t abuse your colonist’s sanity at all, they will remain at high sanity and get a +5 morale/performance bonus. This is quite a small bonus compared with nightshift which makes buildings 33% more productive, and Heavy Workload that makes buildings somewhere between a little and a lot more productive depending on how poor the performance is (Heavy Workload adds +20 shift performance, so if the performance from workers is 150 it’s only a 13% bonus, but if the performance from workers is 7 it’s a 285% bonus). And outdome work is often not optional, as you might absolutely need to mine rare metals or produce polymers.

So ideally, you want to take advantage of the +5 sanity regen, by applying 10 sanity abuse to all colonists. That is, set Heavy Workload on in-dome day-shifts, activate nightshift in in-dome jobs, and for outdome work only run day shifts. At this level of sanity abuse infirmaries are barely stressed at all.

The trickier question is whether to double up sanity abuses. On average:

  • For single sanity abuse you need 1 medic per 40 population.
  • For double sanity abuse you need 1 medic per 13 population.
  • For triple sanity abuse you need 1 medic per 8 population.

Even for triple sanity abuse you only need 12.5% of the population to be medics, so if you can boost worker productivity by 20% that can be acceptable, especially if the building you are boosting is harder to provision than an infirmary, you can build as many infirmaries as you like since they’re just concrete and have negligible power requirements. But other buildings can have higher costs and maintenance, much higher power use and limited placement options. You might prefer to run a Rare Metal Extractor at maximum abuse and build more infirmaries, rather than building a second Rare Metal Extractor and less abusive practises.

In short. Single sanity abuse is great and you should pretty much always do it even though you miss out on the +5 morale for high sanity. Double sanity abuse and triple sanity abuse should be considered, but make sure to provide sufficient medical care!

Personally I use universal single-sanity abuse except where it really doesn’t matter (some service buildings aren’t going to give comfort bonuses anyway). I also use double-sanity abuse quite a bit, but mostly avoid triple-sanity abuse because it leaves colonists too vulnerable to spontaneous breakdown if they suffer a 4th sanity penalty. My rule of thumb is 1 infirmary per 50 population, or 1 Medical Center per 150 population.

Natural and management disasters

Sanity losses from a disaster is about equal to a single sanity abusing work practise. It’s pretty much always worthwhile turning off most of your sanity abusing work practises during these disasters so that colonists can maintain average sanity. Also make sure infirmaries are operational, by setting them to maximum priority.

Achieving High Sanity

There are really only two ways to achieve high sanity:

  • Don’t abuse your colonist’s sanity, they will naturally regenerate to high sanity by resting.
  • Lure colonists to buildings that boost sanity. For example Playing -> Playground, Relaxation -> Infirmary with Rejuvenation Treatment or Relaxation/Social -> Temple.

Other sanity mitigation strategies

Some perks are very helpful and are good to select for.

  • Composed halves absolutely all sanity penalties. These guys need infirmary care a lot less than other colonists and manage disasters much better.
  • Workaholic prevents penalties from Heavy Workload and as if that weren’t enough, also awards +20 work performance! These guy are great and a top pick.
  • Religious prevents suicide and also awards +10 morale/performance. Breakdowns aren’t great because you lose the worker for 3 sols, but suicide is worse.
  • Hypochondriac and Chronic Condition causes colonists to visit infirmaries more often, thus potentially healing their sanity more often than they otherwise would and maybe achieving High Sanity.

The Gamer perk is not useful. Buildings that provide gaming also tend to get filled with other riffraff seeking shopping or social or whatever and tend to be expensive with low capacity. And gamers aren’t smart enough to deliberately seek gaming when their sanity is low.

Sponsor and Commander

The Psychologist Commander provides an extra +5 sanity when resting. This means that a single sanity abusing practise doesn’t cause sanity loss at all and that greatly reduces load on medical buildings and means most single-abuse workers will have +5 performance from high sanity. It has less impact on double or triple sanity abuse.

The Church Sponsor gives all its applicants Religious trait for free, so they’re all immune to suicide. In Space Race they get the Temple spire which is Bonkers, Broken, OP and everything in between. It appeals to Social and Relaxation which is basically all colonists and can award well over 100 sanity per visit. With this broken Spire you can go nuts abusing your colonist’s sanity while skimping on medical care.


Health Bonuses

  • +5 Health for resting at night.
  • Visiting a medical building awards a large bonus, but does not work when colonists are starving, freezing, dehydrated or asphyxiating.
  • Visiting Open Air Gym or Tai-Chi Garden awards a very large bonus and status effects do not prevent the health being awarded.

Health Penalties

  • -10 for Heavy Workload
  • If Oxygen, Water or Power is missing for an unbroken duration of about 1 sol (it’s slightly randomized), a randomized health penalty is applied which can sometimes be very large, oxygen deprivation can even be over 100 health damage, instantly killing full health colonists.
  • If a colonist fails to eat a meal they become starving and lose about 2 health per hour until they eat.

High and Low Health

  • A colonist at high health gets a +5 morale bonus.
  • A colonist with middle health seeks the Medical Checks service if they don’t have anything better to do.
  • A colonist at low health suffers a -10 morale penalty and is unable to work unless they have the Fit trait, they aggressively seek the Medical Checks service.

A colonist will not intentionally seek services that award health other than Medical Checks.

When a colonist reaches 0 health they drop dead and are ejected from the building they are currently in onto the sidewalk. Death is an incurable condition except via the Phoenix Project breakthrough.

Health in Practise

Health is really quite obvious and you hardly ever need to pay attention to it. If you’ve taken care of sanity then health is also taken care of.

Even though Heavy Workload applies a -10 comfort penalty, this does not result in losing the +5 morale/performance bonus for high health. This is because a colonist will go to work, they’ll be flogged to make them work harder and after the shift is over lose 10 health. Now that they have middle health they seek medical care and get healed back over 70 ready to work the next shift at High Health.

There are only a few traits that affect health. Survivor reduces health losses during management disasters, Party Animals gain extra health when exercising at Gym for some reason, it might be a bug. Chronic Condition loses 8 health per sol.

How to keep colonists alive during prolonged disasters

Plan A should be to not run out of life support or provide uninterruptible life support, for example a single hydroponics running Algae provides 1 oxygen to its dome, even if it is disabled.

Plan B is to pulse life support. a colonist needs to have been missing life support for ~24 hours before they suffer a health penalty. Even a brief pulse of life support once per sol will entirely prevent that health penalty. So if you know you ARE going to run out, and there are still several sols to go, switch off tanks/batteries, then switch back on briefly once per sol. Colonists sanity will still get tanked, and some will commit suicide if not religious, but it means no-one will die of low health.

Plan C is what I call Survival of the Fittest and the Last Resort of the Desperate. Provide an ample number of Open Air Gyms and disable any service that provides Social, such as Diners. Colonists who like Exercise or Social will go to the Gym and regenerate large amounts of health, this should cause them to live a lot longer than their more sedentary companions. In fact exercising can very nearly counteract the health penalty from Starving, and Party Animals and Survivors can survive indefinitely without food provided they are working out every day. Since asphyxiation can instantly kill colonists Exercise is less effective against low oxygen.

This colonist refuses to go quietly into the night!


Morale is different to the other three traits in that it is calculated entirely on the basis of the current status of the colonist with no reference to past events.

Colonist’s base morale is somewhat randomized.

Morale Bonuses

  • +5 each for High Health, Comfort and Sanity
  • +10 for being Religious, an additional +10 for each Saint in the Dome.
  • +10 for being a Nerd if a technology has recently been researched (non-stacking)

Morale Penalties

  • -10 each for Low Health, Comfort and Sanity

High and Low Morale

Colonists gain a work performance benefit or penalty equal to Morale – 50.


Renegade creation happens on a dome basis rather than an individual colonist basis and is determined by the average morale of the non-child, non-renegade residents living in the dome. The renegade creation threshold is 65 morale.

Every sol, progress towards the next renegade accumulates equal to

  • 65 – average_morale

(morale higher than 65 reverses progress). Once the accumulated progress equals 231 the colonist with the lowest morale is picked to become a Renegade. If the Rebel Yell game rule is active then the dome is treated as having an average morale of 55 even if it is higher, but this only applies if the dome has more than 15 population and only when fewer than 20% of the population beyond the 15th are renegades, otherwise the non-Rebel Yell rule applies.

A dome with a morale of 64 would take 231 sols to generate a renegade, a dome with a morale of 50 would take 16 sols.

Morale In Practise

Given that Morale is a sum of other factors there is no real way to directly manipulate morale, other than promoting the Religious and Nerd traits when picking applicants and assigning traits to schools. These traits both give +10 morale which is quite a nice bonus especially for wrong-spec workers.

The average worker with proper specialization has a performance of 100, and the +10 performance bonus is a +10% increase in productivity. The average wrong-spec has a performance of 50, and the +10 performance bonus is a +20% increase in productivity. Hence these morale bonuses are extra valuable when colonists are doing wrong-spec work.

The Enthusiast trait awards a +20 performance bonus when at High Morale. In practise the Enthusiast trait is not very useful, unless a colonist rolls particularly high base morale they are unlikely to reach 70 morale unless they are also Religious and a Nerd or being blessed by a saint, or you get lucky with morale-boosting Breakthroughs. Feel free to teach it in schools together with Nerd and Religious.


Low morale causes renegadism and other than avoiding low morale in the first place you have three main ways of dealing with them:

  • Assign them to their own dome via filters and either cut off the life support or don’t provide the dome with food.
  • Ignore them, they still work, just at reduced efficiency, and usually only cause minor economic damage (but keep them out of domes with genuinely expensive stuff), eventually they grow old and die. Security Stations don’t really seem worthwhile, why suffer the guaranteed loss of the output of 6 workers, when renegades usually only cause minor harm.
  • Assign them to their own dome via filters and provide it with life support. After a while an event may cause the dome to declare independence. Leave it for a while and it’ll rejoin you and the renegades are cured.


If you were hoping for a TL;DR:

Provide a Diner, Grocer and Infirmary per 50 population. This keeps people in middle to high comfort, keeps them healthy and is cheap.

Use Heavy Workload and Nightshift liberally to increase building performance and productivity but be aware you need to keep a close eye on medical capacity if you are stacking these abusive work practises, and turn these practises off during Dust Storms and Cold Waves.

When life support is missing, colonists suffer sanity damage immediately but won’t suffer it again until the next sol, on the other hand health damage requires around 24 hours of uninterrupted absence of life support. Use this knowledge for evil.

Open Air Gyms can stave off death by starvation indefinitely for colonists who like Exercise and Social and not much else. This is not typically useful but is hilarious.

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