The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis

Mst Sadia Sultana; Abid Hasan Khan; Sahadat Hossain; Tauhidul Islam; M Tasdik Hasan; Helal Uddin Ahmed; Zezhi Li; Jahangir A M Khan

doi:10.3389/fpsyt.2021.635884

The Association Between Financial Hardship and Mental Health Difficulties Among Adult Wage Earners During the COVID-19 Pandemic in Bangladesh: Findings From a Cross-Sectional Analysis

Front Psychiatry. 2021 Sep 20:12:635884. doi: 10.3389/fpsyt.2021.635884. eCollection 2021.

Authors

Mst Sadia Sultana¹, Abid Hasan Khan¹, Sahadat Hossain^{1

2}, Tauhidul Islam³, M Tasdik Hasan^{2

4}, Helal Uddin Ahmed⁵, Zezhi Li⁶, Jahangir A M Khan⁷

Affiliations

¹ Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh.
² Public Health Foundation, Dhaka, Bangladesh.
³ Faculty of Veterinary, Animal and Biomedical Sciences, Sylhet Agricultural University, Sylhet, Bangladesh.
⁴ Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom.
⁵ National Institute of Mental Health, Sher-E-Bangla Nagar, Dhaka, Bangladesh.
⁶ Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
⁷ Health Economics and Policy Unit, School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Abstract

Background: The ongoing COVID-19 pandemic has created several challenges including financial burdens that may result in mental health conditions. This study was undertaken to gauge mental health difficulties during the COVID-19 pandemic and gain an insight into wage earners' mental health. Method: This cross-sectional study was conducted through an online survey. A t total of 707 individual Bangladeshi wage earners were enrolled between 20 and 30 May 2020. The questionnaire had sections on sociodemographic information, COVID-19 related questions, PHQ-9 and GAD-7 scales. STATA version 14.1 program was used to carry out all the analyses. Results: The study revealed that 58.6 and 55.9% of the respondents had moderate to severe anxiety and depressive symptoms, respectively. The total monthly income was <30,000 BDT (353.73USD) and displayed increased odds of suffering from depressive symptoms (OR = 4.12; 95% CI: 2.68-6.34) and anxiety (OR = 3.31; 95% CI: 2.17-5.03). Participants who did not receive salary income, had no income source during the pandemic, had financial problems, and inadequate food supply and were more likely to suffer from anxiety and depressive symptoms (p ≤ 0.01). Perceiving the upcoming financial crisis as a stressor was a potential risk factor for anxiety (OR = 1.91; 95% CI:1.32-2.77) and depressive symptoms (OR = 1.50; 95% CI:1.04-2.16). Limitations: The online survey method used in this study limits the generalizability of the findings and self-reported answers might include selection and social desirability bias as a community-based survey was not possible during the pandemic. Conclusion: Wage earners in a low resource setting like Bangladesh require mental health attention and financial consideration to deal with mental health difficulties.

Keywords: Bangladesh; COVID-19; anxiety; depressive symptoms; financial crisis; wage earners.