Financial hardship and mental health conditions in people with underlying health conditions during the COVID-19 pandemic in Bangladesh

Md Safaet Hossain Sujan; Rafia Tasnim; Md Saiful Islam; Most Zannatul Ferdous; Atefehsadat Haghighathoseini; Kamrun Nahar Koly; Shahina Pardhan

doi:10.1016/j.heliyon.2022.e10499

Financial hardship and mental health conditions in people with underlying health conditions during the COVID-19 pandemic in Bangladesh

Heliyon. 2022 Sep;8(9):e10499. doi: 10.1016/j.heliyon.2022.e10499. Epub 2022 Aug 31.

Authors

Md Safaet Hossain Sujan^{1

2}, Rafia Tasnim^{1

2}, Md Saiful Islam^{1

2}, Most Zannatul Ferdous¹, Atefehsadat Haghighathoseini³, Kamrun Nahar Koly⁴, Shahina Pardhan⁵

Affiliations

¹ Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh.
² Centre for Advanced Research Excellence in Public Health, Savar, Dhaka-1342, Bangladesh.
³ Department of Health Administration and Policy, George Mason University, USA.
⁴ Health System and Population Studies Division, icddr,b, Mohakhali, Dhaka-1212, Bangladesh.
⁵ Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Young Street, Cambridge UK.

Abstract

Background: Financial hardship is a major concern for patients who are suffering from long-term underlying health conditions. It is likely that emergencies such as the COVID-19 pandemic would impose increased financial distress and lead to the development or exacerbation of mental health conditions.

Objective: The present study aimed to explore the relationship between financial hardship and mental health conditions (loneliness, anxiety, and depression) among patients with underlying health conditions in Bangladesh.

Methods: An e-survey based cross-sectional study was conducted among purposively selected 971 patients (50.1% male; mean age = 42.29 [SD = 15.86]) with underlying health conditions between November 2020 and January 2021. Depression, anxiety, and loneliness were measured using the Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), and UCLA loneliness scale, respectively. Multiple logistic regression analyses were performed to determine any associations between financial hardship and mental health conditions (loneliness, anxiety, and depression).

Results: 46.2% of participants reported experiencing financial difficulties, and a number of respondents (12.3%) had lost their jobs during the COVID-19 pandemic. The prevalence of anxiety, depression and loneliness were 35.2%, 38.9%, and 47.68%, respectively. In the multiple logistic regression analysis, age, gender, occupation, marital status, monthly income, self-reported health status and financial hardship were significantly associated with mental health conditions.

Conclusions: Mental health problems were prevalent among people with underlying health conditions and were also associated with financial difficulties. The findings suggest that care facilities should be strengthened by including psychosocial support components delivered with lower costs, particularly for patients with underlying health conditions.

Keywords: Anxiety; COVID-19; Depression; Financial hardship; Loneliness; Underlying health conditions.