Variations in the financial impact of the COVID-19 pandemic across 5 continents: A cross-sectional, individual level analysis
Khetan A.K. Yusuf S. Lopez-Jaramillo P. Szuba A. Orlandini A. Mat-Nasir N. Oguz A. Gupta R. Avezum Á. Rosnah I. Poirier P. Teo K.K. Wielgosz A. Lear S.A. Palileo-Villanueva L.M. Serón P. Chifamba J. Rangarajan S. Mushtaha M. Mohan D. Yeates K. McKee M. Mony P.K. Walli-Attaei M. Khansaheb H. Rosengren A. Alhabib K.F. Kruger I.M. Paucar M.-J. Mirrakhimov E. Assembekov B. Leong D.P.
February 2022Elsevier Ltd
eClinicalMedicine
2022#44
Background: COVID-19 has caused profound socio-economic changes worldwide. However, internationally comparative data regarding the financial impact on individuals is sparse. Therefore, we conducted a survey of the financial impact of the pandemic on individuals, using an international cohort that has been well-characterized prior to the pandemic. Methods: Between August 2020 and September 2021, we surveyed 24,506 community-dwelling participants from the Prospective Urban-Rural Epidemiology (PURE) study across high (HIC), upper middle (UMIC)-and lower middle (LMIC)-income countries. We collected information regarding the impact of the pandemic on their self-reported personal finances and sources of income. Findings: Overall, 32.4% of participants had suffered an adverse financial impact, defined as job loss, inability to meet financial obligations or essential needs, or using savings to meet financial obligations. 8.4% of participants had lost a job (temporarily or permanently); 14.6% of participants were unable to meet financial obligations or essential needs at the time of the survey and 16.3% were using their savings to meet financial obligations. Participants with a post-secondary education were least likely to be adversely impacted (19.6%), compared with 33.4% of those with secondary education and 33.5% of those with pre-secondary education. Similarly, those in the highest wealth tertile were least likely to be financially impacted (26.7%), compared with 32.5% in the middle tertile and 30.4% in the bottom tertile participants. Compared with HICs, financial impact was greater in UMIC [odds ratio of 2.09 (1.88–2.33)] and greatest in LMIC [odds ratio of 16.88 (14.69–19.39)]. HIC participants with the lowest educational attainment suffered less financial impact (15.1% of participants affected) than those with the highest education in UMIC (22.0% of participants affected). Similarly, participants with the lowest education in UMIC experienced less financial impact (28.3%) than those with the highest education in LMIC (45.9%). A similar gradient was seen across country income categories when compared by pre-pandemic wealth status. Interpretation: The financial impact of the pandemic differs more between HIC, UMIC, and LMIC than between socio-economic categories within a country income level. The most disadvantaged socio-economic subgroups in HIC had a lower financial impact from the pandemic than the most advantaged subgroup in UMIC, with a similar disparity seen between UMIC and LMIC. Continued high levels of infection will exacerbate financial inequity between countries and hinder progress towards the sustainable development goals, emphasising the importance of effective measures to control COVID-19 and, especially, ensuring high vaccine coverage in all countries. Funding: Funding for this study was provided by the Canadian Institutes of Health Research and the International Development Research Centre.
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Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, L8L 2X2, ON, Canada
Medical School, Universidad de Santander (UDES), Masira Research Institute, Bucaramanga, Colombia
Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Wroclaw, Poland
ECLA (Estudios Clínicos Latino America) Instituto Cardiovascular de Rosario, Argentina
Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia
Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey
Eternal Heart Care Center and Research Institute, Jaipur, India
International Research Center, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
Faculty of Medicine of UKM, UKM Medical Center, Kuala Lumpur, Malaysia
Faculté de pharmacie, Université Laval, Institut universitaire de cardiologie et de pneumologie de Québec, Québec, Canada
University of Ottawa Heart Institute, Ottawa, ON, Canada
Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
UP College of Medicine, University of the Philippines Manila, Manila, Philippines
Faculty of Medicine, Universidad de La Frontera, Claro Solar, Temuco, Chile
Department of Biomedical Sciences, Physiology Unit, Faculty of Medicine and Sciences, University of Zimbabwe, Zimbabwe
Department of Epidemiology, Madras Diabetes Research Foundation, Chennai, India
Department of Medicine, Queens University, Kingston, ON, Canada
London School of Hygiene and Tropical Medicine, London, United Kingdom
St Johns Medical College & Research Institute, Bangalore, India
Dubai Health Authority, Dubai, United Arab Emirates
Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, VGR region, Sweden
King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
Potchefstroom Campus, Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, South Africa
Facultad de Ciencias de la Salud Eugenio Espejo, Universidad UTE, Quito, Ecuador
Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
Al-Farabi Kazakh National University, Almaty, Kazakhstan
Population Health Research Institute
Medical School
Department of Angiology
ECLA (Estudios Clínicos Latino America) Instituto Cardiovascular de Rosario
Faculty of Medicine
Faculty of Medicine
Eternal Heart Care Center and Research Institute
International Research Center
Faculty of Medicine of UKM
Faculté de pharmacie
University of Ottawa Heart Institute
Faculty of Health Sciences
UP College of Medicine
Faculty of Medicine
Department of Biomedical Sciences
Department of Epidemiology
Department of Medicine
London School of Hygiene and Tropical Medicine
St Johns Medical College & Research Institute
Dubai Health Authority
Sahlgrenska Academy
King Fahad Cardiac Center
Potchefstroom Campus
Facultad de Ciencias de la Salud Eugenio Espejo
Kyrgyz State Medical Academy
Al-Farabi Kazakh National University
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