Socio-economic Insecurity Research Articles

The Potential Rise of Populism among the Indonesian Muslim Middle Class. Post Covid-19 Pandemic

The economic and political insecurity faced by Indonesia's Muslim middle class may create opportunities for the rise of populism in Indonesia. This study aims to examine the potential for populism supported by Indonesia's Muslim middle class in the aftermath of the Covid-19 pandemic. The critical political economy approach, specifically the class-based approach, has been used in this study. This article uses qualitative research methodology and draws on literary sources. The findings suggest the likely emergence of populist politics in Indonesia, triggered by the economic instability caused by the Covid-19 pandemic, which severely affected the Muslim middle class. This has been exacerbated by long-standing socio-economic insecurity caused by unfavorable labor policies. Furthermore, the emergence of Indonesian populist politics is reinforced by the political polarization of the last decade. The mobilization of the vulnerable Muslim middle class by a charismatic leader could fuel the potential rise of populist politics in Indonesia

Trapped in vicious cycles: unraveling the health experiences and needs of adults living with socioeconomic insecurity

BackgroundThis study explores the role of health in daily life and needs of Dutch adults (aged 25–49) experiencing one or more forms of socioeconomic insecurity stemming from their financial, housing, or employment situations.Methods28 in-depth, semi-structured interviews were conducted in the Netherlands between October 2022 and February 2023. The interview guide included questions on participants’ socioeconomic situation, the role of health in their daily lives, their health-related and broader needs. Data was interpreted using inductive reflexive thematic analysis. An advisory board consisting of adults with lived experiences of socioeconomic insecurity were consulted at multiple stages of the study (recruitment, interview guide, interpretation of results).ResultsHousing insecurity was widely experienced by participants. When asked about their financial situation, most participants expressed having no issues getting by, but later on, described vigorous efforts to minimize expenses. Participants’ narratives revealed four key themes in relation to the role of health in daily life and associated needs. Firstly, socioeconomic insecurity led to diminished control over life, which led to the disruption of routines. Secondly, experiencing socioeconomic insecurity compelled participants to prioritize stress reduction and mental health improvement through calming yet potentially damaging coping mechanisms. Thirdly, those who experienced little opportunity for improvement in their already long-lasting socioeconomic insecurity shared a sense of stagnation in life, which co-occurred with stagnation in unhealthy routines and diminished well-being. Fourthly, participants expressed the need for someone to speak with. This support may help participants regain control over their lives, identify opportunities for more socioeconomic security, and focus on increased health and well-being.ConclusionsThis study sheds light on the challenges individuals face in dealing with socioeconomic insecurity, how it may affect their health, and their needs. Gaining perspective for improved socioeconomic security and having accessible professional support tailored to self-identified needs could have health-promoting effects for individuals living with socioeconomic insecurity. It is recommended to integrate professional support and assistance regarding social security into health policies and interventions. In future research, measures of financial strain should be adjusted to include the effort needed to get by.

Exploring attitudes and variation by sociodemographic factors in consent provided for financial data linkage in an experimental birth cohort study

BackgroundImproving our understanding of household incomes and what constitutes financial insecurity can help us to better understand how financial insecurity is experienced and how this can change over time within and between individuals and populations. However, financial circumstances are often perceived as sensitive and stigmatising, particularly within some ethnic minority groups. This research aims to explore attitudes and variation by sociodemographic factors in consent provided for financial data linkage in an experimental birth cohort study, in order to obtain validated income and benefits data and to better understand the impact of community interventions on the financial security of its participants and their families.MethodsThis research utilises an observational study design to explore consent rates, attitudes and variation in sociodemographic factors between participants of an experimental birth cohort in a deprived and ethnically diverse setting who consent and do not consent to financial data linkage.ResultsOverall, participants were equally likely to consent and decline consent for financial data linkage. Measures of socioeconomic insecurity were associated with being more likely to provide consent for financial data linkage. Participants who were not employed (OR 1.49 95% CI 0.93, 2.40) and were more financially insecure (OR 1.85 95% CI 1.14, 3.93) were more likely to provide consent for financial data linkage. Where the participant’s first language was a language other than English, participants were also less likely to provide consent for data linkage (OR 0.65 95% CI 0.39, 0.98). The choice of consent for financial data linkage was not associated with: ethnicity; relationship factors; employment status of the participant’s partner; person present at time of recruitment; and measures of health, such as general health, mental health, wellbeing and health-related quality of life.ConclusionsThis research sets out an approach to obtaining validated income and benefits data, as a proxy measure for financial security, within an experimental birth cohort study in a deprived and ethnically diverse setting. It achieves good consent rates and demonstrates greater input from those who report greater potential need for financial support. Further research should be conducted to further understand the interplay of language spoken in this context.

Socio-economic vulnerability and deaths of despair in Brazilian counties

Over the past few years, there has been a progressive increase in premature deaths attributable to suicide, drug overdose, and alcohol-related liver disease that impact life expectancy. Regarding the relationship with contextual effects, the evidence is developing, especially in countries with a peripheral economy, as is the case of Brazil. We carried out an analysis aimed at estimating the relationship between socioeconomic insecurity and deaths due to despair in Brazilian cities. We used 5,570 counties' data to create clusters concerning socioeconomic development and then analyzed age-adjusted mortality rates (ASMR) from each of them and compared them using the ANOVA test. Cluster analysis generated two groups of Brazilian municipalities. DoD rates are consistently higher in the group that experiences more deprivation. However, considering differences between 2010 and 2019, the increase in rates was higher in the group with less deprivation experience (48.82 % vs. 39.53 %) We verified an existing gap between the clusters before the beginning of economic stagnation in 2010 The gap between those two groups decreased from 20.58 % (p < 0.001) in 2010 to 14.03 % in 2019 (p = 0.034). The conjuncture of economic crises creates mortality differentials in certain population groups. Also, significant inequalities explain how causes of death from despair affect different subpopulations. Our first approach assessed this assumption, and we could check those differentials at an ecological level. Public policies should focus on reducing the difference in mortality from despair between higher and lower socioeconomic strata.

1046 Socioeconomic insecurity and pregnancy outcomes: A case for comprehensive social services to improve obstetric care

1046 Socioeconomic insecurity and pregnancy outcomes: A case for comprehensive social services to improve obstetric care

Climate change and urban stormwater: vulnerability analysis of the 2010 floods in Lomé, Togo

This manuscript assesses the vulnerability to flooding between June and August 2010 in Lomé, Togo. To this end, we administered a survey to 312 inhabitants of different areas affected by flooding. The flood risk assessment methodology is based on the analysis of socio-economic indicators, risk exposure indicators, sensitivity indicators and indicators relating to the recovery capacity of flood victims. The analyses showed that 61.5% of respondents had no perception of the risk, compared with 38% who were aware of a very low level of risk compared with 2010. In addition, 84.2% of people living in areas vulnerable to flooding said they were not aware of the risk of flooding in their area. The government's assistance consisted of emergency supplies (food, medicines and temporary accommodation) for the most vulnerable sections of the population. The relevance of this research is not limited to understanding vulnerability to flooding, as it also brings new clarity to the relationship between urban management and socio-economic challenges. This research shows that vulnerability has been exacerbated by socio-economic insecurity and the inadequacy of sanitation facilities.

Cancer screening and socioeconomic insecurity in FQHCs: The COVID-19 pandemic and state Medicaid expansion.

112 Background: Previous studies reported improvements in multiple care quality measures, including cancer screening, in patients served in federally qualified health centers (FQHCs) located in Medicaid expansion states compared to non-expansion states. However, the COVID-19 pandemic disrupted delivery of routine primary care. Little is known about whether the COVID-19 pandemic disrupted or worsened cancer screening and socioeconomic insecurity in FQHC patients. Methods: Data on breast, cervical and colorectal cancer screening, and socioeconomic insecurity (food insecurity, financial strain, and lack of transportation to care) were obtained from the 2020 and 2021 Uniform Data System (UDS), a national report of care delivered by FQHCs. To balance clinic characteristics, the inverse probability of treatment weighting method was employed. Using a propensity score, the probability of being in a state that expanded Medicaid as of January 1, 2020, was measured. Clinics were then weighted conditional on the proportion best served in a language other than English and privately insured as well as rural location and which funding streams were received from section 330 of the Public Health Service Act. A weighted generalized estimating equation adjusted for random clustering of FQHCs within state with a Poisson distribution produced the prevalence ratios. Results: Between 2020-2021, approximately 2700 and 1300 clinics reported on cancer screening and socioeconomic insecurity. In 2020 and 2021, FQHCs in Medicaid expansion states had a higher patient screening prevalence for colorectal (2020: aPR: 1.16, 95% CI: 1.1-1.23; 2021: 1.13, 1.07-1.19) and breast (2020: 1.1, 1.05-1.17; 2021: 1.09, 1.03-1.14) cancer compared to clinics in non-Medicaid expansion states. Additionally, patient food (2021: 0.59, 0.36-0.97) and financial (2020: 0.57, 0.38-0.86; 2021: 0.58, 0.41-0.82) insecurity prevalence was lower in clinics in Medicaid expansion v. non-expansion states. Conclusions: State Medicaid expansion status was associated with higher cancer screening and lower socioeconomic insecurity within FQHCs during the COVID-19 pandemic. It remains an important policy intervention for vulnerable populations to receive care and mitigate disparities.[Table: see text]

Feeling of Insecurity and Hope in the Future: Case Study of Tehran

In recent decades, Iranian society has experienced rapid socio-economic changes that seriously affect feelings of hope in the future (HF) among social groups, especially in metropolitan areas such as Tehran. This study on HF, which I conducted in 2019, provides a gender analysis of HF for Tehran residents based on selected demographic variables and indicators of socio-economic and psychological insecurities. It also analyzes organizational and public trust by applying the Classification and Regression Trees (CART). I selected the participants from different areas of Tehran: 590 men and 610 women out of a population of 4,839,249 (3,054,715 men and 1,784,534 women) using two-stage stratified sampling with Probability Proportional to Size (PPS), and I completed with them structured questionnaires. The results showed that HF of Tehran residents is correlated with their gender (P-value = 0.033). Thus, two distinct trees with over 60% accuracies were fitted. Three influential variables on men’s HF were age, socio-economic insecurity, and public trust. Young men had higher HF than older ones.

Evaluating Facilitators’ Experience Delivering a Stress-Reducing Intervention for Indigenous Women with and without HIV

Indigenous women encounter increased stressful life experiences such as socioeconomic insecurities as well as inequities in health services and outcomes. These stress inequities, which stem from the historical and ongoing effects of settler colonialism, also worsen health outcomes for those women living with HIV. As a part of a broader research project on the impacts of stress-reducing interventions for indigenous women, this study examines the experiences of the women who facilitated the intervention. This research was conducted to evaluate the impacts of a biweekly stress-reducing intervention conducted in Thunder Bay, Ontario. The facilitators of the intervention participated in a focus group in 2019 where they detailed the reach, effectiveness, adoption, and implementation of the intervention. The results suggest that effective stress-reducing interventions should strive to be accessible and inclusive and that doing so can increase program engagement with the service organization hosting the intervention. Further, the results highlight the strengths and challenges of the intervention, including how it helped foster leadership skills and increased indigenous cultural learning among facilitators. These findings demonstrate the strength of community-led interventions and subsequent opportunities for facilitators to grow as leaders. Further, the study highlights how this style of intervention can also encourage participants to engage in other health and wellbeing programs offered by the community partner hosting the intervention. These findings suggest that interventions aimed at reducing stress among indigenous women facing socioeconomic insecurities, including those living with HIV, are both feasible and beneficial for participants, facilitators, and the nonprofit service organizations delivering them.

A CONCEPTUAL PAPER ON SUBJECTIVE POVERTY AS PERCEIVED LASTING SOCIOECONOMIC INSECURITY AMONG LOW INCOME HOUSEHOLD DURING MCO AND COVID 19 PANDEMIC

Studies into the relation between subjective perceptions of individuals and objective economic conditions have usually resulted in ambiguous empirical findings. Whilst most studies perceive subjective welfare as being operationalized by indicators of happiness or life satisfaction, this study narrow the approach to an economic domain of subjective , that is perceptions of poverty. Malaysia government is very committed in supporting and implementing the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs). Having reduced absolute poverty to less than one per cent, Malaysia is now focusing on uplifting the quality of life of the bottom 40 per cent of households (B40). Nevertheless, the implementation of the Movement Control Order (MCO) and the COVID-19 outbreaks have affected the financial 'immunity' of households, traders, and employers to survive this critical period. This made many feels poorer. Poverty rates in the country have been found to increase as many Malaysians easily fall into poverty after losing their jobs or having their pay cut due to the Covid-19 pandemic. Recently, economist adding the subjective poverty approach in understanding the poor. Poor people have their own understanding and interpretation of their social certainty, and this is often different to an outsider’s perspective. The paper aims to uncover subjective poverty as perceived lasting socioeconomic insecurity among the low-income household. Keywords: Low income household; Subjective poverty; Socioeconomic insecurity

COVID-19 and Mental Health Among People Who Are Forcibly Displaced: The Role of Socioeconomic Insecurity.

Forcibly displaced persons may be at elevated risk for poor mental health outcomes because of the COVID-19 pandemic. This study sought to examine associations between COVID-19-related socioeconomic insecurity and mental health outcomes among asylum seekers. The authors evaluated the association between the degree of food, housing, and income insecurity related to the pandemic and mental health outcomes among East African asylum seekers in a high-risk, postdisplacement setting in the Middle East (i.e., Israel). Anxiety symptom severity (p=0.03) as well as the rate of suicidal ideation among women (odds ratio [OR]=2.81, p=0.016) were significantly elevated in a community sample of asylum seekers during the COVID-19 pandemic (N=66) relative to a similar sample (N=158) from the same community and context assessed before the pandemic. No differences between the two groups were observed for severity or rate of probable depression or posttraumatic stress disorders. In addition, among the sample assessed during the pandemic, socioeconomic insecurity due to the pandemic was strongly associated with elevated symptom severity and probable anxiety, depression, and posttraumatic stress disorders as well as suicidal ideation (R2 range=0.19-0.35; OR range=4.54-5.46). Findings are consistent with growing evidence of a mental health crisis among asylum seekers that is linked to COVID-19 control policies and residential status policies. The results highlight the risk for suicidal ideation linked to intersectional marginalization among female asylum seekers. These findings may inform postdisplacement policy making, social justice advocacy, humanitarian aid, and clinical science and practice to mitigate poor mental health outcomes associated with COVID-19 among forcibly displaced persons.

Effects of Socioeconomic Status and Food Insecurity on Stunting among Children aged 06-59 Months

Effects of Socioeconomic Status and Food Insecurity on Stunting among Children aged 06-59 Months

How Working Conditions, Socioeconomic Insecurity, and Behavior-Related Factors Mediate the Association Between Working Poverty and Health in Germany.

Objectives: Aims of this study were to Schmitt (Advances in Life Course Research, 2021, 47: 100402) analyze the association of working poverty with mental and physical health-related quality of life and (Wang and Ford, J Organ Behav, 2020, 41 (9): 895–914) to explain these associations by behavior-related factors (heavy drinking, smoking status, body mass index), socioeconomic insecurity (deprivation in living standards, economic worries), and mental working conditions (effort-reward imbalance, job insecurity). Methods: A total of 11,500 employees aged 17–67 from the German Socioeconomic Panel (2014, 2015, and 2016) were used, and mediation analyses with inverse odds weighting stratified by gender were conducted. Results: Working poverty was significantly associated with both outcomes for both genders. Deprivation in living standards contributed the most to differences in mental health, with a mediated proportion of 60.3% (men) and 44.4% (women). Differences in physical health were significantly mediated by inadequate living standards in women, with a mediated proportion of 73.7%, whereas none of the mediators considered were significant in men. Conclusion: Indicators of socioeconomic insecurity contributed most to the association of working poverty with mental and physical health. Results highlight the relevance of policy initiatives to strengthen the socioeconomic living conditions of the working poor.

Urban parks as a potential mitigator of suicide rates resulting from global pandemics: Empirical evidence from past experiences in Seoul, Korea

Globally, the increased suicide rate of the general population has become a concern not only because of the COVID-19 pandemic, but also because of its associated socioeconomic insecurity, loss of jobs, and economic shocks. This study employed robust fixed-effects panel models to empirically identify the mitigating effects of infectious diseases, via urban parks, on the suicide rate, and to examine gender differences in this regard, based on previous experiences in Seoul, Korea. We found that the differentiating mitigating effect did not significantly affect suicide rates during the 2015 MERS epidemic. However, during the 2009 H1N1 pandemic, wherein the number of confirmed cases was very high and diffused nationwide, urban parks significantly reduced the suicide rates for both men and women. The role of parks as a mitigator was more enhanced in cities with a high number of confirmed cases if it was associated with economic shocks. However, this effect was significant only in the suicide rates of men, not women. During a pandemic, urban parks can help maintain social interaction and sustain physical activities (i.e., walking and exercise) while maintaining physical distance. National and local governments should develop urban parks to actively control the suicide rate influenced by movement restriction measures inevitably occurring during the spread of infectious diseases.

Factors associated with the quality of life of Brazilian adults and the elderly: a cross-sectional study

The objective of this study was to analyze the association between socioeconomic, demographic, lifestyle, health, nutrition and food insecurity factors and quality of life (QoL) in 295 Brazilian adults and the elderly residents in Natal-RN, using data from the Brazilian Usual Consumption Assessment – BRAZUCA survey. Multivariate analysis using Poisson Regression was using, to verify the association between the Qol, assessed by the WHOQOL-bref instrument, with the independent variables. Having age 40-59 years (PR=1.70; 95%CI 1.10-2.62) or age ≥ 60 years (PR=1.55; 95%CI 1.00-2.40); having non-white skin (PR=1.56; 95%CI 1.10-2.19); and being in mild food insecurity (PR=2.70; 95%CI 1.75-4.19) moderate (PR=3.19; 95%CI 2.03-5.00) or severe (PR=3.12; 95%CI 1.80-5.42) were associated with a higher probability of Perceived QoL regular, poor, or very poor. Satisfaction with regular, unsatisfactory, or very unsatisfactory health was associated with mild food insecurity (PR= 1.73; 95%CI 1.26-2.37), emotional disturbances (depression or anxiety) (PR=1.88; 95%CI 1.43-2.49) and being hypertensive (PR=1.39; 95%CI 1.05-1.84). The results suggest the need for public policies that fight inequality, hunger, and promote healthy lifestyles.

Liberal modernity and the classical realist critique of the (present) international order

Abstract In their critique of liberal modernity, classical realists theorized its consequence for the heightened sense of insecurity and powerlessness of the individual on the one hand, and the individual's identification with extreme nationalism and violence on the other. This became the challenge posed by liberal modernity in the post-1945 international order. The article argues that the present international order is an extension of the post-1945 order that never resolved this challenge. While the ‘embedded’ form of liberalism that lasted until the early 1970s made social compromises that mitigated the socio-economic insecurities of the individual in liberal modernity, it did not resolve this challenge. The later advancement of neo-liberalism only further intensified it. The article thus critiques existing debates that downplay the challenge of liberal modernity in their analyses of the crisis of the present international order. It concludes that if the present international order is to be put on more stable and peaceful grounds, it requires a more radical break from its post-1945 and post-Bretton Woods past: a break that does not simply call for ‘leadership’ or ‘offshore balancing’ but addresses the psycho-social needs of the individual in liberal modernity.

Socio-economic insecurity perceptions and their societal determinants: Europe in the aftermath of the Great Recession

ABSTRACT The 2008/09 economic crisis was – unsurprisingly – paralleled by noteworthy perceptions of socio-economic insecurity among Europeans. Respondents in different countries reported more or less grave fears of employment and income insecurity depending on their respective countries’ performance during the crisis. Against this background, we are interested in the manifestations of perceived socio-economic insecurity and their macro contextual determinants. After formulating hypotheses regarding socio-economic and welfare-institutional factors, we test them by using two rounds of the European Social Survey (fielded in 2008/09 and 2016/17). Based on three-level regressions with between-within models of 23,000 individuals (11,611 individuals in 2008/09 and 11,389 individuals in 2016/17) nested in 34 country-years and 17 European countries, we find that the level of perceived socio-economic insecurity in 2016/17 was generally lower than in 2008/09. Additionally, we reveal differences in the effects of the socio-economic factors and welfare-institutional factors between and within countries. These findings suggest that the inconsistency of the results of contextual factors among previous studies might stem from jumbling between- and within-country effects.

Recurrent Hypertriglyceridemia-Associated Pancreatitis in a Pregnant Woman Complicated by Severe Socioeconomic Insecurity

Lead Author's Financial Disclosures Nothing to disclose. Study Funding None. Background/Synopsis At 26 weeks gestation, a 24-year-old pregnant woman with type 2 diabetes mellitus (T2DM) and hypertriglyceridemia (HTG) was hospitalized for her second episode of acute pancreatitis (AP) associated with triglycerides (TG) > 4000 mg/dL. Medical therapy including plasma exchange resulted in dramatic improvement of TG, and the remaining hospital course was uneventful. She was discharged with plan for twice weekly plasma exchange. However, she did not have adequate childcare or transportation to enable treatment and the tunneled catheter had to be removed due to infection before she could receive any outpatient plasma exchange. This case highlights potential barriers to management of severe HTG and the need for effective therapy. Objective/Purpose To review a clinical scenario where severe inherited lipid abnormality and socioeconomic distress complicate care. Methods Laboratory testing was performed by University of Pennsylvania Health System Cernmill Laboratory. Results A 24-year-old G6P3 woman at 26 weeks gestation with T2DM presented to the hospital with intractable abdominal pain and was found to have diabetic ketoacidosis (DKA) and severe HTG causing AP (Table 1). Her medical history was notable for one prior episode of AP at age 21, during which she was first diagnosed with HTG and T2DM and treated with gemfibrozil and insulin. Subsequent medical care was disrupted by limited financial resources and housing insecurity. Follow-up lipid testing while on this regimen did not achieve TG less than 1000 mg/dl. She was admitted to the obstetrics unit for intravenous fluids and insulin and kept nill per os (NPO) resulting in resolution of the DKA. She underwent plasma exchange resulting in TG reduction and resolution of abdominal pain and elevated pancreatic enzymes. TG levels rose to >1200 mg/dL two days after plasma exchange despite clear liquid diet. A prolonged discussion about the risk of recurrent AP to her and her pregnancy, the interventions to manage HTG-associated AP, and available resources supported the role of once- or twice-weekly plasma exchange until delivery. Unfortunately, this plan was abandoned one week after discharge from the hospital because of inadequate access to appropriate childcare, transportation costs, and difficulty with safe maintenance of her tunneled IV access catheter. Present therapy includes close monitoring, dietary counseling, and combination of gemfibrozil and high dose omega-3 fatty acid supplementation. Conclusions This case illustrates a treatment dilemma stemming from the intersection of lipid biology, pregnancy, diabetes, and social determinants of health. Our patient has features of familial (FCS) and multifactorial chylomicronemia syndrome (MCS). Proper diagnosis may inform expectations from pharmacotherapy (e.g. gemfibrozil and high dose omega-3 fatty acid supplementation). In this case, the decision was made to initiate twice-weekly plasma exchange until delivery. There are no clinical trials to directly inform clinical decision-making for this rare condition. However, HTG-associated AP during pregnancy is reportedly more severe than non-pregnancy associated AP and intensive treatment is sensible given the expectation of worsening HTG in the last trimester and the high stakes for the patient and fetus. Unfortunately, our patient's socioeconomic barriers did not allow for appropriate treatment with plasma exchange and the social safety net could not solve these problems in the time required. This case serves as a reminder that our patients may face barriers to accessing complex healthcare and further highlights the need for more effective, convenient, and reliable HTG treatments for both FCS and MCS. Nothing to disclose.

COVID-19, chronic conditions and structural poverty: A social psychological assessment of the needs of a marginalized community in Accra, Ghana

In the African region COVID-19 infection and death rates are increasing (writing in May 2020), most deaths have occurred among individuals with chronic conditions, and poor communities face higher risks of infection and socio-economic insecurities. We assessed the psychosocial needs of a chronic illness support group in Accra, Ghana, within the context of their broader community. The community lives in structural poverty and has a complex burden of infectious and chronic non-communicable diseases (NCDs). Between March and May 2020, we conducted interviews, group discussions, and surveys, with members of the support group and their caregivers, frontline healthcare workers, and religious and community leaders. Data was analysed through the social psychology of participation framework. Community members understood COVID-19 as a new public health threat and drew on eclectic sources of information to make sense of this. Members of the support group had psychosocial and material needs: they were anxious about infection risk as well as money, food and access to NCD treatment. Some community members received government food packages during the lockdown period. This support ended after lockdown in April and while anti-poverty COVID policies have been unveiled they have yet to be implemented. We discuss the impact of these representational, relational and power dynamics on the community’s access to COVID-19 and NCD support. We argue that strategies to address immediate and post-COVID needs of vulnerable communities have to focus on the politics and practicalities of implementing existing rights-based policies that intersect health, poverty reduction and social protection.

Co-exploring the effects of COVID-19 pandemic on the livelihood of persons with disabilities in Bangladesh

Background: According to World Health Organization (WHO), vulnerable groups such as persons with disabilities are facing severe impacts of the pandemic. There has always been significant challenges and hurdles in terms of achieving adequate and equitable inclusivity of persons with disabilities in all sections of social life. Education and employment of persons with disabilities were least focused which created more marginalization for the community. The long term impact of these marginalization has also led to the lack of jobs and social security of persons with disabilities, which is very clear now given the crisis in place. In low and middle income countries like Bangladesh the situation is even worse. To better understand the conditions of persons with disabilities in this crisis situation, the present study was initiated to explore the dimensions of livelihood with respect to income and wellbeing of persons with disabilities and to generate evidence for developing policies around these issues.Methods: A qualitative study was undertaken among 30 persons with disabilities from 8 different geographical divisions of Bangladesh. The interviews were conducted through telephone calls due to the existing COVID-19 crisis and mobility restrictions. The respondents were purposively selected based on gender, type of disability, area of resident (urban, rural) and their ability to communicate, therefore most (25/30) respondents were persons with physical disability. Thematic analysis was conducted to generate the findings of the study.Findings: Study findings revealed that majority of the respondents were involved in informal jobs. Predominantly males were daily wage-earners and often the sole breadwinner of the families, very few females were involved in economic activities. Since they had no stable income, the economic shock from the COVID-19 pandemic had affected them badly even leading to household level famine. The study identifies low level of education and informal job security as the primary causes of socio-economic insecurity among persons with disabilities, resulting in challenges in ensuring a stable livelihood during crisis situations, such as COVID-19.Conclusion: Constant alienation of persons of disabilities from the formal sector results in the deterioration of their livelihood standards which even worsen during any emergency crisis such as COVID-19. The study pinpoints that only aided services are not adequate to ensure persons with disabilities' rights rather there is an urgent need of disability inclusion in formal job sector and livelihood training for persons with disabilities. To achieve the Sustainable Development Goals 2030 and to irradiate the inequality towards persons with disabilities in the society it is important for the Government and concern bodies to focus on the inclusiveness with better implementation and monitoring strategies.