{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T07:21:14Z","timestamp":1781853674674,"version":"3.54.5"},"reference-count":44,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T00:00:00Z","timestamp":1629072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-002967"],"award-info":[{"award-number":["INV-002967"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Several countries, including India, imposed mandatory social distancing, quarantine, and lockdowns to stop the spread of the SARS-CoV-2 virus. Although these measures were effective in curbing the spread of the virus, prolonged social distancing, quarantine, and the resultant economic disruption led to an increase in financial stress and mental health concerns. Prior studies established a link between the first lockdown and an increase in mental health issues. However, few studies investigated the association between post-lockdown financial hardship, job loss, and mental health. In this study, we examined the association between COVID-19-related financial hardship, job loss, and mental health symptoms approximately nine months after the end of the first nationwide lockdown in India. Job loss was associated with higher reporting of mental health symptoms among men (aIRR = 1.16) while financial hardship was associated with poor mental health symptoms among women (aIRR = 1.29). Conversely, social support and government aid were associated with better mental health symptoms among women. Our findings highlight the need for financial assistance and job creation programs to aid families in the recovery process. There is also an urgent need for improving the availability and affordability of mental health services in rural areas.<\/jats:p>","DOI":"10.3390\/ijerph18168647","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T21:27:45Z","timestamp":1629149265000},"page":"8647","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["COVID-19-Related Financial Hardship, Job Loss, and Mental Health Symptoms: Findings from a Cross-Sectional Study in a Rural Agrarian Community in India"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5836-514X","authenticated-orcid":false,"given":"Sangeeta","family":"Chatterji","sequence":"first","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lotus","family":"McDougal","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Johns","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-4156","authenticated-orcid":false,"given":"Mohan","family":"Ghule","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Namratha","family":"Rao","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Raj","sequence":"additional","affiliation":[{"name":"Center on Gender Equity and Health, University of California San Diego, La Jolla, CA 92093, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ashraf, B.N. (2020). Economic impact of government interventions during the COVID-19 pandemic: International evidence from financial markets. J. Behav. Exp. Financ., 27.","DOI":"10.1016\/j.jbef.2020.100371"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2462","DOI":"10.1016\/S0140-6736(21)01245-9","article-title":"India\u2019s problem of data and deaths","volume":"397","author":"Zadey","year":"2021","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"(2021). The Lancet. India\u2019s COVID-19 emergency. Lancet, 397, 1683.","DOI":"10.1016\/S0140-6736(21)01052-7"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.1192\/j.eurpsy.2020.35","article-title":"The consequences of the COVID-19 pandemic on mental health and implications for clinical practice","volume":"63","author":"Fiorillo","year":"2020","journal-title":"Eur. Psychiatry"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1192\/j.eurpsy.2021.9","article-title":"One year after the COVID-19: What have we learnt, what shall we do next?","volume":"64","author":"Gorwood","year":"2021","journal-title":"Eur. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.jad.2020.08.001","article-title":"Impact of COVID-19 pandemic on mental health in the general population: A systematic review","volume":"277","author":"Xiong","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Hossain, M., Rahman, M., Trisha, N.F., Tasnim, S., Nuzhath, T., Hasan, N.T., Clark, H., Das, A., McKyer, E.L.J., and Ahmed, H.U. (2021). Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis. Heliyon, 7.","DOI":"10.1016\/j.heliyon.2021.e06677"},{"key":"ref_8","first-page":"2","article-title":"Factors Influencing Mental Health During Covid-19 Outbreak: An Exploratory Survey among Indian Population","volume":"10","author":"Ahmad","year":"2020","journal-title":"J. Health Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Gopal, A., Sharma, A.J., and Subramanyam, M.A. (2020). Dynamics of psychological responses to COVID-19 in India: A longitudinal study. PLoS ONE, 15.","DOI":"10.1101\/2020.06.12.20129791"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13033-020-00422-2","article-title":"Analysis of news media reports of suicides and attempted suicides during the COVID-19 lockdown in India","volume":"14","author":"Pathare","year":"2020","journal-title":"Int. J. Ment. Health Syst."},{"key":"ref_11","unstructured":"Center for Monitoring Indian Economy (2021, July 06). Unemployment Rate in India. Available online: https:\/\/unemploymentinindia.cmie.com\/."},{"key":"ref_12","unstructured":"Ministry of Statistics and Programme Implementation (2021, July 06). Gross Domestic Product. Available online: http:\/\/mospi.nic.in\/133-gross-domestic-product."},{"key":"ref_13","unstructured":"(2019). Annual Report\u2014Periodic Labour Force Survey 2017\u20132018, Ministry of Statistics and Programme Implementation."},{"key":"ref_14","first-page":"104","article-title":"Wage gap between formal and informal regular workers in india: Evidence from the national sample survey","volume":"13","author":"Kumar","year":"2021","journal-title":"Glob. J. Emerg. Mark. Econ."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1080\/02255189.2021.1890003","article-title":"Pandemic, informality, and vulnerability: Impact of COVID-19 on livelihoods in India","volume":"42","author":"Kesar","year":"2021","journal-title":"Can. J. Dev. Stud."},{"key":"ref_16","unstructured":"Totapally, S., Sonderegger, P., Rao, P., and Gupta, G. (2021, July 06). Efficacy of Government Entitlements for Low-Income Families During Covid-19. Available online: https:\/\/impactsofcovid.in\/assets\/front_assets\/download\/20.07.27_Efficacy%20of%20government%20entitlements%20for%20low-income%20families%20during%20Covid-19.pdf."},{"key":"ref_17","unstructured":"Action Aid India (2020). Workers in the Time of COVID 19, Action Aid India."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bauza, V., Sclar, G.D., Bisoyi, A., Owens, A., Ghugey, A., and Clasen, T. (2021). Experience of the COVID-19 pandemic in rural Odisha, India: Knowledge, Preventative actions, and impacts on daily life. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18062863"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Frasquilho, D., Matos, M.G., Salonna, F., Guerreiro, D., Storti, C.C., Gaspar, T., and Caldas-de-Almeida, J.M. (2016). Mental health outcomes in times of economic recession: A systematic literature review. BMC Public Health, 16.","DOI":"10.1186\/s12889-016-2720-y"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s40471-016-0068-6","article-title":"Health impacts of the great recession: A critical review","volume":"3","author":"Falconi","year":"2016","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1007\/BF03391695","article-title":"A Review of Health consequences of recessions internationally and a synthesis of the US response during the great recession","volume":"35","author":"Modrek","year":"2013","journal-title":"Public Health Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.socscimed.2015.03.025","article-title":"Social welfare matters: A realist review of when, how, and why unemployment insurance impacts poverty and health","volume":"132","author":"Molnar","year":"2015","journal-title":"Soc. Sci. Med."},{"key":"ref_23","first-page":"1","article-title":"India\u2019s $5-Trillion Gdp Journey: Contribution Of Each State Crucial","volume":"1","author":"Pai","year":"2020","journal-title":"Fin. Exp."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/s12978-019-0744-3","article-title":"A gender synchronized family planning intervention for married couples in rural India: Study protocol for the CHARM2 cluster randomized controlled trial evaluation","volume":"16","author":"Dixit","year":"2019","journal-title":"Reprod. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/mpr.168","article-title":"The world mental health (WMH) survey initiative version of the world health organization (WHO) composite international diagnostic interview (CIDI)","volume":"13","author":"Kessler","year":"2004","journal-title":"Int. J. Methods Psychiatr. Res."},{"key":"ref_26","first-page":"83","article-title":"An exploratory clinical study of adult attention deficit\/hyperactivity disorder from India","volume":"129","author":"Sitholey","year":"2009","journal-title":"Indian J. Med Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"46","DOI":"10.4103\/psychiatry.IndianJPsychiatry_333_16","article-title":"Twelve-month prevalence and treatment gap for common mental disorders: Findings from a large-scale epidemiological survey in India","volume":"59","author":"Sagar","year":"2017","journal-title":"Indian J. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/0277-9536(91)90150-B","article-title":"The MOS social support survey","volume":"32","author":"Sherbourne","year":"1991","journal-title":"Soc. Sci. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jveb.2019.06.009","article-title":"Assessment of pet attachment and its relationship with stress and social support among residents in Mangalore city of south India","volume":"34","author":"Joseph","year":"2019","journal-title":"J. Vet. Behav."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1080\/09540120802614358","article-title":"Stigma, social support, and depression among people living with HIV in Thailand","volume":"21","author":"Li","year":"2009","journal-title":"AIDS Care"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jvb.2009.01.001","article-title":"Unemployment impairs mental health: Meta-analyses","volume":"74","author":"Paul","year":"2009","journal-title":"J. Vocat. Behav."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Eckhard, J. (2020). Gender differences in the social consequences of unemployment: How job loss affects the risk of becoming socially isolated. Work Employ. Soc.","DOI":"10.1177\/0950017020967903"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1017\/sjp.2018.68","article-title":"Unemployment, self-esteem, and depression: Differences between men and women","volume":"22","author":"Garrido","year":"2019","journal-title":"Span. J. Psychol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1111\/1467-9655.t01-1-00007","article-title":"Migration, money and masculinity in Kerala","volume":"6","author":"Osella","year":"2000","journal-title":"J. R. Anthr. Inst."},{"key":"ref_35","first-page":"58","article-title":"Wage inequality in India: Decomposition by sector, gender and activity status","volume":"47","author":"Das","year":"2012","journal-title":"Econ. Political Wkly."},{"key":"ref_36","unstructured":"(2017). National Family Health Survey-4 India Fact Sheet 2015\u20132016, International Institute of Population Studies."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.socscimed.2016.01.050","article-title":"The role of social support in protecting mental health when employed and unemployed: A longitudinal fixed-effects analysis using 12 annual waves of the HILDA cohort","volume":"153","author":"Milner","year":"2016","journal-title":"Soc. Sci. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1007\/s00127-006-0051-5","article-title":"Negative life events, social support and gender difference in depression","volume":"41","author":"Dalgard","year":"2006","journal-title":"Soc. Psychiatry Psychiatr. Epidemiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/0001-8791(91)90018-H","article-title":"Gender differences in responses to unemployment","volume":"38","author":"Leana","year":"1991","journal-title":"J. Vocat. Behav."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Siddiqui, A.F., Wiederkehr, M., Rozanova, L., and Flahault, A. (2020). Situation of India in the COVID-19 pandemic: India\u2019s initial pandemic experience. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17238994"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1007\/s40812-020-00170-x","article-title":"A critique of the Indian government\u2019s response to the COVID-19 pandemic","volume":"47","author":"Ghosh","year":"2020","journal-title":"J. Ind. Bus. Econ."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Kaur, A., Kallakuri, S., Kohrt, B.A., Heim, E., Gronholm, P.C., Thornicroft, G., and Maulik, P.K. (2021). Systematic review of interventions to reduce mental health stigma in India. Asian J. Psychiatry, 55.","DOI":"10.1016\/j.ajp.2020.102466"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1093\/inthealth\/ihs011","article-title":"Stigma and discrimination as a barrier to mental health service utilization in India","volume":"5","author":"Shidhaye","year":"2013","journal-title":"Int. Health"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1002\/wps.20766","article-title":"Psychiatry in the age of COVID-19","volume":"19","author":"Kimmel","year":"2020","journal-title":"World Psychiatry"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/16\/8647\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:47:01Z","timestamp":1760165221000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/16\/8647"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8,16]]},"references-count":44,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["ijerph18168647"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18168647","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,8,16]]}}}