ABSTRACT
Socially disadvantaged individuals and communities consistently showed lower COVID-19 vaccination acceptance. We aimed to examine the psychological mechanisms that could explain such vaccination disparities. This study used data from serial population-based surveys conducted since the COVID-19 vaccination programme being launched in Hong Kong (N = 28,734). We first assessed the correlations of community-level and individual-level social vulnerability with COVID-19 vaccination acceptance. Structural equation modelling (SEM) was then conducted to test whether psychological distress measured by PHQ-4 can account for the associations between participants' socio-economic vulnerability and COVID-19 vaccination acceptance. The third part analysis examined whether perceived negativity of vaccine-related news and affect towards COVID-19 vaccines accounted for the association between psychological distress and COVID-19 vaccination. Communities with higher social vulnerability scores and participants who had more vulnerable socio-economic status showed lower COVID-19 vaccination acceptance. Individuals with more vulnerable socio-economic status reported higher psychological distress, which lowered COVID-19 vaccination acceptance. Furthermore, higher psychological distress was associated with lower vaccination acceptance through its psychological mechanisms of processing vaccine-related information. We proposed a renewed focus on tackling psychological distress rather than merely increasing vaccine accessibility in more socio-economic-disadvantaged groups for promoting COVID-19 vaccination acceptance.
ABSTRACT
The European Union Cohesion Policy for the period 2021-2027 focuses on five goals to make the European Union smarter, greener, more connected, more social and closer to citizens. However, a macroeconomic index is proposed as the predominant criterion for allocating the Structural Funds among regions. In this paper, we hypothesise that it is possible to take into account new, complementary criteria that better reflect citizens' quality of life. To that end, we build a composite index of socio-economic vulnerability for the 233 regions. The results show that following our multidimensional approach for allocating the Structural Funds, there are remarkable differences in the maps of priority regions. In addition, the COVID-19 pandemic represents a threat to well-being. Are all regions equally exposed to COVID-19 in terms of their socio-economic vulnerability? To address this issue, we estimate multilevel models which indicate that country characteristics interact with regions' characteristics to alter patterns of vulnerability. More specifically, increases in government expenditures in education and an improvement in political stability would reduce the regional vulnerability or foster the capacity for resilience, whereas increases in poverty would be associated with greater vulnerability. Likewise, more vulnerable regions would be the most exposed to the negative socio-economic effects of COVID-19. However, it is remarkable that several regions of Sweden and Finland would be among the group of regions whose socio-economic vulnerability would be the most negatively affected.
ABSTRACT
OBJECTIVES: Although literature broadly reports the impact of COVID-19 on global mental health, little is known about the extent of its deleterious impact on the most vulnerable individuals. The present study aimed to evaluate the level of psychological distress of adult's residents of two urban shantytown communities located in São Paulo city, Brazil. STUDY DESIGN: This was a cross-sectional study. METHODS: An online questionnaire was divided into four sections: (1) informed consent, (2) socio-economic data, (3) 12-item general health questionnaire, and (4) Brazilian food insecurity scale was applied. RESULTS: Of the 495 family headship (448 females and 47 males), the mean age was 36.1 years, 85% have an indication of psychological distress, 61.4% had a monthly income less than or equal to $70, and the incidence of households experiencing moderate or severe food insecurity was 40%. Multivariate logistic regression revealed that respondents who experienced moderate or severe food insecurity (odds ratio [OR] = 2.701, confidence interval [CI] 95% = 1.265-5.769; P = 0.010) and lower monthly income (OR = 2.031, CI 95% = 1.056-3.908; P = 0.034) had a higher risk of psychological distress. On the other hand, having an employment is a protective factor against the stressful situations caused by COVID-19 pandemic (P = 0.029). CONCLUSION: The present study identified low-income younger women residents of urban slums who suffer from food insecurity as high-risk groups to have psychological distress. Our findings are of particular importance because they showed the intersection of vulnerabilities during the COVID-19 outbreak.