Asian Journal for Public Opinion Research

Center for Asian Public Opinion Research & Collaboration Initiative (충남대학교 아시아여론조사학회)
권호 표지
DOI QR코드

DOI QR Code

Uncovering Income Class Heterogeneity in Self-Reported Anxiety Levels among Indonesians Before and During the COVID-19 Pandemic

  • Received : 2024.01.13
  • Accepted : 2024.03.17
  • Published : 2024.05.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study investigates the variation in anxiety levels across income classes in the wake of the COVID-19 pandemic in Indonesia. The research is based on data from nationally representative surveys conducted in 2017 and 2021, and it employs a multilevel mixed-effects ordered logistic model. The unique aspect of this investigation lies in its utilization of the Cantril ladder, a commonly employed tool in public opinion research, to gauge anxiety levels. Participants are prompted to assess their present life circumstances concerning their daily worries and anxieties. The empirical findings provide evidence that individuals in provinces with higher exposures to COVID-19 reported heightened anxiety levels. Furthermore, the results highlight a consistent association between higher household income and lower levels of anxiety. Notably, individuals from the highest income group experienced a substantial decline in anxiety levels during the pandemic. When examining specific income classes, the study reveals heightened anxiety among women in higher-income brackets and among lower-income households residing in urban areas. Furthermore, regarding macroeconomic circumstances, the results illustrate a positive correlation between economic prosperity and anxiety levels among members of low-income households. The study also uncovers a positive connection between income inequality and self-assessed anxiety within upper-middle and high-income brackets.

Keywords

Acknowledgement

The author expresses sincere gratitude to Professor Emma Porio from the School of Social Sciences, Ateneo de Manila University, as well as to Professor Iwan Gardono Sudjatmiko and Hari Nugroho from the Department of Sociology, Universitas Indonesia for the valuable insights and discussions provided during the preparation of this study.

References

  1. Alexander, J. L., Dennerstein, L., Kotz, K., & Richardson, G. (2007). Women, anxiety and mood: a review of nomenclature, comorbidity and epidemiology. Expert Review of Neurotherapeutics, 7(sup1), S45-S58. https://doi.org/10.1586/14737175.7.11s.s45
  2. Alon, T., Doepke, M., Olmstead-Rumsey, J., & Tertilt, M. (2020). The impact of COVID-19 on gender equality (Working Paper 26947). National Bureau of Economic Research. https://doi.org/10.3386/w26947
  3. Andrade, C. (2020). The limitations of online surveys. Indian Journal of Psychological Medicine, 42(6), 575-576. https://doi.org/10.1177/0253717620957496
  4. Anindyajati, G., Wiguna, T., Murtani, B. J., Christian, H., Wigantara, N. A., Putra, A. A., Hanafi, E., Minayati, K., Ismail, R. I., Kaligis, F., Savitri, A. I., Uiterwaal, C. S. P. M., & Diatri, H. (2021). Anxiety and its associated factors during the initial phase of the COVID-19 pandemic in Indonesia. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.634585
  5. Atkinson, W. (2015). Class. Polity Press.
  6. Badan Pusat Statistik (2017). Indeks Kebahagiaan 2017 [Happiness index 2017]. Badan Pusat Statistik. https://www.bps.go.id/id/publication/2017/12/05/1f99cefd596c449b93405fcd/indeks-kebahagiaan-2017.html
  7. Badan Pusat Statistik (2021). Indeks Kebahagiaan 2021 [Happiness index 2021]. Badan Pusat Statistik. https://www.bps.go.id/id/publication/2021/12/27/ba1b0f03770569b5ac3ef58e/indeks-kebahagiaan-2021.html
  8. Balakrishnan, V., Ng, K. S., Kaur, W., & Lee, Z. L. (2023). COVID-19 mental health prevalence and its risk factors in South East Asia. Current Psychology, 42(20), 17523-17538. https://doi.org/10.1007/s12144-021-02556-z
  9. Barbek, R. M. E., Makowski, A. C., & von dem Knesebeck, O. (2022). Social inequalities in health anxiety: A systematic review and meta-analysis. Journal of Psychosomatic Research, 153(110706), 110706. https://doi.org/10.1016/j.jpsychores.2021.110706
  10. Barone, C., Hertel, F. R., & Smallenbroek, O. (2022). The rise of income and the demise of class and social status? A systematic review of measures of socio-economic position in stratification research. Research in Social Stratification and Mobility, 78(100678), 100678. https://doi.org/10.1016/j.rssm.2022.100678 
  11. Bittmann, F. (2022). Is there a dose-response relationship? Investigating the functional form between COVID-19 incidence rates and life satisfaction in a multilevel framework. Journal of Happiness Studies, 23(7), 3315-3330. https://doi.org/10.1007/s10902-022-00542-1
  12. Blanchflower, D., & Bryson, A. (2021). Biden, COVID and mental health in America. National Bureau of Economic Research. https://doi.org/10.3386/w29040
  13. Blanchflower, D. G., & Bryson, A. (2023). Seasonality and the female happiness paradox. Quality & Quantity, 58(1), 1-33. https://doi.org/10.1007/s11135-023-01628-5
  14. Brunoni, A. R., Suen, P. J. C., Bacchi, P. S., Razza, L. B., Klein, I., dos Santos, L. A., de Souza Santos, I., da Costa Lane Valiengo, L., Gallucci-Neto, J., Moreno, M. L., Pinto, B. S., de Cassia Silva Felix, L., de Sousa, J. P., Viana, M. C., Forte, P. M., de Altisent Oliveira Cardoso, M. C., Bittencourt, M. S., Pelosof, R., de Siqueira, L. L., ... Bensenor, I. M. (2021). Prevalence and risk factors of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: Findings from the ELSA-Brasil COVID-19 mental health cohort. Psychological Medicine, 1-12. https://doi.org/10.1017/s0033291721001719
  15. Choi, E. P. H., Hui, B. P. H., & Wan, E. Y. F. (2020). Depression and anxiety in Hong Kong during COVID-19. International Journal of Environmental Research and Public Health, 17(10), 3740. https://doi.org/10.3390/ijerph17103740
  16. Choi, S. H., & Kim, S. (2023). Factors associated with adverse mental health outcomes during the COVID-19 pandemic. Public Health in Practice (Oxford, England), 5(100360), 100360. https://doi.org/10.1016/j.puhip.2023.100360
  17. Cockerham, W. C. (2016). Sociology of mental disorder. Routledge.
  18. Dang, H.-A. H., & Nguyen, C. V. (2021). Gender inequality during the COVID-19 pandemic: Income, expenditure, savings, and job loss. World Development, 140, 105296. https://doi.org/10.1016/j.worlddev.2020.105296
  19. Di Napoli, I., & Arcidiacono, C. (2013). The use of self-anchoring scales in social research: The Cantril scale for the evaluation of community action orientation. In C. Davino, L. Fabbris (Eds.), Survey data collection and integration (pp. 73-85). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-642-21308-3_5
  20. Dragan, M., Grajewski, P., & Shevlin, M. (2021). Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic. European Journal of Psychotraumatology, 12(1). https://doi.org/10.1080/20008198.2020.1860356
  21. Dunlop, B. W., Granros, M., Lechner, A., Mletzko-Crowe, T., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2019). Recall accuracy for the symptoms of a major depressive episode among clinical trial participants. Journal of Psychiatric Research, 116, 178-184. https://doi.org/10.1016/j.jpsychires.2019.03.008
  22. Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020). Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Network Open, 3(9), e2019686. https://doi.org/10.1001/jamanetworkopen.2020.19686
  23. Fancourt, D., Steptoe, A., & Bu, F. (2021). Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: A longitudinal observational study. The Lancet Psychiatry, 8(2), 141-149. https://doi.org/10.1016/s2215-0366(20)30482-x
  24. Fauk, N. K., Ernawati, Dent, E., Asa, G. A., & Ward, P. R. (2022). Impact of COVID-19 lockdowns on the activity and mental health of older people in Indonesia: A qualitative study. International Journal of Environmental Research and Public Health, 19(20), 13115. https://doi.org/10.3390/ijerph192013115
  25. Fitzpatrick, K. M., Harris, C., & Drawve, G. (2020). Living in the midst of fear: Depressive symptomatology among US adults during the COVID-19 pandemic. Depression and Anxiety, 37(10), 957-964. https://doi.org/10.1002/da.23080
  26. Fone, D., Dunstan, F., Williams, G., Lloyd, K., & Palmer, S. (2007). Places, people and mental health: A multilevel analysis of economic inactivity. Social Science & Medicine (1982), 64(3), 633-645. https://doi.org/10.1016/j.socscimed.2006.09.020
  27. Frankenthal, D., Keinan-Boker, L., & Bromberg, M. (2023). Rise in depression and anxiety during the COVID-19 pandemic: Results from a cross-sectional national survey. Psychology, Health & Medicine, 28(1), 139-147. https://doi.org/10.1080/13548506.2022.2057558
  28. Hanandita, W., & Tampubolon, G. (2014). Does poverty reduce mental health? An instrumental variable analysis. Social Science & Medicine (1982), 113, 59-67. https://doi.org/10.1016/j.socscimed.2014.05.005
  29. Hossain, M. M., Rahman, M., Trisha, N. F., Tasnim, S., Nuzhath, T., Hasan, N. T., Clark, H., Das, A., McKyer, E. L. J., Ahmed, H. U., & Ma, P. (2021). Prevalence of anxiety and depression in South Asia during COVID-19: A systematic review and meta-analysis. Heliyon, 7(4), e06677. https://doi.org/10.1016/j.heliyon.2021.e06677
  30. Huato, J., & Chavez, A. (2021). Household income, pandemic-related income loss, and the probability of anxiety and depression. Eastern Economic Journal, 47(4), 546-570. https://doi.org/10.1057/s41302-021-00199-3
  31. Hyland, P., Shevlin, M., Murphy, J., McBride, O., Fox, R., Bondjers, K., Karatzias, T., Bentall, R. P., Martinez, A., & Vallieres, F. (2021). A longitudinal assessment of depression and anxiety in the Republic of Ireland before and during the COVID-19 pandemic. Psychiatry Research, 300(113905), 113905. https://doi.org/10.1016/j.psychres.2021.113905
  32. Jia, H., Guerin, R. J., Barile, J. P., Okun, A. H., McKnight-Eily, L., Blumberg, S. J., Njai, R., & Thompson, W. W. (2021). National and state trends in anxiety and depression severity scores among adults during the COVID-19 pandemic - United States, 2020-2021. MMWR. Morbidity and Mortality Weekly Report, 70(40), 1427-1432. https://doi.org/10.15585/mmwr.mm7040e3
  33. Julianto, V., Sumintono, B., Wilhelmina, T. M., Almakhi, N. P. Z., & Avetazain, H. (2023). Mental health condition of vocational high school students during COVID-19 pandemic in Indonesia. Asian Journal of Psychiatry, 82(103518), 103518. https://doi.org/10.1016/j.ajp.2023.103518
  34. Kenntemich, L., von Hu lsen, L., Scha fer, I., Bo ttche, M., & Lotzin, A. (2023). Profiles of risk factors for depressive and anxiety symptoms during the COVID-19 pandemic: A latent class analysis. Psychiatry Research, 323, 115150. https://doi.org/10.1016/j.psychres.2023.115150
  35. Khan, A. A., Lodhi, F. S., Rabbani, U., Ahmed, Z., Abrar, S., Arshad, S., Irum, S., & Khan, M. I. (2021). Impact of Coronavirus disease (COVID-19) pandemic on psychological well-being of the Pakistani general population. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.564364
  36. Kilpatrick, F. P., & Cantril, H. (1960). Self-anchoring scaling: A measure of individuals' unique reality worlds. Journal of Individual Psychology, 16(2), 158-173.
  37. Knudsen, A. K. S., Stene-Larsen, K., Gustavson, K., Hotopf, M., Kessler, R. C., Krokstad, S., Skogen, J. C., Overland, S., & Reneflot, A. (2021). Prevalence of mental disorders, suicidal ideation and suicides in the general population before and during the COVID-19 pandemic in Norway: A population-based repeated cross-sectional analysis. The Lancet Regional Health. Europe, 4(100071), 100071. https://doi.org/10.1016/j.lanepe.2021.100071
  38. Kurcer, M. A., Erdogan, Z., & Cakir Kardes, V. (2022). The effect of the COVID-19 pandemic on health anxiety and cyberchondria levels of university students. Perspectives in Psychiatric Care, 58(1), 132-140. https://doi.org/10.1111/ppc.12850
  39. Le, K., & Nguyen, M. (2021). The psychological burden of the COVID-19 pandemic severity. Economics and Human Biology, 41, 100979. https://doi.org/10.1016/j.ehb.2021.100979
  40. Leong Bin Abdullah, M. F. I., Ahmad Yusof, H., Mohd Shariff, N., Hami, R., Nisman, N. F., & Law, K. S. (2021). Depression and anxiety in the Malaysian urban population and their association with demographic characteristics, quality of life, and the emergence of the COVID-19 pandemic. Current Psychology (New Brunswick, N.J.), 40(12), 6259-6270. https://doi.org/10.1007/s12144-021-01492-2
  41. Leung, C. M. C., Ho, M. K., Bharwani, A. A., Cogo-Moreira, H., Wang, Y., Chow, M. S. C., Fan, X., Galea, S., Leung, G. M., & Ni, M. Y. (2022). Mental disorders following COVID-19 and other epidemics: A systematic review and meta-analysis. Translational Psychiatry, 12(1). https://doi.org/10.1038/s41398-022-01946-6
  42. Maric, N. P., Lazarevic, L. J. B., Priebe, S., Mihic, L. J., Pejovic-Milovancevic, M., TerzicSupic, Z., Toskovic, O., Vukovic, O., Todorovic, J., & Knezevic, G. (2022). Covid-19-related stressors, mental disorders, depressive and anxiety symptoms: A cross-sectional, nationally-representative, face-to-face survey in Serbia. Epidemiology and Psychiatric Sciences, 31(e36). https://doi.org/10.1017/s2045796022000117
  43. Marmot, M. (2002). The influence of income on health: Views of an epidemiologist. Health Affairs (Project Hope), 21(2), 31-46. https://doi.org/10.1377/hlthaff.21.2.31
  44. McKenzie, K., Murray, A., & Booth, T. (2013). Do urban environments increase the risk of anxiety, depression and psychosis? An epidemiological study. Journal of Affective Disorders, 150(3), 1019-1024. https://doi.org/10.1016/j.jad.2013.05.032
  45. Mehmetoglu, M., & Jakobsen, T. G. (2016). Applied statistics using Stata: A guide for the social sciences. SAGE Publications.
  46. Moreno, C., Wykes, T., Galderisi, S., Nordentoft, M., Crossley, N., Jones, N., Cannon, M., Correll, C. U., Byrne, L., Carr, S., Chen, E. Y. H., Gorwood, P., Johnson, S., Karkkainen, H., Krystal, J. H., Lee, J., Lieberman, J., Lopez-Jaramillo, C., Mannikko, M., ... Arango, C. (2020). How mental health care should change as a consequence of the COVID-19 pandemic. The Lancet. Psychiatry, 7(9), 813-824. https://doi.org/10.1016/s2215-0366(20)30307-2
  47. Mwinyi, J., Pisanu, C., Castelao, E., Stringhini, S., Preisig, M., & Schioth, H. B. (2017). Anxiety disorders are associated with low socioeconomic status in women but not in men. Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health, 27(3), 302-307. https://doi.org/10.1016/j.whi.2017.01.001
  48. Nagasu, M., Muto, K., & Yamamoto, I. (2021). Impacts of anxiety and socioeconomic factors on mental health in the early phases of the COVID-19 pandemic in the general population in Japan: A web-based survey. PloS One, 16(3), e0247705. https://doi.org/10.1371/journal.pone.0247705
  49. Newby, J. M., O'Moore, K., Tang, S., Christensen, H., & Faasse, K. (2020). Acute mental health responses during the COVID-19 pandemic in Australia. PloS One, 15(7), e0236562. https://doi.org/10.1371/journal.pone.0236562
  50. Nguyen, C. V. (2021). Does the COVID-19 pandemic cause people to be unhappy? Evidence from a six-country survey (Global Labor Organization (GLO) discussion paper No. 768).
  51. Noh, J.-W., Kim, K.-B., Park, J., Hong, J., & Kwon, Y. D. (2017). Relationship between the number of family members and stress by gender: Cross-sectional analysis of the fifth Korea National Health and Nutrition Examination Survey. PloS One, 12(9), e0184235. https://doi.org/10.1371/journal.pone.0184235
  52. Okoro, C. A., McKnight-Eily, L. R., Strine, T. W., Crews, J. E., Holt, J. B., & Balluz, L. S. (2011). State and local area estimates of depression and anxiety among adults with disabilities in 2006. Disability and Health Journal, 4(2), 78-90. https://doi.org/10.1016/j.dhjo.2010.05.001
  53. Pappa, S., Chen, J., Barnett, J., Chang, A., Dong, R. K., Xu, W., Yin, A., Chen, B. Z., Delios, A. Y., Chen, R. Z., Miller, S., Wan, X., & Zhang, S. X. (2022). A systematic review and meta-analysis of the mental health symptoms during the Covid-19 pandemic in Southeast Asia. Psychiatry and Clinical Neurosciences, 76(2), 41-50. https://doi.org/10.1111/pcn.13306
  54. Peretti-Watel, P., Alleaume, C., Le ger, D., Beck, F., & Verger, P. (2020). Anxiety, depression and sleep problems: A second wave of COVID-19. General Psychiatry, 33(5), e100299. https://doi.org/10.1136/gpsych-2020-100299
  55. Rabe-Hesketh, S., & Skrondal, A. (2021). Multilevel and longitudinal modeling using Stata, volumes I and II (4th ed.). Stata Press.
  56. Rampal, L., Liew, B. S., Choolani, M., & Shorey, S. (2023). Evaluating healthcare response to COVID-19 across Southeast Asia: A post-Pandemic Reflection and Way Forward. The Medical Journal of Malaysia, 78(6). https://pubmed.ncbi.nlm.nih.gov/38031208/
  57. Rehman, U., Yildirim, M., & Shahnawaz, M. G. (2023). A longitudinal study of depression, anxiety, and stress among Indians during COVID-19 pandemic. Psychology, Health & Medicine, 28(1), 60-68. https://doi.org/10.1080/13548506.2021.2023751
  58. Reiss, F., Meyrose, A.-K., Otto, C., Lampert, T., Klasen, F., & Ravens-Sieberer, U. (2019). Socioeconomic status, stressful life situations and mental health problems in children and adolescents: Results of the German BELLA cohort-study. PloS One, 14(3), e0213700. https://doi.org/10.1371/journal.pone.0213700
  59. Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 pandemic and lockdown measures impact on mental health among the general population in Italy. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00790
  60. Santomauro, D. F., Mantilla Herrera, A. M., Shadid, J., Zheng, P., Ashbaugh, C., Pigott, D. M., Abbafati, C., Adolph, C., Amlag, J. O., Aravkin, A. Y., Bang-Jensen, B. L., Bertolacci, G. J., Bloom, S. S., Castellano, R., Castro, E., Chakrabarti, S., Chattopadhyay, J., Cogen, R. M., Collins, J. K., ... Ferrari, A. J. (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet, 398(10312), 1700-1712. https://doi.org/10.1016/s0140-6736(21)02143-7
  61. Shevlin, M., McBride, O., Murphy, J., Miller, J. G., Hartman, T. K., Levita, L., Mason, L., Martinez, A. P., McKay, R., Stocks, T. V. A., Bennett, K. M., Hyland, P., Karatzias, T., & Bentall, R. P. (2020). Anxiety, depression, traumatic stress and COVID-19-related anxiety in the UK general population during the COVID-19 pandemic. BJPsych Open, 6(6). https://doi.org/10.1192/bjo.2020.109
  62. Soria, K. M., & Horgos, B. (2020). Social class differences in students' experiences during the COVID-19 pandemic. SERU Consortium, University of California - Berkeley and University of Minnesota. https://cshe.berkeley.edu/seru-covid-survey-reports
  63. Stickley, A., & Ueda, M. (2022). Loneliness in Japan during the COVID-19 pandemic: Prevalence, correlates and association with mental health. Psychiatry Research, 307(114318), 114318. https://doi.org/10.1016/j.psychres.2021.114318
  64. Sunjaya, D. K., Herawati, D. M. D., & Siregar, A. Y. M. (2021). Depressive, anxiety, and burnout symptoms on health care personnel at a month after COVID-19 outbreak in Indonesia. BMC Public Health, 21(1). https://doi.org/10.1186/s12889-021-10299-6
  65. Sutarto, A. P., Wardaningsih, S., & Putri, W. H. (2021). Work from home: Indonesian employees' mental well-being and productivity during the COVID-19 pandemic. International Journal of Workplace Health Management, 14(4), 386-408. https://doi.org/10.1108/ijwhm-08-2020-0152
  66. Tay, W. W. Y., Jesuthasan, J., Wan, K. S., Ong, T., & Mustapha, F. (2022). Eighteen months into the COVID-19 pandemic: The prevalence of depression, anxiety, and stress symptoms in Southeast Asia and the associated demographic factors. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.863323
  67. Tumin, M. M. (1970). Some principles of stratification: A critical analysis. In M. M. Tumin (Ed.), Readings on Social Stratification (pp. 378-386). Prentice-Hall.
  68. Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., Choo, F. N., Tran, B., Ho, R., Sharma, V. K., & Ho, C. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity, 87, 40-48. https://doi.org/10.1016/j.bbi.2020.04.028
  69. Worldometer. (n.d.). Countries where Coronavirus has spread. Retrieved February 23, 2023, from https://www.worldometers.info/coronavirus/countries-where-coronavirus-has-spread/
  70. Zhang, J., Zhu, L., Li, S., Huang, J., Ye, Z., Wei, Q., & Du, C. (2021). Rural-urban disparities in knowledge, behaviors, and mental health during COVID-19 pandemic: A community-based cross-sectional survey. Medicine, 100(13), e25207. https://doi.org/10.1097/md.0000000000025207
  71. Zhang, S. X., Miller, S. O., Xu, W., Yin, A., Chen, B. Z., Delios, A., Dong, R. K., Chen, R. Z., McIntyre, R. S., Wan, X., Wang, S., & Chen, J. (2022). Meta-analytic evidence of depression and anxiety in Eastern Europe during the COVID-19 pandemic. European Journal of Psychotraumatology, 13(1). https://doi.org/10.1080/20008198.2021.2000132
  72. Zhang, W., & Chen, X. (2023). Does 'class count'? The evolution of health inequalities by social class in early 21st century China (2002-2013). Critical Public Health, 33(1), 13-24. https://doi.org/10.1080/09581596.2022.2077700