Impact of the COVID-19 Pandemic on Physical and Mental Health in Lower and Upper Middle-Income Asian Countries: A Comparison Between the Philippines and China

Abstract

Objective: The differences between the physical and mental health of people living in a lower-middle-income country (LMIC) and upper-middle-income country (UMIC) during the COVID-19 pandemic was unknown. This study aimed to compare the levels of psychological impact and mental health between people from the Philippines (LMIC) and China (UMIC) and correlate mental health parameters with variables relating to physical symptoms and knowledge about COVID-19.Methods: The survey collected information on demographic data, physical symptoms, contact history, and knowledge about COVID-19. The psychological impact was assessed using the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety, and Stress Scale (DASS-21).Findings: The study population included 849 participants from 71 cities in the Philippines and 861 participants from 159 cities in China. Filipino (LMIC) respondents reported significantly higher levels of depression, anxiety, and stress than Chinese (UMIC) during the COVID-19 (p < 0.01) while only Chinese respondents' IES-R scores were above the cut-off for PTSD symptoms. Filipino respondents were more likely to report physical symptoms resembling COVID-19 infection (p < 0.05), recent use of but with lower confidence on medical services (p < 0.01), recent direct and indirect contact with COVID (p < 0.01), concerns about family members contracting COVID-19 (p < 0.001), dissatisfaction with health information (p < 0.001). In contrast, Chinese respondents requested more health information about COVID-19. For the Philippines, student status, low confidence in doctors, dissatisfaction with health information, long daily duration spent on health information, worries about family members contracting COVID-19, ostracization, and unnecessary worries about COVID-19 were associated with adverse mental health. Physical symptoms and poor self-rated health were associated with adverse mental health in both countries (p < 0.05).Conclusion: The findings of this study suggest the need for widely available COVID-19 testing in MIC to alleviate the adverse mental health in people who present with symptoms. A health education and literacy campaign is required in the Philippines to enhance the satisfaction of health information.

An investigation into the relationship between climate change anxiety and mental health among Gen Z Filipinos

“…According to Tee, Salido, et al (2020a), Filipinos reported moderate-to-severe feelings of anxiety, stress, and depression during the early phase of the pandemic. Another study supported this result, which concluded that Filipinos experience increased stress, anxiety, and depression than Chinese people (Tee et al, 2021). Various factors such as gender, age, marital status, occupation, experiencing physical symptoms (such as headache, coughs, and chills), quarantine, staying at home, negative cognitions about personal health and COVID-19, concern for relatives, and feeling discrimination from other countries influence stress and anxiety (Tee, Salido, et al, 2020a).…”

COVID-19: The Level of Knowledge, Anxiety and Symptom Presentation

“…Tee et al 31 have compared seven different middle-income countries in Asia and they have found similar risk factors for adverse mental health status. The protecting factors they have established also seemed to be similar within the seven countries.…”

A Comparative Study on the Psychological Health of Frontline Health Workers in Wuhan Under and After the Lockdown

“…In order to understand the psychological impact caused by the COVID-19 outbreak, the PHQ-9, and GAD-7 scales were used to measure the symptom severity of depression, and anxiety, respectively. In addition, we used IES-R (a 22-item selfreported scale describing avoidance, intrusion, and hyperarousal symptoms after a traumatic event) to assess the subjective stress caused by the specific event of COVID-19 (16)(17)(18)(19). The total scores of these measuring tools were categorized as follows: PHQ-9, normal (0-4), mild (5)(6)(7)(8)(9), moderate (10)(11)(12)(13)(14), and severe (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) depression; GAD-7, normal (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), and severe (15)(16)(17)(18)(19)(20)(21) anxiety; and IES-R, normal (0-8), mild (9)(10)(11)(12)(13)(14)…”