Risk factors of family stress during the COVID-19 pandemic in Urban Kazakhstan: A Secondary Analysis of the Cross-Sectional Survey Data

Abstract

The COVID-19 outbreak introduced serious stressors affecting family wellbeing worldwide. Kazakhstan, like major middle-income countries, faced with significant psychological troubles, namely family stress as an independent outcome, lacks sufficient research in Central Asia. This study observes individual, household and coronavirus 2019 related risk factors associated with stress in family during the COVID 19 in Kazakhstan. A secondary data analysis of the population-based cross-sectional cell phone survey conducted in two megapolises (Astana and Almaty) among populations aged 18-75 years, in 2020. Chi squared and Fisher’s exact tests were used for bivariate analysis and Poisson regression with robust variance were applied during the multivariate analysis to identify statistically significant predictors of high family stress (p<0.05). The study sample was mainly females (59.85%), with a mean age of 34 years; majority of participants were Kazakhs (70.5%), married/cohabiting (54.85%) and living in Almaty city (55%). The multivariate Poisson regression with robust variance identified six independent factors: young generation (18-24) had higher family stress (IRR= 1.73, 95% CI:1.11-2.73), having a depressive symptoms were strongly associated with family distress (IRR=2.99, 95% CI:1.54-5.81), low household income increased stress in family (IRR= 1.57, 95% CI: 1.12-2.20), sufficient money for food reduced stress within a household (IRR=0.75, 95% CI:0.56-0.99), children in distance learning elevated stress (IRR=1.40, 95% CI: 1.05-1.88) and having friends/coworkers diagnosed with coronavirus associated with lower family stress (IRR=0.69, 95%CI: 0.51-0.92). Moreover, significant interaction among the 35-44 age group with depressive symptoms (IRR=2.8, 95% CI: 1.21-6.49) showed an amplified effect of mental stress in middle-aged adults. This research is the first quantitative study of family stress as a main outcome during the coronavirus 2019 pandemic in Kazakhstan. Stress in urban families was associated with socioeconomic vulnerability, mental wellbeing, pandemic related changes rather than direct infection. The main predictors included depressive symptoms, insufficient money for food, low family income, pupils in online schooling and young adult age. Findings underline the necessity of financial help, available mental health services, and policies to mitigate educational burdens, supporting the household level outcomes in national psychological well-being strategies and emergency readiness.