Listening to Young Lives at Work Covid-19 Phone Survey: First Call shows widening inequality

With the virtual fieldwork just completed on our second Covid-19 phone survey, we reflect on seven key findings from the first call that point to widening inequality. 

Young Lives at Work adapted to the coronavirus situation to implement a Covid-19 phone survey about the pandemic's short and medium term impacts. You can read more about Young Lives' response to the pandemic here and here. In June, we wrote about the design of the first call and what we were hoping to find out.  After virtual training in four countries, seven weeks of on-line fieldwork, almost 40,000 phone calls, data cleaning, coding, merging, and preliminary analysis, the headline reports of our first Covid-19 Phone survey were released in August and the data are available here.  In this blog we share our approach to the first call and key findings. 

We interviewed a total of 9,541 individuals in the Older and Younger Cohorts, reaching almost 91% of those who we were aiming to reach (see our attrition report here).  We discovered seven common findings, as well as key differences between the four countries, Ethiopia, India, Peru and Vietnam (below). The crisis is impacting the poorest most severely and widening inequalities, with poorer people less able to protect themselves, get information, work from home or stay in education.


Seven Findings from the Young Lives at Work Covid-19 Phone Survey

 

1. Poverty and a lack of information has impacted people’s ability to take precautionary measures against Covid-19 infection, especially in Ethiopia.

2. The economic effects of lockdown policies have been more significant than the health impacts to date - although many households in Peru and India are likely to have been exposed to Covid-19.

3. Across all countries, except Vietnam, many young people are going hungry. Although government support is well targeted, it is not sufficient in Peru and Ethiopia.

4. Remote working has been the exception, not the rule. Job losses or suspension without pay are widespread, even in Vietnam, the least affected country.

5. Education of 19-year-olds, in all countries, has been severely disrupted while access to online learning has been highly unequal.

6. Caring responsibilities increased for 25-year-olds with the burden still tending to fall on young women most of all.

7. Levels of anxiety about the current situation are high, especially in India​.

Poverty and a lack of information impact people’s ability to take precautionary measures against Covid-19 infection

According to the WHO, the most common symptoms associated with COVID-19 are a dry cough, fever, and tiredness. Public information in each country has emphasized a list of symptoms which overlap with this but there are some differences (e.g. in Peru difficulty breathing is highlighted on the official government website). Most respondents were able to identify at least two of the symptoms, and those with internet access were most likely to be informed. 

We asked respondents about the five behaviours which are widely recommended as a means of preventing infection: social distancing, washing hands more frequently, avoiding handshakes or physical greetings, avoiding groups and wearing protective gear when outside. Only slightly more than half (56%) of the Ethiopia sample adhered to all five, rising to 69% in Vietnam, 72% in India and 84% in Peru. Those with internet access or residing in urban areas showed a higher degree of compliance with these measures, and overall, females tended to comply more than males. In Peru, social distancing is the behavior with the least adherence, especially among vulnerable households.

We also assessed the resources available in households to comply with the World Health Organization's (WHO) recommendations on self-isolation, through an adapted version of the Home Environment for Protection Index (HEP) developed by Brown et al., 2020. The HEP measures the ability to receive reliable information on virus protection and the presence of available space and facilities suitable for implementing social distancing within the household.  

Young Lives Households: Home Environment for Protection


 

Information/ communication device

2 or less people per room

Household toilet

Household piped water

HEP score all indices

Ethiopia

0.58

0.40

0.59

0.32

0.47

India

0.97

0.62

0.52

0.24

0.59

Peru

0.98

0.73

0.96

0.89

0.89

Vietnam

0.99

0.78

0.87

0.38

0.76

Notes: Proportion of households. Adapted from Brown et al, 2020. Detail on the Young Lives HEP index can be found here.

Peru and Vietnam have relatively high averages for the protective index, but in Ethiopia, under a third have access to a piped water source, and the number of people sharing a room also makes it difficult to implement self-isolation when someone is believed to be infected with Covid-19. We find that young people who are the most vulnerable, are living in households with lower protection. Households in the higher HEP group (who are wealthier, on average) are also more likely to follow all behaviours, relative to those in the lower HEP group. 

A cause for concern is the number of those employing ineffective (though benign) preventative measures. A large number reported eating garlic or ginger to protect themselves against the virus, as well as drinking lemon, or adding hot pepper to food to prevent infection.

So far, the health impact of the crisis has been higher in Peru and India than in Ethiopia and Vietnam. In both Peru and India, approximately 6% believed someone in their household had been infected. In contrast, this figure was fewer than 1% in Ethiopia, and almost zero in Vietnam. Whilst our sample are not representative of the national populations, the rates do reflect the situation in each country. Of those who were believed to be infected in Peru and India, only around one-in-three were tested for the virus in both countries.

Many young people are going hungry in all countries except Vietnam: although government support is well targeted it is not sufficient in Peru and Ethiopia. 

The crisis has impacted food security in Vietnam notably less than in the other countries. One in six Young Lives households in Peru, India, and Ethiopia reported running out of food at some point since the beginning of the crisis. This percentage was even larger among households that faced food shortages (food insecurity) in our last visit in 2016 (about twice as high in India). In Vietnam, the overall proportion was much lower, at 4%.

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Source: Young Lives COVID-19 phone survey. We defined food insecure households as those reporting “sometimes do not eat enough” or “frequently do not eat enough” and food secure households those reporting “eating enough but not always what they would like” or “eat enough of what we want”.

Government assistance has reached our respondents to very different degrees. About 92% of the households in India received at least one form of support from the government during the lockdown, although in many cases the support consists of a small basket of food or face masks.  This compares to around half of those in Peru, falling to just 6% in Ethiopia. In all countries it was relatively well targeted, reaching proportionately more of those households that reported food insecurity in a previous visit. However, in Peru the proportion of the most vulnerable households that received a direct cash transfer was far from universal. This could signal either a targeting problem, a delay in payments, or both. Moreover, the size of the transfer appears insufficient (as its value corresponds to about 82% of a minimum wage per family for the entire period).  

Job losses or suspension without pay are widespread even in Vietnam, the least affected country, and remote working is the exception rather than the rule

Many of our 25-year-old respondents lost their jobs. This was particularly severe for respondents who had been informal workers with no written contract in our last visit. In Peru and India, 7 out of 10 respondents had reduced or lost their source of income due to lockdown, 6 in 10 in Vietnam, and 4 in 10 in Ethiopia.  A concentration of income losses among those in the informal sector is an indication of this group’s additional vulnerability to the economic consequences associated with the pandemic. However, it is important to state that everyone, even those who were formal workers prior to the crisis, was severely affected.

The proportion of those who lost income or employment was also relatively higher in urban areas compared to rural areas and a higher proportion of males experienced these losses in both locations. 

Remote working has been possible only for a lucky minority of 25-year-old workers living in urban areas. The highest proportion (28%) in India were able to work from home during the outbreak, falling to 20% in Vietnam, 18% in Ethiopia and 17% in Peru. The percentage is much higher within households who are better equipped for protective measures against Coronavirus (High-HEP). Presumably, this is due to the availability of better infrastructure (e.g. access to internet, computer ownership) and the nature of the work activities performed. 

Education of 19-year olds in all countries has been severely disrupted and access to online learning has been highly unequal

With schools and universities closed very early on in the outbreak in all countries, the interruption to education was striking. Inequalities in those whose studies were interrupted are clear both across countries, gender and wealth. Access to study from home was slightly higher for females than males in all countries, and wealth and parental education almost doubled the chances of being able to study at home. In Vietnam, the vast majority of our 19-year-old cohort (almost 90%) accessed remote learning, falling to 70% in Peru, and 38% in India. In contrast, only 28% in Ethiopia continued to learn remotely, this fell to 14% if their parents had no education. 

This echoes the findings of another Young Lives study that interviewed headteachers in Ethiopia and India, see here for more information

Caring responsibilities increased for 25-year olds and the burden still tends to fall on young women

Although slightly more 19 year-old women have been able to continue their studies online, wide disparities are clear when looking at caring. In all countries except Peru, more than double the number of young women, relative to young men, have had to take on extra caring responsibilities during the lockdown.  The disparity is particularly striking in India and Ethiopia.

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Source: Young Lives COVID-19 phone survey.

Levels of anxiety about the current situation are high, especially in India

How is this impacting on young people’s stress levels? We asked respondents whether the statement "I am nervous when I think about current circumstances" applies to them. We found that stress levels are worryingly high – in India more than 90% of all the young people indicated it applied or strongly applied to them. In Vietnam and Ethiopia 65% agreed with these statements. Peru had surprisingly the lowest anxiety levels, with just under 50% feeling nervous. In the second call we have asked more detailed questions about mental health based on validated scales.

What happens next? 

The data are available on open access (see here).  Due to the nature of the confidentiality agreement that Young Lives has with the families, the datasets are anonymized, and information on geographical location is limited. 

The second call fieldwork has now been completed. We will release headline findings in November. This second phone call has gone into more depth about young people’s labour market experiences, to understanding the medium-term impacts of the pandemic on their work life, their home life, and their education. More specifically, it contains information on the household socio-economic status, food security, labour, education, time use, health (including mental health) - the main themes of the YL survey that can be implemented over the phone.

This is a longer version of our blog first published in The Conversation in August, here.  Follow us on Twitter @yloxford for news on Young LIves at Work.