Money, Work and Mind: Socio-geographic Patterns of Financial Hardship and Psychological Distress in Urban Faisalabad and Rural Jaranwala, Pakistan

Abstract

Background: Economic strain has been widely linked with common mental disorders, but evidence from place-stratified household samples in Pakistan remains limited. This study examined how objective and perceived financial difficulties relate to symptoms of depression and anxiety among adults sampled from urban Faisalabad and rural Jaranwala, and whether associations varied by age, sex, marital status, education, employment and household income.

Methods: A household questionnaire-based survey (place-stratified) was administered to 1,010 adult respondents (aged ≥ 20 years). We used the Kessler K 6 scale (K 6 ≥ 5) to measure depression and the GAD—7 scale (GAD—7 ≥ 10) to measure anxiety. Financial exposures (potential risk) encompassed income bands (monthly), job loss during the COVID-19 pandemic, reported financial concerns/difficulties, and five items assessing perceived financial resilience. We calculated “crude odds ratios (COR)” and “adjusted odds ratios (AOR)” by employing multivariable logistic regression analysis, controlling for key socio-demographic covariates and testing place (urban/rural) effects.

Results: Generalized occurrence persisted at 31.3% for probable depression and 42.9% for probable anxiety. Financial difficulties were prevalent (approximately 75% reported at least one difficulty) and demonstrated significant correlations with both outcomes: greater objective hardship was associated with increased likelihood/odds of depression and anxiety following adjustment. Perceived financial or economic resilience served as a significant protective factor; depression adjusted odds ratios (AORs) ranged from ~0.05 to 0.10, while anxiety AORs ranged from ~0.42 to 0.60. Younger employed-age adults (20 to 45 years) exhibited significantly elevated adjusted odds of depression (AORs ≈ 4.9–6.3 compared to those over 50 years). Individuals employed in semi-governmental, private, or alternative sectors exhibited a heightened risk of depression compared to government employees (AORs ~ 1.6–3.7). Middle-income bands (25–100k PKR) showed higher adjusted depression odds compared with the lowest income group, and reporting financial difficulty during COVID-19 was associated with increased depression (AOR ≈1.67). Urban–rural differences were attenuated after adjustment, indicating that socio-economic conditions rather than place per se explain much variation.

Conclusions: In Faisalabad and Jaranwala, financial insecurity—both objective shocks and lack of perceived resilience—is tightly linked to psychological distress, particularly among young adults and workers in precarious jobs. Policy responses should combine economic supports (cash transfers, labor protections) with accessible, place-sensitive mental-health services (workplace programs, primary-care integration and telehealth) targeted to vulnerable subgroups.