Michal Shamai and Alisa C. Lewin
University of Haifa

Research funded by the Israel Ministry of Science and Technology

Goal: This study focuses on the way people living in poverty have coped with the challenges they encountered in face of the COVID 19 pandemic.  Four main areas were examined at two time points: 1) Emotional wellbeing, measured as levels of stress, anxiety, depression, and resilience. 2) Types of hardship and difficulties experienced (economic / social / family). 3) The specific need for services (welfare / health / education) and these services’ responsiveness (Social Security, Welfare, Health and Education Services). 4) Formal and informal sources of social support. In addition social workers from Departments of Social Services were asked how they perceived the pandemic’s impact on clients living in poverty.

People in Poverty

Method

Sample: Participants were recruited through departments of social services administration in the northern part of Israel. The first wave of data collection was carried out in May-June 2020, and included 88 participants.  This survey focused on  coping during the first lockdown. The second wave of data collection was carried out in August-September 2020, and included 82 participants (recruited from wave 1’s original sample).

Measurement Instrument: The questionnaire was delivered through telephone interviews. Most of the questions were identical in the two waves, to allow comparison and detect changes over time. The first questionnaire included the following topics: 1) Demographic information and background questions about work, income and hardships before the  pandemic and the lockdown. 2) Questions regarding work and income changes due to the pandemic and lockdown.  3) Types of  difficulties (financial / scial/ family) encountered during the lockdown. 4) Connection with formal and informal sources of support. 5) Type of help given by the Department of Social Services 6) Levels of stress (Anxiety and Depression) measured by BSI 7) Level of resilience, measured by CD-Risk 10 8) Levels of social support, measured by the Multidimensional Scale of Perceiver Social Support questionnaire (MSPSS). In the second wave we examined changes in all areas measured in the first wave.

Data Analysis: Data were analyzed using quantitative and qualitative (content analysis) methods. The quantitative data were analyzed using descriptive statistics of each one of the waves and comparisons between the two waves. In addition, we conducted multivariate analyses to examine the effect of material hardship (and changes in material hardship) on stress, anxiety, depression, and resilience. The qualitative data consisted of participants’ comments throughout the interview and their responses to open questions in the survey. These data were examined using content analysis that identifies both common themes as well as unique responses.

Results

The findings show that people in poverty experienced increased hardships following the COVID 19 pandemic and the crisis it created. . These hardships affected multiple (if not all) life spheres: 1. Household expenses increased: a) Lockdown policy restricted most household members to stay at home most of the time, leading to increased household expenses. For example, children from economically distressed families, who are usually entitled to a warm lunch at school, had to eat all meals at home during lockdown, increasing food expenditures.   In addition, parents commented that on an increase in the amount of food eaten during lockdown, and the consequent increase in food expenditures.  This increased expenditure created a hardship for families living in poverty who typically live on strict and small budgets, with fewer reserves upon which to draw in times of crisis.   b) Staying at home also increased the use of electricity and subsequent expenses. c) Reductions in uses and trains sometimes forced people living in poverty to use taxis, which are a very expensive alternative to public transportation, thus increasing their transportation expenses.  2) Income declined: People living in poverty usually work in less protected sectors, in types of jobs  that do not enable online work or work from home.   Instead, many work in low-skilled jobs in places that cut hours or closed entirely due to lockdown.   Thus, many of the study’s participants were fired or sent on temporary unpaid leave of absence. The combination of declining incomes and increasing expenses created stress and increased material and emotional hardship. These hardships also led to difficulties with partners and conflicts about financial issues.  3) Difficulties with children: a) for long periods during COVID 19 pandemic, most children had to stay at home.  Homes are usually small and crowded, with little privacy. b)  Many families did not have computers or internet connection therefore their children could not participate in online learning. This situation improved by the second wave because many children received computers. c) Many parents felt they did not have the skills to help their children with distance learning because of their low levels of education, others did not have time, either because they were at work, or they had other children to help, or other household chores to complete. Needless to say, people in poverty cannot afford help from private tutors . d) Many parents felt they did not have the means to keep the children occupied during the long hours they were at home. They commented they did not have enough board games or electronic games for their children. e) Some participants reported that they had to leave very young children in the care of older siblings who were still young themselves, in order to go to work. f) Participants reported that many conflicts with partners were centered on raising the children during this difficult period. 4) Mental health: a) People in poverty have significantly higher level of stress, anxiety and depression and lower level of resilience than Israel’s general population. Anxiety levels among people in poverty declined in the second wave, whereas it increased in the general population, so that the difference between the two groups became non-significant by the second wave.  Levels of depression among people in poverty remained high and stable, but it increased in the general population, so here too there was no significant difference between the groups by wave 2.    In contrast to the convergence in levels of anxiety and depression, the difference in levels of resilience between the two populations remained statistically significant. b) Our multivariate analyses show that the number of material hardships increases stress, anxiety and depression in the first and second waves. Our findings also show that enduring material hardship (inability to pay household expenses before and after COVID 19) is associated with higher levels of stress, anxiety and depression and lower levels of resilience compared to people who are able to pay for expenses and to people whose ability to pay for expenses declined following COVID 19. 

5) Request for help: a) People in poverty request support from both formal and informal sources. The highest percentage of the participants reported the Departments of Social Service as their primary source of support. b) Most participants reported full or partial satisfaction from the social workers’ help, the level of satisfaction being higher in the first wave than the second. c) Most participants requested material help, such as, food, clothes for children, computers and more. d) Many participants expected social workers to initiate phone calls to inquire about material difficulties and their psychological needs. Many participants compared the first and second lockdowns, claiming there was substantial decline in social workers' help over time.   

Conclusions

 1) Contrary to the claim that people living in poverty were not harmed by the COVID 19 crisis because they subsist of welfare grants, our findings show that the crisis increased hardship and introduced new difficulties. a) We found that work activity and incomes declined.  b) We found strong evidence that material hardship increased due to COVID 19.   c) Crowded living conditions and lack of computers led to difficulties in online learning and to conflicts with the children and partners among people living in poverty. 2) People living in poverty depended on Social Services Departments and NGO's for fulfilling their basic needs since the pandemic started even more than before. 3) Many people of poverty also needed emotional support, and most of them received it from their social workers. 4) Material hardship has detrimental effects of emotional wellbeing, and enduring, long-term material hardship is more detrimental than recent material hardship. The group with the highest level of stress, anxiety and depression and lower level of resilience on average consisted of those who had difficulty meeting household expenses before the crisis and since its beginning. Thus, we conclude that the long term constant need to cope with material hardships results in mental burnout that  reduces the ability to cope with additional and unexpected challenges, such as those created by the pandemic.

Social Workers

Method

Sample: Our sample consists of 40 family social workers, mainly from the northern part of Israel.

Measurement Instrument: A survey that gathered information on the following topics: 1) Perceptions of clients in poverty before and during the pandemic. 2) Types of help that clients requested. 3) Contact with clients during first lockdown, between lockdowns. 4) Specific directives received from Department of Social Services regarding contact with clients during the COVID 19 crisis.

Data Collection: The social workers who agreed to take part in the study filled out the online questionnaire.

Data Analysis: Data analysis included descriptive statistics that were enriched by the responses to the open questions.

Results

 The social workers’ perceptions of clients’ needs, functioning, and emotional state was similar to those reported by the people in poverty.  Social workers reported that they got instructions to initiate phone calls to their clients in poverty (as most of the people in poverty reported). They also reported the challenges they encountered in their professional capacity due to the conditions created by the pandemic.  Social workers reported being overworked preparing food packages, as well as tending to their usual work.  In addition, social workers who were parents of young children experienced difficulty finding childcare solutions. 

Conclusions

 1) There is a need to repeat and clarify instructions and directives during long- term crisis situations. 2) There is a need to provide support and child-care to social workers during long-term crisis periods.   3) Low skill jobs (such as preparing food packages) can be transferred from trained social workers who have caseloads to deal with, to low skilled workers who need the income.

Implications and Practical Recommendation 

• People in poverty have higher expenses following COVID-19, both during and after the lockdowns. Since they lack financial reserves, they find themselves facing financial difficulties within a very short time, and most do not seem to recover. Therefore, it is important to develop policy that takes this situation into consideration, to which the provision of food is not a complete answer. A financial grant is needed for this population, of a sum that is high enough to help them realistically meet their own and their children’s needs and to prevent further financial deterioration.
• The high emotional stress presented by people in poverty must be considered, since the significant impact of stress goes beyond mental health, affecting physical health as well. Social workers require direction to initiate contact with their clients to provide constant support and guidance regarding various stress-inducing issues. Social workers succeeded in achieving this partly during the first lockdown, but less so between lockdowns and during the second lockdown.
• People in poverty cannot be considered as one homogeneous group. The group that could never pay household expenses were at the highest risk for mental health issues and thus needs special attention during crises. They have no financial reserves and they experience long-term, enduring material hardship, which is associated with negative emotional outcomes.
• Social workers need training programs in special telephone or online intervention techniques, especially for reducing anxiety and for increasing problem-solving and resilience. In addition, family social workers need to develop appropriate plans to help parents cope with their children in the specific pandemic-induced crisis. It is of paramount importance that the children of families in poverty will not be harmed in the long-term, and will be able to close the schooling gap created by the crisis and will be able to access higher education that can open opportunities to exit poverty.