Document Type : Original Article
Authors
1
Centre for Healthy Communities, School of Public Health, University of Alberta, Edmonton, AB, Canada
2
PolicyWise for Children & Families, Edmonton, AB, Canada
3
Centre for Health Equity Training Research & Evaluation (CHETRE), University of New South Wales, Sydney, NSW, Australia
4
Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW, Australia
5
Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
6
School of Social Sciences, University of New South Wales, Sydney, NSW, Australia
Abstract
Background
Rapid, strategic action is required to mitigate the negative and unequal impact of the coronavirus disease 2019 (COVID-19) pandemic on the financial well-being (FWB) of global populations. Personal financial strain (FS) worsened most significantly among systematically excluded groups. Targeted government- and community-led initiatives are needed to address these inequities. The purpose of this applied research was to identify what works for whom, under what conditions, and why in relation to community and government initiatives that promote personal and household FWB and/or address FS in high income economies.
Methods
We employed a critical realist analysis to literature that reported on FWB/FS initiatives in high income countries. This included initiatives introduced in response to the pandemic as well as those that began prior to the pandemic. We included sources based on a rapid review. We coded academic, published literature (n = 39) and practicebased (n = 36) reports abductively to uncover generative mechanisms – ie, underlying, foundational factors related to community or government initiatives that either constrained and/or enabled FWB and FS.
Results
We identified two generative mechanisms: (1) neoliberal ideology; and (2) social equity ideology. A third mechanism, social location (eg, characteristics of identity, location of residence), cut across the two ideologies and demonstrated for whom the initiatives worked (or did not) in what circumstances. Neoliberal ideology (ie, individual responsibility) dominated initiative designs, which limited the positive impact on FS. This was particularly true for people who occupied systematically excluded social locations (eg, low-income young mothers). Social equity-based initiatives were less common within the literature, yet mostly had a positive impact on FWB and produced equitable outcomes.
Conclusion
Equity-centric initiatives are required to improve FWB and reduce FS among systemically excluded and marginalized groups. These findings are of relevance now as nations strive for financial recovery in the face of the ongoing global pandemic.
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