Impact of COVID Pandemic on Financial Burdens in Metro and Non-Metro Regions: Findings from a Cross-Sectional Survey.

Purpose: The impact of the COVID-19 pandemic on employment and various financial burden domains has not been well researched, particularly in vulnerable populations. This study examined the impact of the pandemic among those living in an Ohio metro county compared to a non-metro county on employment and financial concerns. Methods: We conducted a survey between June and November 2020 and collected participants' demographics, employment status, perceived financial status, and health-related conditions. Multivariable logistic regression models assessed the association between regions of residence (metro or non-metro) and various perceived financial concerns. Findings: Among the 6,123 respondents with complete data, the average age was 55.7 years, 67.2% were female, 87.1% were white non-Hispanic, and 30.2% lived in a non-metro county. Compared to those living in metro counties, non-metro respondents had significantly higher odds of reporting not having full- or part-time employment right before the start of the lockdown (aOR=1.24; 95% Cl 1.02-1.52) and significantly higher odds of being unpaid for a full- or part-time job (aOR=1.5; 95%C11.23-1.84) during the pandemic. Region of residence did not significantly differ in terms of employment loss or concern regarding financial outcomes. Conclusions: Although metro and non-metro residents did not differ in employment loss due to the COVID-19 pandemic, non-metro residents had a higher likelihood of not having a full- or part-time job prior to the pandemic and remained more likely to be unpaid during the pandemic. However, nonmetro residents reported fewer financial concerns, although statistically insignificant, highlighting potential differences in perception and cognitive processes.