Economic and psycho-social stressors associated with unintentional injuries during COVID-19 in South Africa

The COVID-19 pandemic strained global health systems and disrupted daily life. In South Africa, where unintentional injury rates are high, lockdown measures introduced stressors such as confinement, financial hardship and psychological strain that may have increased injury risk. This study examined how adherence to stay-at-home restrictions, financial stress and psychological distress during South Africa's COVID-19 lockdown were associated with reports of household members being injured and requiring medical treatment. Data were drawn from a province-stratified computer-assisted telephone interview survey conducted from December 2020 to March 2021. The study used a cross-sectional design and included 1854 adults. Logistic regression estimated adjusted associations. Overall, 6.3% of respondents reported an injury in the household. In bivariate analyses, reports of injury were more frequent with higher poverty, financial distress and psychological distress and less frequent among household heads and those living in other dwelling types. In the multivariable model, financial distress remained associated with higher odds of reporting a household injury, while household headship and residence in dwellings other than a formal house were associated with lower odds. Injuries requiring medical treatment during lockdown were linked to economic strain, highlighting the need for financial and contextual injury-prevention support during public health emergencies.