Salinity and Livelihoods: Dermatological Health Challenges in Coastal Bangladesh

Salinity intrusion in coastal Bangladesh presented critical challenges to both health and livelihoods, particularly in communities reliant on saline-exposed water sources and occupations. This study investigated how environmental salinity exposure and related socio-demographic and resilience factors influenced dermatological health outcomes in coastal Bangladesh. A cross-sectional survey of 400 randomly selected households was conducted in Gabura Union, Shyamnagar subdistrict, complemented by seven focus group discussions (FGDs) to triangulate findings. Probit regression analysis revealed that using unsafe drinking water (45.2%, p < 0.001), living more than 1 km from a safe source (17.1%, p < 0.001), and working in salinity-linked occupations (14.3%, p < 0.001) significantly increased the likelihood of reporting skin disease. Notably, higher coping capacity was also associated with an increased probability of skin disease (2.3%, p< 0.05), which appeared counterintuitive. While gender was significant in the bivariate analysis, it did not remain significant in the multivariate model. However, FGDs and KIIs supported the overall findings, highlighting occupational exposure, water insecurity, and gendered vulnerabilities as key contributors to dermatological health risks. Although the study revealed important associations, its cross-sectional design and reliance on self-reported symptoms limited causal inference and biochemical specificity. The findings underscore the urgent need for comprehensive policy measures that advance sustainable water resource management, promote alternative livelihood strategies, and strengthen access to dermatological healthcare in coastal communities.