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Improving the Epidemiological Understanding of the Dynamic Relationship Between Life Course Financial Well-Being and Health

  • Samuel L. SwiftEmail author
  • Zinzi Bailey
  • Adina Zeki Al Hazzouri
Social Epidemiology (A Aiello, Section Editor)
  • 8 Downloads
Part of the following topical collections:
  1. Topical Collection on Social Epidemiology

Abstract

Purpose of Review

We posit that there are many different measures of financial well-being such as income, debt, assets, and wealth, which may have different consequences for health at different times in the life course. We frame our discussion of financial well-being within existing theories and mechanisms by which financial well-being may influence health.

Recent Findings

We contrast the influences of “snap shot” or one point in time measures of financial well-being with those of repeated measures of financial well-being across the life course. Reviewing recent research, we show the importance of measures apart from income in understanding how financial well-being influences health.

Summary

We argue that because financial well-being is multidimensional, the salient effect of financial well-being on health may not be captured by only focusing on singular aspects of this construct. We believe that there is an impetus on epidemiologists to embrace the multidimensionality of financial well-being, which will, in turn, improve public health practice and inform health policy in a more consequentialist manner.

Keywords

Epidemiological methods Financial well-being Income Social determinants of health 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Case A, Lubotsky D, Paxson C. Economic status and health in childhood: the origins of the gradient. Am Econ Rev. 2002;92(5):1308–34.CrossRefGoogle Scholar
  2. 2.
    Baird S, De Hoop J, Özler B. Income shocks and adolescent mental health. J Hum Resour. 2013;48(2):370–403.Google Scholar
  3. 3.
    Feinglass J, Lin S, Thompson J, Sudano J, Dunlop D, Song J, et al. Baseline health, socioeconomic status, and 10-year mortality among older middle-aged Americans: findings from the health and retirement study, 1992–2002. J Gerontol Ser B Psychol Sci Soc Sci. 2007;62(4):S209–17.CrossRefGoogle Scholar
  4. 4.
    Knapp EA, Dean LT. Consumer credit scores as a novel tool for identifying health in urban U.S. neighborhoods. Ann Epidemiol. 2018;28(10)724–29.Google Scholar
  5. 5.
    • Golberstein E. The effects of income on mental health: evidence from the social security notch. J Ment Health Policy Econ. 2015;18(1):27 Using an instrument variable approach, this analysis examines the influence of a large increase in financial well-being in the form of a larger pension in later life. In this analysis, the author examined increases in pensions due to a change in Social Security Policy in the USA and the influence of this change on late life mental health outcomes. This analysis provides a good example of how exogenous variations in measures of financial wellbeing cold be leveraged, allowing researchers to make stronger causal inferences. PubMedPubMedCentralGoogle Scholar
  6. 6.
    Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;35:80–94.CrossRefGoogle Scholar
  7. 7.
    Glymour MM, Avendano M, Kawachi I. Socioeconomic status and health. Soc Epidemiol. 2014;2:17–63.Google Scholar
  8. 8.
    Diez-Roux AV, Link BG, Northridge ME. A multilevel analysis of income inequality and cardiovascular disease risk factors. Soc Sci Med. 2000;50(5):673–87.CrossRefGoogle Scholar
  9. 9.
    Basu S. Income volatility: a preventable public health threat. Am J Public Health. 2017;107(12):1898–9.CrossRefGoogle Scholar
  10. 10.
    Wolff EN. Recent trends in household wealth, 1983–2009: the irresistible rise of household debt. Rev Econ Inst. 2010;2(1).Google Scholar
  11. 11.
    Bricker J, Dettling LJ, Henriques A, et al. Changes in US family finances from 2013 to 2016: evidence from the survey of consumer finances. Fed Reserv Bull. 2017;103:1.Google Scholar
  12. 12.
    Dynan K, Elmendorf D, Sichel D. The evolution of household income volatility. BE J Econ Anal Policy. 2012;12(2).Google Scholar
  13. 13.
    Halpern-Meekin S, Greene SS, Levin E, Edin K. The rainy day earned income tax credit: a reform to boost financial security by helping low-wage workers build emergency savings. RSF. 2018.Google Scholar
  14. 14.
    DeSilver D. For most workers, real wages have barely budged for decades: Pew Research Center; 2014. p. 9.Google Scholar
  15. 15.
    • Chetty R, Grusky D, Hell M, Hendren N, Manduca R, Narang J. The fading American dream: trends in absolute income mobility since 1940. Science. 2017;356(6336):398–406 The authors show that despite an increasing Gross Domestic Product within the USA, intergenerational mobility has declined steadily since the 1940s. This trend has implications for the worsening of health outcomes related to lower financial well-being status. CrossRefGoogle Scholar
  16. 16.
    Kahn K. Reconecting work and wealth: a report from the 2017: Aspen Institute Economic Security Summit. Aspen Institute; 2018.Google Scholar
  17. 17.
    Kawachi I, Adler NE, Dow WH. Money, schooling, and health: mechanisms and causal evidence. Ann N Y Acad Sci. 2010;1186(1):56–68.CrossRefGoogle Scholar
  18. 18.
    James SA. John Henryism and the health of African-Americans. Cult Med Psychiatry. 1994;18(2):163–82.CrossRefGoogle Scholar
  19. 19.
    McEwen BS, Seeman T. Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci. 2006;896(1):30–47.CrossRefGoogle Scholar
  20. 20.
    Subramanyam M, Kawachi I, Berkman L, Subramanian S. Relative deprivation in income and self-rated health in the United States. Soc Sci Med. 2009;69(3):327–34.CrossRefGoogle Scholar
  21. 21.
    Berkman LF, Kawachi I, Glymour MM. Social epidemiology: Oxford University Press; 2014.Google Scholar
  22. 22.
    Corak M. Income inequality, equality of opportunity, and intergenerational mobility. J Econ Perspect. 2013;27(3):79–102.CrossRefGoogle Scholar
  23. 23.
    Kendzor DE, Caughy MO, Owen MT. Family income trajectory during childhood is associated with adiposity in adolescence: a latent class growth analysis. BMC Public Health. 2012;12(1):611.CrossRefGoogle Scholar
  24. 24.
    Tali E, Swift SL, Maria Glymour M, Calonico S, Jacobs DR, Jr, Mayeda ER, Kershaw KN, Kiefe C, Al Hazzouri AZ. Associations of Income Volatility with Incident Cardiovascular Disease and All-cause Mortality in a US cohort: 1990 to 2015. Circulation 2019.Google Scholar
  25. 25.
    Brody GH, Yu T, Chen E, Miller GE, Kogan SM, Beach SRH. Is resilience only skin deep? Rural African Americans’ preadolescent socioeconomic status-related risk and competence and age 19 psychological adjustment and allostatic load. Psychol Sci. 2013;24(7):1285–93.CrossRefGoogle Scholar
  26. 26.
    Duncan GJ, Ziol-Guest KM, Kalil A. Early-childhood poverty and adult attainment, behavior, and health. Child Dev. 2010;81(1):306–25.CrossRefGoogle Scholar
  27. 27.
    Willson AE, Shuey KM, Glen H, Elder J. Cumulative advantage processes as mechanisms of inequality in life course health. Am J Sociol. 2007;112(6):1886–924.CrossRefGoogle Scholar
  28. 28.
    McDonough P, Berglund P. Histories of poverty and self-rated health trajectories. J Health Soc Behav. 2003;44:198–214.CrossRefGoogle Scholar
  29. 29.
    • Willson AE, Shuey KM. Life course pathways of economic hardship and mobility and midlife trajectories of health. J Health Soc Behav. 2016;57(3):407–22 The authors examined trajectories of financial well-being and their relationship with self-rated health later in life. They found that leaving situations of economic hardship in earlier life was associated with better self-rated health in midlife than staying in economic hardship across the life course, supporting a cumulative advantage hypothesis for financial well-being and health. CrossRefGoogle Scholar
  30. 30.
    Al Hazzouri AZ, Elfassy T, Sidney S, Jacobs D, Yaffe K. Sustained economic hardship and cognitive function: the coronary artery risk development in young adults study. Am J Prev Med. 2017;52(1):1–9.CrossRefGoogle Scholar
  31. 31.
    Mohanan M. Causal effects of health shocks on consumption and debt: quasi-experimental. Rev Econ Stat. 2013;95(2):673–81.CrossRefGoogle Scholar
  32. 32.
    Angelucci M, Attanasio O, Di Maro V. The impact of Oportunidades on consumption, savings and transfers*. Fisc Stud. 2012;33(3):305–34.CrossRefGoogle Scholar
  33. 33.
    Hoynes H, Miller D, Simon D. Income, the earned income tax credit, and infant health. Am Econ J Econ Pol. 2015;7(1):172–211.CrossRefGoogle Scholar
  34. 34.
    Mani A, Mullainathan S, Shafir E, Zhao J. Poverty impedes cognitive function. Science. 2013;341(6149):976–80.CrossRefGoogle Scholar
  35. 35.
    Guo G. The timing of the influences of cumulative poverty on children’s cognitive ability and achievement. Soc Forces. 1998;77(1):257–87.CrossRefGoogle Scholar
  36. 36.
    •• Marden JR, Tchetgen Tchetgen EJ, Kawachi I, Glymour MM. Contribution of socioeconomic status at 3 life-course periods to late-life memory function and decline: early and late predictors of dementia risk. Am J Epidemiol. 2017;186(7):805–14 This research examines the association between measures of socioeconomic status and financial well-being at different times in the life course and late life memory function and decline. This analysis illustrates a potential strategy for examining the relationship between financial well-being and health within the life course context using marginal structural models to account for time-dependent confounding related to the longitudinal nature of these exposures. CrossRefGoogle Scholar
  37. 37.
    • Dean LT, Schmitz KH, Frick KD, et al. Consumer credit as a novel marker for economic burden and health after cancer in a diverse population of breast cancer survivors in the USA. J Cancer Surviv. 2018;12(3):306–15 Shows the relationship between consumer credit scores and self-rated health among cancer patients post diagnosis while adjusting for other measures of financial well-being. The authors found that increases in consumer credit scores were associated with increases in self-rated health, showing the utility of the consumer credit score, which tracks a different aspect of financial wellbeing than income. CrossRefGoogle Scholar
  38. 38.
    Sweet E, Nandi A, Adam EK, McDade TW. The high price of debt: household financial debt and its impact on mental and physical health. Soc Sci Med. 2013;91:94–100.CrossRefGoogle Scholar
  39. 39.
    Charters TJ, Harper S, Strumpf EC, Subramanian S, Arcaya M, Nandi A. The effect of metropolitan-area mortgage delinquency on health behaviors, access to health services, and self-rated health in the United States, 2003–2010. Soc Sci Med. 2016;161:74–82.CrossRefGoogle Scholar
  40. 40.
    Galea S. An argument for a consequentialist epidemiology. Am J Epidemiol. 2013;178(8):1185–91.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Samuel L. Swift
    • 1
    • 2
    Email author
  • Zinzi Bailey
    • 3
  • Adina Zeki Al Hazzouri
    • 1
  1. 1.Division of Epidemiology, Department of Public Health SciencesUniversity of MiamiMiamiUSA
  2. 2.Division of Epidemiology and Populations Health Sciences, Department of Public Health SciencesUniversity of Miami Miller School of MedicineMiamiUSA
  3. 3.Jay Weiss Institute for Health Equity, Sylvester Comprehensive Cancer CenterUniversity of MiamiMiamiUSA

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