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Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States

INTRODUCTION: While financial hardship has been consistently linked to psychological distress, little research exists on associations between financial hardship experienced during the pandemic and mental health. METHODS: We conducted a nationally representative, online survey of American Indian/Alas...

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Autores principales: Alhomsi, Alia, Strassle, Paula D., Ponce, Stephanie, Mendez, Izzy, Quintero, Stephanie M., Wilkerson, Miciah, Stewart, Anita L., Napoles, Anna M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mary Ann Liebert, Inc., publishers 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362911/
https://www.ncbi.nlm.nih.gov/pubmed/37483650
http://dx.doi.org/10.1089/heq.2022.0197
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author Alhomsi, Alia
Strassle, Paula D.
Ponce, Stephanie
Mendez, Izzy
Quintero, Stephanie M.
Wilkerson, Miciah
Stewart, Anita L.
Napoles, Anna M.
author_facet Alhomsi, Alia
Strassle, Paula D.
Ponce, Stephanie
Mendez, Izzy
Quintero, Stephanie M.
Wilkerson, Miciah
Stewart, Anita L.
Napoles, Anna M.
author_sort Alhomsi, Alia
collection PubMed
description INTRODUCTION: While financial hardship has been consistently linked to psychological distress, little research exists on associations between financial hardship experienced during the pandemic and mental health. METHODS: We conducted a nationally representative, online survey of American Indian/Alaska Native, Asian, Black/African American, Latino (English and Spanish speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults, 12/2020–2/2021 (n=5500). Six financial hardship domains were measured (lost income, debt, unmet expenses, unmet health care expenses, housing insecurity, and food insecurity). Psychological distress measures included anxiety-depression symptoms (Patient Health Questionnaire-4), perceived stress (modified Perceived Stress Scale), and loneliness-isolation (“In the past month, how often have you felt lonely and isolated?”). Associations between financial hardship and psychological distress were estimated using multinomial logistic regression. RESULTS: Overall, 70.3% of participants reported experiencing financial hardship (substantial hardship: 21.3%; some hardship: 27.4%; and a little hardship: 21.6%), with Spanish-speaking Latino (87.3%) and Native Hawaiian/Pacific Islander (79.2%) adults being most likely. Debt (57.6%), lost income (44.5%), and unmet expenses (33.7%) were the most common. There was a dose–response association between financial hardship and moderate/severe anxiety-depression symptoms (a little hardship: adjusted odds ratio [aOR]=1.42, 95% confidence interval [CI]=1.12–1.80; some hardship: aOR=3.21, 95% CI=2.58–3.98; and substantial hardship: aOR=8.15, 95% CI=6.45–10.29). Similar dose–response trends were observed with perceived stress and loneliness-isolation. No racial-ethnic difference in the association between financial hardship during the pandemic and psychological distress was seen. DISCUSSION: Financial hardship has had a major impact on psychological distress during the pandemic; moreover, while no racial-ethnic difference in the effect of financial hardship was observed, because racial-ethnic minorities experienced greater hardship, financial hardship may exacerbate psychological distress disparities.
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spelling pubmed-103629112023-07-23 Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States Alhomsi, Alia Strassle, Paula D. Ponce, Stephanie Mendez, Izzy Quintero, Stephanie M. Wilkerson, Miciah Stewart, Anita L. Napoles, Anna M. Health Equity Original Article INTRODUCTION: While financial hardship has been consistently linked to psychological distress, little research exists on associations between financial hardship experienced during the pandemic and mental health. METHODS: We conducted a nationally representative, online survey of American Indian/Alaska Native, Asian, Black/African American, Latino (English and Spanish speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults, 12/2020–2/2021 (n=5500). Six financial hardship domains were measured (lost income, debt, unmet expenses, unmet health care expenses, housing insecurity, and food insecurity). Psychological distress measures included anxiety-depression symptoms (Patient Health Questionnaire-4), perceived stress (modified Perceived Stress Scale), and loneliness-isolation (“In the past month, how often have you felt lonely and isolated?”). Associations between financial hardship and psychological distress were estimated using multinomial logistic regression. RESULTS: Overall, 70.3% of participants reported experiencing financial hardship (substantial hardship: 21.3%; some hardship: 27.4%; and a little hardship: 21.6%), with Spanish-speaking Latino (87.3%) and Native Hawaiian/Pacific Islander (79.2%) adults being most likely. Debt (57.6%), lost income (44.5%), and unmet expenses (33.7%) were the most common. There was a dose–response association between financial hardship and moderate/severe anxiety-depression symptoms (a little hardship: adjusted odds ratio [aOR]=1.42, 95% confidence interval [CI]=1.12–1.80; some hardship: aOR=3.21, 95% CI=2.58–3.98; and substantial hardship: aOR=8.15, 95% CI=6.45–10.29). Similar dose–response trends were observed with perceived stress and loneliness-isolation. No racial-ethnic difference in the association between financial hardship during the pandemic and psychological distress was seen. DISCUSSION: Financial hardship has had a major impact on psychological distress during the pandemic; moreover, while no racial-ethnic difference in the effect of financial hardship was observed, because racial-ethnic minorities experienced greater hardship, financial hardship may exacerbate psychological distress disparities. Mary Ann Liebert, Inc., publishers 2023-07-20 /pmc/articles/PMC10362911/ /pubmed/37483650 http://dx.doi.org/10.1089/heq.2022.0197 Text en © Alia Alhomsi et al., 2023; Published by Mary Ann Liebert, Inc. https://creativecommons.org/licenses/by/4.0/This Open Access article is distributed under the terms of the Creative Commons License [CC-BY] (http://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Alhomsi, Alia
Strassle, Paula D.
Ponce, Stephanie
Mendez, Izzy
Quintero, Stephanie M.
Wilkerson, Miciah
Stewart, Anita L.
Napoles, Anna M.
Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title_full Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title_fullStr Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title_full_unstemmed Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title_short Financial Hardship and Psychological Distress During the Pandemic: A Nationally Representative Survey of Major Racial-Ethnic Groups in the United States
title_sort financial hardship and psychological distress during the pandemic: a nationally representative survey of major racial-ethnic groups in the united states
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362911/
https://www.ncbi.nlm.nih.gov/pubmed/37483650
http://dx.doi.org/10.1089/heq.2022.0197
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