Material hardship, perceived stress, and health in early adulthood

PURPOSE: We examined the associations between material hardship and health outcomes in early adulthood and the extent to which these associations are mediated by perceived stress. METHODS: We used wave I and IV of the National Longitudinal Study of Adolescent Health, a nationally representative survey of young adults aged 18–34 years old (n = 13,313). Multivariate logistic regression and decomposition methods were used to evaluate the associations between types and depth of material hardship (food, bill-paying, and health resource hardship), health outcomes (self-rated health, depression, sleep problems, and suicidal thoughts) in early adulthood, and the extent to which these associations were mediated by perceived stress. RESULTS: The adjusted odds of fair or poor health status, depression, sleep problems, and suicidal thoughts were higher among individuals with material hardship than counterparts without. A considerable proportion of the association between material hardship and health outcomes was attributable to perceived stress. CONCLUSIONS: Material hardship is associated with adverse health outcomes in early adulthood, and these relationships are robust after accounting for various sociodemographic characteristics and family background. Perceived stress accounted for a sizable portion of the effects of material hardship on health. PUBLIC HEALTH IMPLICATIONS: Efforts to promote health equity in young adults should focus on material hardship and associated stressful conditions.