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Talamonti D, Schneider J, Gibson B, Forshaw M. The impact of national and international financial crises on mental health and well-being: a systematic review. J Ment Health 2023:1-38. [PMID: 37934869 DOI: 10.1080/09638237.2023.2278104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/03/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Evidence suggests that financial crises and poor mental health are reciprocally related, but no systematic review has been conducted to synthesise the existing literature on the impact of national and international financial crises on population-level mental health and well-being. AIMS The aim of this study was to systematically review the available literature on the global impact of financial crises on mental health and well-being outcomes. METHODS After registration on PROSPERO, a systematic search was conducted in PsycINFO, MEDLINE, Wiley, and Web of Science for papers published until 21 November 2022. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement, 98 papers were identified as meeting eligibility criteria. Included studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and results were presented in a formal narrative synthesis. RESULTS Our findings show that financial crises are significantly associated with well-being and occurrence of psychological conditions. Several socio-demographic, cultural, and country-specific characteristics played a crucial role in the prevention of population mental health decline in periods of financial crises. CONCLUSIONS Based on the findings of this review, evidence-based recommendations were developed to guide the design of policy actions that protect population mental health during and after financial crises.
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Affiliation(s)
- Deborah Talamonti
- AXDEV Group Inc, Québec, Canada
- Université de Montréal, Montreal, Canada
| | - Jekaterina Schneider
- Centre for Appearance Research, School of Social Sciences, College of Health, Science and Society, University of the West of England, Bristol, UK
| | - Benjamin Gibson
- Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Mark Forshaw
- Department of Psychology, Edge Hill University, Ormskirk, UK
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2
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Kirsch JA, Coe C, Ryff CD. Racial and Educational Disparities in Cumulative Exposure to Hardships of the 2008 Great Recession and Inflammation. Psychosom Med 2023; 85:699-709. [PMID: 37506298 PMCID: PMC10543484 DOI: 10.1097/psy.0000000000001233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
OBJECTIVE This cross-sectional analysis examined self-reported economic hardships of the 2008 Great Recession, race/ethnicity, educational attainment, and psychological well-being (PWB) as predictors of systemic inflammatory physiology at midlife. We also tested for differential vulnerability in the relationship between recession hardship and inflammatory physiology by race/ethnicity, education, and PWB. METHODS Adults from the Midlife in the United States Refresher sample completed a survey and biomedical assessments after the recession ( n = 592 non-Hispanic White respondents, n = 158 Black/African American respondents, n = 108 respondents with other race/ethnicity). Cumulative recession hardship was the sum of financial, housing, and employment-related events. Outcomes included circulating levels of interleukin 6 and C-reactive protein. General linear regression models tested main effects interactions between primary predictor variables. RESULTS Educational attainment was inversely associated with recession hardships ( b = -0.18, 95% confidence interval = -0.26 to -0.11, p < .001). Black/African American respondents reported more recession hardships than White respondents ( b = 1.17, 95% confidence interval = 0.67 to 1.68, p < .001). More recession hardships predicted higher levels of interleukin 6 ( b = 0.06, p < .001) and C-reactive protein ( b = 0.04, p = .004). Analyses did not support race/ethnicity, education, and PWB as moderators of the association between recession hardship and inflammatory markers. CONCLUSIONS Race/ethnicity and education independently predicted disparities in cumulative recession hardship exposure. Recession hardship predicted higher blood levels of inflammatory proteins associated with long-term health. The lack of findings for differential vulnerability in the relationship between recession hardship and inflammatory markers by race/ethnicity, education, or PWB was possibly due to the limited sample size.
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Affiliation(s)
- Julie A. Kirsch
- Department of Family Medicine and Community Health and the Center for Tobacco Research and Intervention, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison
| | - Christopher Coe
- Harlow Center for Biological Psychology, University of Wisconsin-Madison
| | - Carol D. Ryff
- Department of Psychology and the Institute on Aging, University of Wisconsin-Madison
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3
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Alam SA, Bose B. The Great Recession and Physical Activity of Young Adults. Am J Lifestyle Med 2023; 17:290-298. [PMID: 36896032 PMCID: PMC9989492 DOI: 10.1177/15598276211008400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 02/07/2021] [Accepted: 03/19/2021] [Indexed: 11/15/2022] Open
Abstract
Objective. Since physical inactivity has been identified as a pandemic and a public health priority, it is crucial to understand the role of adverse economic shocks on physical activity. In this study, we examine the impact of job losses during the U.S. Great Recession from January 2008 to June 2009 on the likelihood of physical activities of young adults. Methods. We use individual fixed effects estimation on a nationally representative longitudinal data from 2005 to 2015, the Panel Study of Income Dynamics (PSID), to examine the impact of job losses of young adults, their spouses, and their parents on physical exercise of young adults aged 18 to 27 years. Results. Own job losses during the Great Recession led to a decrease in the likelihood of physical exercise among young adults. However, job losses of parents and partners had no effect on the likelihood of young adults' physical exercise. Conclusion. Our findings indicate a negative impact of the recession on physical activity of young adults and highlights the need for policymakers to consider the impact of major economic downturns on the physical activity of young adults.
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Affiliation(s)
- Shamma Adeeb Alam
- Department of International Studies, Dickinson College, Carlisle, Pennsylvania
| | - Bijetri Bose
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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Ginapp C, Aminawung JA, Harper A, Puglisi LB. Exploring the Relationship between Debt and Health after Incarceration: a Survey Study. J Urban Health 2023; 100:181-189. [PMID: 36650355 PMCID: PMC9918653 DOI: 10.1007/s11524-022-00707-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 01/19/2023]
Abstract
Financial debt and incarceration are both independently associated with poor health, but there is limited research on the association between debt and health for those leaving incarceration. This exploratory study surveyed 75 people with a chronic health condition and recent incarceration to examine debt burden, financial well-being, and possible associations with self-reported health. Eighty-four percent of participants owed at least one debt, with non-legal debt being more common than legal debt. High financial stress was associated with poor self-reported health and the number of debts owed. Owing specific forms of debt was associated with poor health or high financial stress. Non-legal financial debt is common after incarceration, and related stress is associated with poor self-reported health. Future research is needed in larger populations in different geographical areas to further investigate the relationship and the impact debt may have on post-release poor health outcomes. Policy initiatives to address debt in the post-release population may improve health.
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Affiliation(s)
- Callie Ginapp
- Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06520-8056, USA.
| | - Jenerius A Aminawung
- Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06520-8056, USA
- SEICHE Center for Health and Justice, 300 George Street G05, New Haven, CT, 06520, USA
| | - Annie Harper
- Department of Psychiatry, Yale University School of Medicine, 319 Peck St., Erector Sq. Building #1, New Haven, CT, 06511, USA
| | - Lisa B Puglisi
- Yale School of Medicine, 330 Cedar Street, New Haven, CT, 06520-8056, USA.
- SEICHE Center for Health and Justice, 300 George Street G05, New Haven, CT, 06520, USA.
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Zhang R, Zhang C, Xia J, Feng D, Wu S. Household Wealth and Individuals' Mental Health: Evidence from the 2012-2018 China Family Panel Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11569. [PMID: 36141835 PMCID: PMC9517491 DOI: 10.3390/ijerph191811569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
Based on the data from the 2012-2018 China Family Panel Survey, this study examines the impact of household wealth on individuals' mental health using a two-way fixed effects model. The findings indicate that household wealth exerts a significant positive effect on individuals' mental health. Furthermore, this study shows that the impact of household wealth on individuals' mental health is nonlinear but inverted U-shaped. Considering the possible endogeneity problem, this study further examines the effect of household wealth on residents' mental health using two-stage least squares, and the conclusions remain robust. The results of the heterogeneity analysis indicate that household wealth has a greater impact on the mental health of residents in the low-education group and western region. Furthermore, the results of the mechanisms reveal that household wealth affects mental health by influencing insurance investment and individuals' labor supply. Moreover, this study finds that household wealth affects individuals' mental health not only in the short term but also in the medium and long terms. This study provides policy implications for the government toward improving individuals' mental health.
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Affiliation(s)
- Rui Zhang
- Department of Economics, Jinan University, Guangzhou 510632, China
| | - Chenglei Zhang
- School of Economics & Trade, Guangdong University of Finance, Guangzhou 510521, China
| | - Jiahui Xia
- School of Management, Jinan University, Guangzhou 510632, China
| | - Dawei Feng
- Institute of Industrial Economics, Jiangxi University of Finance and Economics, Nanchang 330013, China
| | - Shaoyong Wu
- Institute of Industrial Economics, Jiangxi University of Finance and Economics, Nanchang 330013, China
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6
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Wang B. Housing market volatility under COVID-19: Diverging response of demand in luxury and low-end housing markets. LAND USE POLICY 2022; 119:106191. [PMID: 35665311 PMCID: PMC9136486 DOI: 10.1016/j.landusepol.2022.106191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/06/2022] [Accepted: 05/05/2022] [Indexed: 06/15/2023]
Abstract
The ongoing pandemic has led to substantial volatility in residential housing markets. However, relatively little is known about whether the volatility is dominated by housing demand or supply, and how different priced markets contribute to the volatility. This article first examines the temporal effect of COVID-19 on house prices, housing demand, and supply in Los Angeles, and second explores the effect heterogeneity in luxury and low-end housing markets within the city. For identification, the article employs a revised difference-in-differences (DID) method that controls more rigorously for unobservables and improves on the traditional DID with smaller prior trends. Using individual level data, the result first shows that, in response to the outbreak, house prices, demand, and supply all decreased in March to May 2020 and increased in July and August 2020, with demand dominating the process. Second, the heterogeneity exploration identifies diverging COVID-19 impacts in higher- and lower- priced markets. Particularly, the decline in overall price and demand before June originates mainly from the lower-priced market while the higher-priced one experienced limited changes in demand. After July, higher-priced markets led housing market's surge in price, demand, and supply, whereas the lower-priced market has not fully recovered from decreases in house prices and housing demand. Finally, a larger price decline in lower-priced markets is found to be associated with higher service shares and lower homeownership rates. The results not only facilitate market participants in their decision making but also aid local governments in formulating policies and allocating subsidies to mitigate the effects of the outbreak.
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Affiliation(s)
- Bingbing Wang
- Department of Finance, Law, and Real Estate, California State University at Los Angeles, Los Angeles, CA 90032, USA
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7
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Alam SA, Bose B. Stepping into adulthood during a recession: Did job losses during the Great Recession impact health of young adults? HEALTH ECONOMICS 2022; 31:1730-1751. [PMID: 35643918 DOI: 10.1002/hec.4535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 04/22/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
This is the first study to comprehensively examine the impact of job losses during the Great Recession on mental health, physical health, health behavior, and risky health behavior of young adults (ages 18-27). We employ U.S. longitudinal data with individual fixed effects to control for time-invariant factors that may bias the results. We find that job losses during the recession of young adults living by themselves led to increased onset of doctor-diagnosed mental health problems and worries related to jobs. Poorer individuals suffered more from increased worries, obesity, and binge drinking. In contrast, for those living with their parents, job loss of young adults did not negatively affect their own health. Instead, fathers' job losses led to worse mental health, physical health, and health behavior for young adults. Overall, the results suggest that when living on their own, young adults were responsible for their households' livelihood, and consequently, own job losses led to stress and negative health outcomes. However, when living with parents, they were financially reliant on their parents. Therefore, own job losses did not affect health, but job losses of fathers, the primary income earners for most households, worsened the health of young adults.
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Affiliation(s)
- Shamma Adeeb Alam
- Department of International Studies, Dickinson College, Carlisle, Pennsylvania, USA
| | - Bijetri Bose
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
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8
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Zhang R, Zhang Y, Xia J. Impact of mobile payment on physical health: Evidence from the 2017 China household finance survey. Front Public Health 2022; 10:963234. [PMID: 35979469 PMCID: PMC9376227 DOI: 10.3389/fpubh.2022.963234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals' health status is an essential indicator of the overall strength of a country. Existing literature has studied the determinants of individuals' health, but there is no direct evidence to date on the impact of mobile payment on health. To supplement relevant research and provide insightful policy suggestions to families, government and societies, based on data of 32,058 observations from the 2017 China Household Finance Survey, we estimate the effects of mobile payment on physical health using ordinary least squares and two-stage least squares strategy. This paper provides direct evidence that mobile payment has a positive impact on citizens' physical health. Heterogeneity analysis shows that mobile payment has a more profound impact on the health of citizens who are rural and less educated. Finally, further findings in this paper suggest that commercial insurance and leisure consumption are the mechanism through which the link between mobile payment and individuals' health operates.
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Affiliation(s)
- Rui Zhang
- Department of Economics, Jinan University, Guangzhou, China
| | - Yunzhi Zhang
- Department of Economics, Jinan University, Guangzhou, China
- Faculty of Law, Economic, and Management, LEO-University of Orléans, Orléans, France
- *Correspondence: Yunzhi Zhang
| | - Jiahui Xia
- School of Management, Jinan University, Guangzhou, China
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9
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Wolfe JD. The Financial Correlates of Midlife Obesity. Am J Prev Med 2022; 63:S18-S27. [PMID: 35725137 PMCID: PMC9219113 DOI: 10.1016/j.amepre.2022.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study explored the associations between midlife obesity and an array of common financial stressors related to wealth loss, debt, and bankruptcy. METHODS The analysis was conducted in 2022 with data from the National Longitudinal Survey of Youth 1979. The final sample included 36,122 observations on 8,059 respondents as they aged from ages 31‒39 years in 1996 to ages 51‒59 in 2016. Associations between obesity and financial stressors were estimated with logistic regression models adjusting for a comprehensive set of relevant control variables. RESULTS The analysis found significant relationships between obesity and multiple types of financial stressors, including property debt, unsecured debt, and bankruptcy. Property debt and unsecured debt increased the odds of obesity by 29% and 20%, respectively, and bankruptcy increased the odds of obesity by 43%. Average Marginal Effects (AMEs) in combination with model fit statistics confirmed that these stressors-unsecured debt, property debt, and bankruptcy-were important financial correlates of midlife obesity among the National Longitudinal Survey of Youth 1979 cohort. CONCLUSIONS The financial correlates of obesity included multiple financial stressors, but the magnitude of associations varied substantially across types of financial stressors. Results suggest that future interventions aimed at reducing obesity disparities should target populations with high levels of debt and bankruptcy.
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Affiliation(s)
- Joseph D Wolfe
- Department of Sociology, College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama.
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10
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Wang HQ, Liang LQ. How Do Housing Prices Affect Residents' Health? New Evidence From China. Front Public Health 2022; 9:816372. [PMID: 35096759 PMCID: PMC8793009 DOI: 10.3389/fpubh.2021.816372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 12/16/2021] [Indexed: 11/28/2022] Open
Abstract
This paper aims to explore the effect and mechanism of rising housing prices on residents' physical and mental health. Using data from the China Family Panel Studies from 2014 to 2018, we investigate the impact and mechanism of rising housing prices on the mental and physical health of urban residents through multiple grouping regression and analysis of variance. The study finds that overall, rising housing prices have a positive effect on residents' mental health but a negative effect on physical health, and those who do not own a house show the greatest adverse effect. The impact of rising housing prices on health is mainly reflected in three aspects: the wealth effect, cost effect, and comprehensive environmental expectation effect. Of these, the wealth effect and comprehensive environmental expectation effect play a role in promoting residents' health, whereas the cost effect has a strong inhibitory effect. This paper also analyzes how house prices impact health and finds that having health insurance reduces residents' active health behavior, thus affecting their physical and mental health levels, which has a positive effect on uninsured residents.
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Affiliation(s)
- Hui-Qin Wang
- College of Economics and Management, Nanning Normal University, Nanning, China
| | - Li-Qiu Liang
- College of Economics and Management, Nanning Normal University, Nanning, China
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11
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Ettman CK, Adam GP, Clark MA, Wilson IB, Vivier PM, Galea S. Wealth and depression: A scoping review. Brain Behav 2022; 12:e2486. [PMID: 35134277 PMCID: PMC8933775 DOI: 10.1002/brb3.2486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 11/16/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION The inverse relation between income and depression is well established. Less is understood about the relation between wealth and depression. We therefore conducted a scoping review to answer the question: What is known from the existing literature about the relation between wealth and depression? METHODS We searched for studies and articles in Medline (via PubMed), Embase, PsycINFO, PsycArticles, EconLit, and SocINDEX from inception through July 19, 2020. Ninety-six articles were included in our review. Key article characteristics were year of publication, sample size, country, study design, definition of depression, definition of wealth, and association between wealth and depression. Thirty-two longitudinal articles were included in a detailed charted review. RESULTS Depression was defined in a relatively standard manner across articles. In contrast, definitions and measurements of wealth varied greatly. The majority of studies in the full review (n = 56, 58%) and half of the studies in the longitudinal charted review (n = 16, 50%) reported an inverse relation between wealth and depression. The longitudinal charted review showed that (1) macro-economic events influenced depression, (2) wealth status influenced depression across the lifecourse, (3) wealth protected against depression in the face of stressors such as job loss, (4) subjective or psychosocial factors such as perception of wealth, relative comparison, and social status modified the relation between wealth and depression, and (5) savings interventions were successful in reducing depression and varied by context. CONCLUSION These findings suggest that wealth should be included in our consideration of the forces that shape mental health.
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Affiliation(s)
- Catherine K Ettman
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA.,Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Gaelen P Adam
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Melissa A Clark
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Ira B Wilson
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Patrick M Vivier
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Providence, Rhode Island, USA
| | - Sandro Galea
- Office of the Dean, Boston University School of Public Health, Boston, Massachusetts, USA
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12
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Bao W, Tao R, Afzal A, Dördüncü H. Real Estate Prices, Inflation, and Health Outcomes: Evidence From Developed Economies. Front Public Health 2022; 10:851388. [PMID: 35237557 PMCID: PMC8884244 DOI: 10.3389/fpubh.2022.851388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/24/2022] [Indexed: 11/24/2022] Open
Abstract
Population health is a key pillar of the fast-growing economies, but several challenges threaten it. This study scrutinizes the impact of real estate prices (housing rent) and inflation on population health by using advanced economies from 1996 to 2019. Health is measured by infant mortality rates and life expectancy at birth. The empirical outcomes show a positive and significant effect of housing rent on the infant mortality rate. In contrast, housing rent improves life expectancy. We also find that an increase in inflation positively affects the infant mortality rate and has a negative effect on life expectancy. GDP and health expenditure tend to improve health by increasing life expectancy and reducing the infant mortality rate. However, unemployment is harmful effects on population health. This study recommends that healthcare practitioners consider the housing market and inflationary pressure.
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Affiliation(s)
- Wensheng Bao
- Department of Jiaozhou Campus Construction, Qingdao University, Qingdao, China
| | - Ran Tao
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, China
- *Correspondence: Ran Tao
| | - Anees Afzal
- Department of Accountancy, Superior University, Lahore, Pakistan
| | - Hazar Dördüncü
- Department of International Trade and Logistics, Faculty of Economics, Administrative and Social Sciences, Nisantasi University, Istanbul, Turkey
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13
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Graaf G, Baiden P, Keyes L, Boyd G. Barriers to Mental Health Services for Parents and Siblings of Children with Special Health Care Needs. JOURNAL OF CHILD AND FAMILY STUDIES 2022; 31:881-895. [PMID: 35039741 PMCID: PMC8754365 DOI: 10.1007/s10826-022-02228-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2022] [Indexed: 06/14/2023]
Abstract
Caregivers of children with special health care needs (CSHCNs), especially those whose children have emotional, behavioral, or developmental problems (EBDPs), experience considerable strain and stress related to caring for their child's special needs. The enormous burden of caregiving can decrease a parent's ability to provide care, impacting the health of the child, the parents, and overall family functioning. To manage these challenges, these parents report the need for mental health care for themselves or their children, but many families with need go without care. Comprehensive knowledge about barriers to family mental health care for families of CSHCN is lacking. This study examines data from the National Survey of Children with Special Health Care Needs (2005/2006 and 2009/2010) to estimate time-specific, population-based prevalence of fourteen specific barriers to family mental health services and identifies risk factors for experiencing barriers to care for families of CSHCN. Among all CSHCN, cost barriers (33.5%) and lack of insurance (15.9%) were the most commonly reported obstacles to service access in 2005 and 2009, followed by inconvenient service times (12.3%), and locations (8.7%). Reports of these barriers increased significantly from 2005 to 2009. All types of barriers to family mental health services were reported significantly more frequently by CSHCN with EBDPs than by those without. CSHCN's race, insurance, and parent education and income levels were factors associated with cost barriers to family mental health care. Understanding barriers to mental health care for families of CSHCN is critical to creating policy and practice solutions that increase access to mental health care for these families.
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Affiliation(s)
- Genevieve Graaf
- School of Social Work, University of Texas at Arlington 211 South Cooper Street, Box 19129, Arlington, TX 76019 USA
| | - Philip Baiden
- School of Social Work, University of Texas at Arlington 211 South Cooper Street, Box 19129, Arlington, TX 76019 USA
| | - Latocia Keyes
- Department of Social Work, Tarleton State University, 1333 W. Washington, Stephenville, TX 76402 USA
| | - George Boyd
- School of Social Work, University of Texas at Arlington 211 South Cooper Street, Box 19129, Arlington, TX 76019 USA
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14
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De PK, Segura-Escano R. Drinking during downturn: New evidence from the housing market fluctuations in the United States during the Great Recession. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101070. [PMID: 34700198 DOI: 10.1016/j.ehb.2021.101070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 06/13/2023]
Abstract
We investigate how the decline in home prices over the Great Recession in the U.S. impacted drinking behavior. We match data on actual and shadow home prices (from Zillow Research) to individuals' drinking behavior from the Behavioral Risk Factor Surveillance System (BRFSS) by county of residence and year/month of the interview. We improve upon the existing literature by using new measures of exogenous macroeconomic shocks captured by fluctuations in home prices and finding heterogeneous impacts of the downturn based on homeownership. We find that decline in home prices is commonly associated with increases in alcohol consumption, both on extensive and intensive margins. Additionally, we find that the effects are more consistent among homeowners compared to renters. Given that alcohol consumption is one of the leading causes of death in the U.S. and that the COVID-19 pandemic has triggered an economic crisis in many societies, the results have important public health implications.
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Affiliation(s)
- Prabal K De
- Department of Economics, Colin Powell School at City College and The Graduate Center, City University of New York, New York, New York, USA; The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA.
| | - Raul Segura-Escano
- The Graduate Center, City University of New York, 365 5th Ave, New York, NY 10016, USA.
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15
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Tilstra AM, Simon DH, Masters RK. Trends in "Deaths of Despair" Among Working-Aged White and Black Americans, 1990-2017. Am J Epidemiol 2021; 190:1751-1759. [PMID: 33778856 DOI: 10.1093/aje/kwab088] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/09/2023] Open
Abstract
Life expectancy for US White men and women declined between 2013 and 2017. Initial explanations for the decline focused on increases in "deaths of despair" (i.e., deaths from suicide, drug use, and alcohol use), which have been interpreted as a cohort-based phenomenon afflicting middle-aged White Americans. There has been less attention on Black mortality trends from these same causes, and whether the trends are similar or different by cohort and period. We complement existing research and contend that recent mortality trends in both the US Black and White populations most likely reflect period-based exposures to 1) the US opioid epidemic and 2) the Great Recession. We analyzed cause-specific mortality trends in the United States for deaths from suicide, drug use, and alcohol use among non-Hispanic Black and non-Hispanic White Americans, aged 20-64 years, over 1990-2017. We employed sex-, race-, and cause-of-death-stratified Poisson rate models and age-period-cohort models to compare mortality trends. Results indicate that rising "deaths of despair" for both Black and White Americans are overwhelmingly driven by period-based increases in drug-related deaths since the late 1990s. Further, deaths related to alcohol use and suicide among both White and Black Americans changed during the Great Recession, despite some racial differences across cohorts.
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Health Effects of Housing Insecurity and Unaffordability in the General Population in Barcelona, Spain. J Urban Health 2021; 98:496-504. [PMID: 34231119 PMCID: PMC8382804 DOI: 10.1007/s11524-021-00546-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 10/20/2022]
Abstract
While the negative effects of housing insecurity and unaffordability on health are well known, most of the studies in Spain have focused on very specific social groups so their findings cannot be extrapolated to the general population. The aim of this study is to assess the effects of housing stress and risk of displacement due to economic reasons, and their combined effect, on the mental and physical health of the general population from a middle-income neighborhood of Barcelona. We conducted a cross-sectional study using a household health survey which included respondents from a representative sample of 1202 non-institutionalized residents (> 18 years old) of the Horta neighborhood. We carried out a descriptive analysis, estimated the prevalence of poor mental and self-rated health (stratifying by the independent variables) and fitted robust Poisson regression models to estimate the effects of housing stress (HS) and the risk of forced displacement (RD) on self-rated health and mental health (GHQ-12). All analyses were stratified by sex. We found a higher likelihood of poor general and mental health among people affected by HS and/or RD compared to those not affected by HS and/or RD. A graded effect of HS and RD emerged mainly on mental health, even after adjusting by socioeconomic variables and housing tenure. The serious problem of housing insecurity and unaffordability in Spain is a widespread public health issue. Evidence-based public policies to improve well-being and health of people under this threat are urgently needed.
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Mulia N, Ye Y, Karriker-Jaffe KJ, Li L, Kerr WC, Greenfield TK. The Great Recession, behavioral health, and self-rated health: An examination of racial/ethnic differences in the US. Addict Behav 2021; 118:106873. [PMID: 33652334 PMCID: PMC8483811 DOI: 10.1016/j.addbeh.2021.106873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Revised: 02/04/2021] [Accepted: 02/04/2021] [Indexed: 01/14/2023]
Abstract
The Great Recession has been associated with racial/ethnic disparities in economic loss, alcohol-related problems and mental health in the US. In this study, we examine its effect on overall health, the role of heavy drinking and mental health, and whether these relationships vary by race/ethnicity. Using US National Alcohol Survey data collected from White, African American and Latino individuals between June 2009 and March 2010 (N = 4656), we conducted gender-stratified simultaneous path modeling to test racial/ethnic differences in hypothesized paths from recession-related hardships to overall self-rated health through current depressive symptoms and heavy drinking. Recession impacts were measured using an index of job-related, financial and housing hardships. Models accounted for demographic characteristics and heavy drinking, health conditions and alcohol-related health harms occurring prior to the Great Recession. We found that in men and women of each racial/ethnic group, more accumulated recession hardships were associated with greater depressive symptoms and more frequent heavy drinking, and depressive symptoms were associated with poorer self-rated health. Further, heavy drinking was related to poorer self-rated health in Black men and depressive symptoms in Latino men, and for Black and Latina women, prior heavy drinking was associated with current depressive symptoms. Findings highlight adverse, behavioral and overall health consequences of a severe recession for men and women of diverse racial/ethnic groups, as well as unique risks for Black and Latino men and women. Findings suggest the need for behavioral health interventions alongside multisector strategies to bolster the labor market and social safety net during severe economic downturns.
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Affiliation(s)
- Nina Mulia
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA.
| | - Yu Ye
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | | | - Libo Li
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - William C Kerr
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
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Wolfe JD, Baker EH, Uddin J, Kirkland S. Varieties of Financial Stressors and Midlife Health Problems. J Gerontol B Psychol Sci Soc Sci 2021; 77:gbab108. [PMID: 34137839 DOI: 10.1093/geronb/gbab108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Financial stressors such as wealth loss, indebtedness, and bankruptcy have gained the attention of public health scholars since the Great Recession. In this study, we extend this area of research by comparing the mental and physical impact of multiple financial stressors during midlife, a pivotal period in the life course for wealth accumulation and disease onset. METHODS With data from the National Longitudinal Survey of Youth 1979 (www.nlsinfo.org), an ongoing survey of adult men and women in the U.S., we used logistic regression to estimate the associations between financial stressors and the risk of a psychiatric disorder or high blood pressure diagnosis from ages 31-39 in 1996 to ages 50-59 in 2016 (N = 7,143). Financial stressors include multiple types of wealth loss, debt, and bankruptcy. RESULTS Even after adjusting for a comprehensive set of confounders, many of the financial stressors we considered had similar associations with the risk of a psychiatric disorder, whereas only debt and bankruptcy were associated with the risk of high blood pressure. The best fitting models for both health outcomes included a simple indicator of indebtedness. Stock losses were not significantly associated with either health outcome. DISCUSSION Given the recent volatility in the U.S. economy, our results highlight the potential loss of health that may occur if nothing is done to prevent economically vulnerable populations from sliding into financial crisis. Our results also emphasize the need for additional research to develop individual-level interventions to improve health among those already experiencing financial difficulties.
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Affiliation(s)
- Joseph D Wolfe
- University of Alabama at Birmingham, Department of Sociology, Birmingham, AL
| | - Elizabeth H Baker
- University of Alabama at Birmingham, Department of Sociology, Birmingham, AL
| | - Jalal Uddin
- University of Alabama at Birmingham, Department of Epidemiology, Birmingham, AL
| | - Stephanie Kirkland
- University of Alabama at Birmingham, Department of Sociology, Birmingham, AL
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Bierman A. Why Have Sleep Problems in Later-Midlife Grown Following the Great Recession? A Comparative Cohort Analysis. J Gerontol B Psychol Sci Soc Sci 2021; 76:1005-1014. [PMID: 32227082 DOI: 10.1093/geronb/gbaa034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This research compares three cohorts of individuals in their fifth decade of life and examines whether sleep problems are greater in cohorts following the Great Recession. We argue that these differences will occur because postrecession cohorts are exposed to more economic burdens that harm sleep. We also suggest that postrecession exposure to economic burdens will be amplified among women, leading to greater cross-cohort differences in sleep problems. METHOD Data were derived from the Health and Retirement Study, focusing on cohort surveys starting in 2004, 2010, and 2016 (N = 12,129). Structural equation models compared cohorts in latent levels of sleep problems and also examined whether economic burdens mediated cohort differences. Interactions tested whether cohort differences varied between men and women. RESULTS The 2010 and 2016 cohorts had higher mean levels of sleep problems than the 2004 cohort. Greater postrecession exposure to economic burdens largely explained inter-cohort change in sleep problems, with this pattern stronger among women. DISCUSSION Americans are approaching their senior years increasingly burdened by economic stressors that incur sleep problems. Practitioners and aging researchers should be prepared to address deleterious health consequences created by heightened sleep impairments.
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Affiliation(s)
- Alex Bierman
- Department of Sociology, University of Calgary, Canada
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20
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Yue D, Ponce NA. Booms and Busts in Housing Market and Health Outcomes for Older Americans. Innov Aging 2021; 5:igab012. [PMID: 34056139 PMCID: PMC8152867 DOI: 10.1093/geroni/igab012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background and Objectives The US housing market has experienced considerable fluctuations over the last decades. This study aimed to investigate the impacts of housing price dynamics on physical health, mental health, and health-related behaviors for older American outright owners, mortgaged owners, and renters. Research Design and Methods We drew longitudinal data from the 1992–2016 Health and Retirement Study and merged it to the 5-digit zip code–level Housing Price Index. The analytic sample comprised 34 182 persons and 174 759 person-year observations. We used a fixed-effects model to identify the health impacts of housing price dynamics separately for outright owners, mortgaged owners, and renters. Results A 100% increase in Housing Price Index was associated with a 2.81 and 3.50 percentage points (pp) increase in the probability of reporting excellent/very good/good health status for mortgage owners and renters, respectively. It was also related to a lower likelihood of obesity (1.82 pp) for outright owners and a lesser chance of obesity (2.85 pp) and smoking (3.03 pp) for renters. All of these relationships were statistically significant (p < .05). Renters also experienced significantly decreased depression scores (−0.24), measured by the Center for Epidemiologic Studies—Depression scale, associated with the same housing price changes. Discussion and Implications Housing price dynamics have significant health impacts, and renters are more sensitive to fluctuations in the housing market. Our study rules out the wealth effect as the mechanism through which changes in housing prices affect older adults’ health. Our findings may inform policies to promote older adults’ health by investing in local area amenities and improving socioeconomic conditions.
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Affiliation(s)
- Dahai Yue
- Department of Health Policy and Management, University of Maryland, College Park, USA
| | - Ninez A Ponce
- Department of Health Policy and Management, University of California, Los Angeles, USA
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21
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Swift SL, Elfassy T, Bailey Z, Florez H, Feaster DJ, Calonico S, Sidney S, Kiefe CI, Zeki Al Hazzouri A. Association of negative financial shocks during the Great Recession with depressive symptoms and substance use in the USA: the CARDIA study. J Epidemiol Community Health 2020; 74:995-1001. [PMID: 32788306 DOI: 10.1136/jech-2020-213917] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/03/2020] [Accepted: 07/10/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND The Great Recession of 2008 was marked by large increases in unemployment and decreases in the household wealth of many Americans. In the 21st century, there have also been increases in depressive symptoms, alcohol use and drug use among some groups in the USA. The objective of this analysis is to evaluate the influence of negative financial shocks incurred during the Great Recession on depressive symptoms, alcohol and drug use. METHODS We employed a quasi-experimental fixed-effects design, using data from adults enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study. Our financial shock predictors were within-person change in employment status, income and debt to asset ratio between 2005 and 2010. Our outcomes were within-person change in depressive symptoms score, alcohol use and past 30-day drug use. RESULTS In adjusted models, we found that becoming unemployed and experiencing a drop in income and were associated with an increase in depressive symptoms. Incurring more debts than assets was also associated with an increase in depressive symptoms and a slight decrease in daily alcohol consumption (mL). CONCLUSION Our findings suggest that multiple types of financial shocks incurred during an economic recession negatively influence depressive symptoms among black and white adults in the USA, and highlight the need for future research on how economic recessions are associated with health.
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Affiliation(s)
- Samuel Longworth Swift
- Center for Healthcare Equity in Kidney Disease, University of New Mexico, New Mexico, Albuquerque, USA
| | - Tali Elfassy
- Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Zinzi Bailey
- Sylvester Cancer Center, University of Miami, Miami, Florida, USA
| | - Hermes Florez
- Public Health Sciences, University of Miami, Miami, Florida, USA
| | - Daniel J Feaster
- Public Health Sciences, University of Miami, Miami, Florida, USA
| | | | - Steve Sidney
- Kaiser Permanente Norther California Division of Research, Oakland, California, USA
| | - Catarina I Kiefe
- Quantitative Health Sciences, UMass Medical School, Worcester, Massachusetts, USA
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22
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Boen C, Keister L, Aronson B. Beyond Net Worth: Racial Differences in Wealth Portfolios and Black-White Health Inequality across the Life Course. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2020; 61:153-169. [PMID: 32447993 PMCID: PMC8034808 DOI: 10.1177/0022146520924811] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
A large body of research links wealth and health, but most previous work focuses on net worth. However, the assets and debts that comprise wealth likely relate to health in different and meaningful ways. Furthermore, racial differences in wealth portfolios may contribute to racial health gaps. Using longitudinal data from the Panel Study of Income Dynamics (PSID) and mixed effects growth curve models, we examined the associations between various wealth components and multiple health outcomes. We also investigated whether black-white differences in wealth portfolios contributed to racial health inequality. We found that savings, stock ownership, and homeownership consistently improve health, but debt is associated with worse health, even after adjusting for total net worth. We found little evidence that home equity is associated with health. Findings also revealed differential health returns to assets by race. These findings provide new insights into the complex relationship among race, wealth, and health.
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23
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Hawkley LC, Zheng B, Song X. Negative financial shock increases loneliness in older adults, 2006-2016: Reduced effect during the Great Recession (2008-2010). Soc Sci Med 2020; 255:113000. [PMID: 32439199 PMCID: PMC7310672 DOI: 10.1016/j.socscimed.2020.113000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 03/13/2020] [Accepted: 04/14/2020] [Indexed: 10/24/2022]
Affiliation(s)
| | - Boyan Zheng
- University of Wisconsin-Madison, United States
| | - Xi Song
- University of Pennsylvania, United States
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24
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Wilkinson LR, Schafer MH, Wilkinson R. How painful is a recession? An assessment of two future-oriented buffering mechanisms. Soc Sci Med 2020; 255:112455. [PMID: 32416438 DOI: 10.1016/j.socscimed.2019.112455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 06/14/2019] [Accepted: 07/28/2019] [Indexed: 12/13/2022]
Abstract
RATIONALE AND OBJECTIVE Guided by stress process theory, this study investigates the association between the economic downturn and chronic pain interference, as well as the role of two future-oriented buffering mechanisms (anticipated stressor duration and pre-recession financial optimism) in this relationship. This research integrates both an objective measure of the recession based on negative personal experiences, as well as subjective event-based appraisals of how the recession impacted people's lives. METHOD Drawing on longitudinal data from the National Survey of Midlife Development in the United States, linear lagged dependent variable models are used to estimate associations between recession-era stressors and chronic pain interference among 1113 adults. The analysis further examines the moderating influences of anticipated stressor duration and pre-recession financial optimism. RESULTS Findings reveal that both an accumulation of adverse experiences and global appraisals of the economic recession have harmful associations with chronic pain interference; however, their magnitude varied according to future-oriented moderating factors. Specifically, people with high pre-recession financial optimism fared better when confronted with recession-related stressors than did those with low levels of financial optimism. Moreover, pain interference was greater among individuals who appraised the recession as having a negative impact on their lives, but only if they perceived the recession would extend into the future. CONCLUSIONS This study demonstrates distinctive links between two recession-related measures and pain interference. Findings suggest that positive future orientations can be protective during an economic crisis, whereas negative orientations heighten the pain.
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Affiliation(s)
- Lindsay R Wilkinson
- Department of Gerontology, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE 68182, USA.
| | - Markus H Schafer
- Department of Sociology, University of Toronto, 725 Spadina Ave., Toronto, ON M5S 2J4, Canada
| | - Renae Wilkinson
- Department of Sociology, Baylor University, One Bear Place #97326, Waco, TX 76798, USA
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25
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Abstract
Public health scholars and policy-makers are concerned that the United States continues to experience unmanageable health care costs while struggling with issues surrounding access and equity. To addresses these and other key issues, the National Academy of Medicine held a public symposium, Vital Directions for Health and Health Care: A National Conversation during September 2016, with the goal of identifying clear priorities for high-value health care and improved well-being. One important area was addressing social determinants of health. This article contributes to this objective by investigating the impact of wealth on older Black women's health. Employing the 2008/2010 waves of the RAND Health and Retirement Study on a sample of 906 older Black women, this panel study examined self-assessed health ratings of very good/good/fair/poor within a relaxed random effects framework, thereby controlling for both (i) observed and (ii) unobserved individual-level heterogeneity. This analysis did not find a statistically significant association with wealth despite a difference of approximately $75 000 in its valuation from very good to poor health. This also occurred after wealth was (i) readjusted for outliers and (ii) reformulated as negative, no change or positive change from 2008. This finding suggests that wealth may not play as integral a role. However, the outcome was significant for earnings and education, particularly higher levels of education. Scholars should further this inquiry to better understand how earnings/education/wealth operate as social determinants of health for minority populations.
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Affiliation(s)
- Andy Sharma
- Institute for Governmental Service and Research, University of Maryland, College Park, MD, USA
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26
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Bell ON, Hole MK, Johnson K, Marcil LE, Solomon BS, Schickedanz A. Medical-Financial Partnerships: Cross-Sector Collaborations Between Medical and Financial Services to Improve Health. Acad Pediatr 2020; 20:166-174. [PMID: 31618676 PMCID: PMC7331932 DOI: 10.1016/j.acap.2019.10.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 09/04/2019] [Accepted: 10/01/2019] [Indexed: 12/29/2022]
Abstract
Financial stress is the root cause of many adverse health outcomes among poor and low-income children and their families, yet few clinical interventions have been developed to improve health by directly addressing patient and family finances. Medical-Financial Partnerships (MFPs) are novel cross-sector collaborations in which health care systems and financial service organizations work collaboratively to improve health by reducing patient financial stress, primarily in low-income communities. Financial services provided by MFPs include individually tailored financial coaching, free tax preparation, budgeting, debt reduction, savings support, and job assistance, among others. MFPs have been shown to improve finances and, in the few existing studies available, health outcomes. We describe the rationale for MFPs and examine 8 established MFPs providing financial services under 1 of 3 models: full-scope on-site service partnerships; targeted on-site service partnerships; and partnerships facilitating referral to off-site financial services. The services MFPs provide complement clinical social risk screening and navigation programs by preventing or repairing common financial problems that would otherwise lead to poverty-related social needs, such as food and housing insecurity. We identify common themes, as well as unique strengths and solutions to a variety of implementation challenges MFPs commonly encounter. Given that the financial circumstances and health outcomes of socially marginalized patients and families are closely linked, MFPs represent a promising and feasible cross-sector service delivery approach and a new model for upstream health care to promote synergistic financial well-being and health improvement.
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Affiliation(s)
- Orly N Bell
- David Geffen School of Medicine at UCLA (ON Bell), Los Angeles, Calif.
| | - Michael K Hole
- Department of Pediatrics, Dell Medical School, The University of Texas at Austin (MK Hole), Austin, Tex
| | - Karl Johnson
- Krieger School of Arts and Sciences, Johns Hopkins University (K Johnson), Baltimore, Md
| | - Lucy E Marcil
- Department of Pediatrics, Boston University School of Medicine (LE Marcil), Boston, Mass
| | - Barry S Solomon
- Department of Pediatrics, Johns Hopkins University School of Medicine (BS Solomon), Baltimore, Md
| | - Adam Schickedanz
- Department of Pediatrics, David Geffen School of Medicine at UCLA (A Schickedanz), Los Angeles, Calif
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Pak TY. Welfare stigma as a risk factor for major depressive disorder: Evidence from the Supplemental Nutrition Assistance Program. J Affect Disord 2020; 260:53-60. [PMID: 31493639 DOI: 10.1016/j.jad.2019.08.079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/17/2019] [Accepted: 08/25/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Negative public attitude about welfare is known to impair feelings of self-worth and psychological well-being in welfare recipients. What is missing in the extant literature is whether the stress of being on welfare increases the risk for clinically severe depression. To fill this gap, the present study examines the association between participation in the food stamp program and major depressive disorder. METHODS Study data is drawn from the 2008-2014 waves of the Health and Retirement Study (N = 67076). Depressive symptom is assessed with the Composite International Diagnostic Interview - Short Form, and modeled by a continuous score of major depressive symptoms (0-7) and a binary indicator for three or more symptoms. A fixed effects regression is used to estimate changes in depressive symptoms explained by the food stamp participation, adjusted for confounding covariates. RESULTS Food stamp participation was associated with an average of 19% increases in depressive symptoms (p < 0.001) and 29% higher odds of having major depression (p < 0.01). The associations were statistically significant only for men, middle-aged adults, Whites, and those without disability - groups that are more likely to be stigmatized by the social norm for not being able to rise above poverty. LIMITATIONS Depression outcomes are self-reported. Causality remains not established. The recession during the study periods may have dampened the stigma effects. CONCLUSIONS Welfare participation is a risk factor for clinical depression in a low-income setting. Depressive symptoms induced by welfare stigma need to be clinically targeted through counseling and cognitive therapy programs.
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Affiliation(s)
- Tae-Young Pak
- University of Alabama, Tuscaloosa, AL 35487, United States.
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28
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Abstract
The full scope of the impact of The Great Recession on individuals' mental health has not been quantified to date. This study aimed to determine whether financial, job-related, and housing impacts experienced by individuals during the recession predicted changes in the occurrence of symptoms of depression, generalized anxiety, panic attacks, and problematic alcohol or other substance use. Longitudinal survey data (n = 2,530 to n = 3,293) were analyzed from the national Midlife in the United States (MIDUS) study collected before (2003-2004) and after (2012-2013) The Great Recession. The population-level trend was towards improvements in mental health over time. However, for individuals each recession impact experienced was associated with long-lasting and transdiagnostic declines in mental health. These relationships were stronger for some sociodemographic groups, suggesting the need for additional support for people who suffer marked losses during recessions and for those without a strong safety net.
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Affiliation(s)
- Miriam K Forbes
- Departments of Psychiatry and Psychology, University of Minnesota, USA, 55454 Centre for Emotional Health, Department of Psychology, Macquarie University, Australia, 2109
| | - Robert F Krueger
- Department of Psychology, University of Minnesota-Twin Cities, USA, 55455
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29
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Associations between Home Foreclosure and Health Outcomes in a Spanish City. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060981. [PMID: 30893804 PMCID: PMC6466329 DOI: 10.3390/ijerph16060981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 03/17/2019] [Accepted: 03/17/2019] [Indexed: 11/16/2022]
Abstract
The financial crisis has caused an exponential increase of home foreclosures in Spain. Recent studies have shown the effects that foreclosures have on mental and physical health. This study explores these effects on a sample of adults in the city of Granada (Spain), in terms of socio-demographic, socio-economic and process characteristics. A cross-sectional survey was administered to obtain information on self-perceived changes in several indicators of physical and mental health, consumption of medications, health-related behaviors and use of health services. A total of 205 persons, going through a foreclosure process, participated in the study. 85.7% of the sample reported an increase of episodes of anxiety, depression, and stress; 82.6% sleep disturbances; 42.8% worsening of previous chronic conditions, and 40.8% an increase in consumption of medication. Women, married persons and persons already in the legal stage of the foreclosure process reported higher probability of worsening health according to several indicators, in comparison with men, not married, and individuals in the initial stages of the foreclosure process. The results of this study reveal a general deterioration of health associated with the foreclosure process. These results may help to identify factors to prevent poor health among populations going through a foreclosure process.
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30
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Hughes AE, Tiro JA, Balasubramanian BA, Skinner CS, Pruitt SL. Social Disadvantage, Healthcare Utilization, and Colorectal Cancer Screening: Leveraging Longitudinal Patient Address and Health Records Data. Cancer Epidemiol Biomarkers Prev 2018; 27:1424-1432. [PMID: 30135072 PMCID: PMC6279539 DOI: 10.1158/1055-9965.epi-18-0446] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/11/2018] [Accepted: 08/17/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Social disadvantage predicts colorectal cancer outcomes across the cancer care continuum for many populations and places. For medically underserved populations, social disadvantage is likely intersectional-affecting individuals at multiple levels and through membership in multiple disadvantaged groups. However, most measures of social disadvantage are cross-sectional and limited to race, ethnicity, and income. Linkages between electronic health records (EHR) and external datasets offer rich, multilevel measures that may be more informative. METHODS We identified urban safety-net patients eligible and due for colorectal cancer screening from the Parkland-UT Southwestern PROSPR cohort. We assessed one-time screening receipt (via colonoscopy or fecal immunochemical test) in the 18 months following cohort entry via the EHR. We linked EHR data to housing and Census data to generate measures of social disadvantage at the parcel- and block-group level. We evaluated the association of these measures with screening using multilevel logistic regression models controlling for sociodemographics, comorbidity, and healthcare utilization. RESULTS Among 32,965 patients, 45.1% received screening. In adjusted models, residential mobility, residence type, and neighborhood majority race were associated with colorectal cancer screening. Nearly all measures of patient-level social disadvantage and healthcare utilization were significant. CONCLUSIONS Address-based linkage of EHRs to external datasets may have the potential to expand meaningful measurement of multilevel social disadvantage. Researchers should strive to use granular, specific data in investigations of social disadvantage. IMPACT Generating multilevel measures of social disadvantage through address-based linkages efficiently uses existing EHR data for applied, population-level research.
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Affiliation(s)
- Amy E Hughes
- Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Jasmin A Tiro
- Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
| | - Bijal A Balasubramanian
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
- Department of Epidemiology, Human Genetics, and Environmental Sciences UTHealth in Dallas, Dallas, Texas
| | - Celette Sugg Skinner
- Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
| | - Sandi L Pruitt
- Department of Clinical Sciences, The University of Texas Southwestern Medical Center, Dallas, Texas
- Harold C. Simmons Comprehensive Cancer Center, Dallas, Texas
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Habibov N, Auchynnikava A, Luo R, Fan L. Effects of the 2008 global financial crisis on population health. Int J Health Plann Manage 2018; 34:e327-e353. [PMID: 30265409 DOI: 10.1002/hpm.2652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Accepted: 08/13/2018] [Indexed: 12/26/2022] Open
Abstract
We compare the transmission channels through which the 2008 global financial crisis affected health. We find that postponing or skipping visits to the doctor after falling ill and stopping buying regular medication had the strongest negative effects on health, followed by a reduced consumption of staple foods, utilities being cut, being forced to move, and having to sell assets. In comparison, experiencing cuts in TV, phone, and internet services, as well as delaying payments for utilities had relatively weaker negative impacts. In contrast, having a household head or household member lose a job also had negative effects on health status, although this effect was relatively lower. Finally, a reduced flow of remittances had the weakest negative effect.
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Affiliation(s)
| | | | - Rong Luo
- University of Windsor, Ontario, Canada
| | - Lida Fan
- Lakehead University, Thunderbay, Ontario, Canada
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32
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The impact of intergenerational financial transfers on health and wellbeing outcomes: A longitudinal study. Soc Sci Med 2018; 214:179-186. [PMID: 30177364 DOI: 10.1016/j.socscimed.2018.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 08/22/2018] [Accepted: 08/24/2018] [Indexed: 11/21/2022]
Abstract
This paper estimates the impacts of intergenerational financial transfers on the physical health, mental health and perceived financial security of Australian males and females. We distinguish between two key sources of intergenerational financial transfers - inheritances and inter vivos parental cash transfers. Taking nationally representative data from the 2001-2015 Household, Income and Labour Dynamics in Australia Survey, we develop a two-stage modelling strategy that controls for potential bias in reported health and wellbeing responses that arise due to unobserved heterogeneity. In the first stage, propensity score matching is applied to achieve matched treatment and control groups, where the former is comprised of intergenerational financial transfer beneficiaries while the latter is made up of non-beneficiaries with a matched set of characteristics to the beneficiaries. This is followed by the application of regression models that further control for unobservable heterogeneity, so that the coefficients on the intergenerational financial transfer predictors can be attributed to the effect of the transfers on health and wellbeing. We do not find systematic evidence of a causal link between receipt of intergenerational financial transfers and health and wellbeing outcomes. This applies to both inheritances and inter vivos parental cash transfers, and for both males and females.
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Meraya AM, Dwibedi N, Innes K, Mitra S, Tan X, Sambamoorthi U. Heterogeneous Relationships between Labor Income and Health by Race/Ethnicity. Health Serv Res 2017; 53 Suppl 1:2910-2931. [PMID: 29134632 DOI: 10.1111/1475-6773.12802] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To examine the race-stratified relationships between labor income and health among working-age adults in the United States. DATA SOURCES Data from eight waves of the Panel Study of Income Dynamics from 1999 through 2013 were used for this study. STUDY DESIGN The study utilized a retrospective observational longitudinal design with repeated measures of labor income and health measures. System-generalized method of moment and heteroscedasticity-based instrument regressions were used to examine the relationships between labor income and physical and mental health measures, respectively. Dynamic panel models were used to examine the effect of loss in income on health measures. DATA COLLECTION/EXTRACTION METHODS We performed secondary data analysis. PRINCIPAL FINDINGS Adults in higher labor income quartiles had better self-rated health than those in the lowest quartile regardless of racial group. The relationship between labor income and psychological distress varied by race groups. Reductions in labor income were associated with increases in psychological distress among whites only. CONCLUSION These findings suggest heterogeneous relationships between labor income and overall health across racial groups. Our results highlight the need to provide safety nets for adults who experience a decline in income to prevent deterioration in health.
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Affiliation(s)
- Abdulkarim M Meraya
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV.,Department of Clinical Pharmacy, Faculty of Pharmacy, Jazan University, Jazan, Saudi Arabia
| | - Nilanjana Dwibedi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV
| | - Kim Innes
- Department of Epidemiology, West Virginia University School of Public Health, Morgantown, WV
| | - Sophie Mitra
- Department of Economics, Fordham University, Bronx, NY
| | - Xi Tan
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV
| | - Usha Sambamoorthi
- Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV
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34
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Pak TY, Kim G. The impact of Medicare Part D on cognitive functioning at older ages. Soc Sci Med 2017; 193:118-126. [PMID: 29049904 DOI: 10.1016/j.socscimed.2017.09.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 07/10/2017] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
Abstract
Research has shown that the establishment of Medicare prescription drug benefit in 2006 leads to improvement in medication adherence and mortality outcomes. Despite a clear connection between physical/mental health and the risk of dementia, little is known about the extent to which this reform has affected the cognitive functioning of the elderly. Using data from the Health and Retirement Study and difference-in-differences approach, this study provides the first evidence on the cognition-enhancing effects of Medicare Part D. Our estimates show that Part D implementation is associated with 1.6% increase in cognitive functioning or 1.1-year delay of cognitive aging among benefit-eligible persons. Further analyses indicate that most of the cognitive benefits accrue to the vulnerable populations who previously lacked prescription drug coverage, and that a reduction in cardiovascular mortality is the most likely pathway through which the expansion improved cognitive functioning.
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Affiliation(s)
- Tae-Young Pak
- Department of Consumer Sciences, University of Alabama, Tuscaloosa, AL 35487, United States.
| | - GwanSeon Kim
- Department of Agricultural Economics, University of Kentucky, Lexington, KY 40546, United States.
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Mehdipanah R, Schulz AJ, Israel BA, Mentz G, Eisenberg A, Stokes C, Rowe Z. Neighborhood Context, Homeownership and Home Value: An Ecological Analysis of Implications for Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E1098. [PMID: 28937613 PMCID: PMC5664599 DOI: 10.3390/ijerph14101098] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/04/2017] [Accepted: 09/19/2017] [Indexed: 11/16/2022]
Abstract
While homeownership has been linked to positive health outcomes there is limited evidence regarding the conditions under which it may be health protective. We present a conceptual model linking homeownership to health, highlighting key potential pathways. Using the Detroit Metropolitan Area as a case study, and data from the American Community Survey (2009-2013; 5-years estimates) and Michigan Department of Community Health, we tested the following questions: (1) Is neighborhood percentage non-Hispanic Black (NHB) associated with homeownership? (2) Is neighborhood percentage NHB associated with health? (3) Is the association between percentage NHB and health mediated by homeownership? (4) Does neighborhood housing value modify associations between percentage NHB and health, or between homeownership and health? Percentage NHB was associated with homeownership and health outcomes; Associations between percentage NHB and mortality, but not disability, were partially mediated by neighborhood homeownership. Neighborhood housing value modified associations between neighborhood homeownership and both disability and mortality, but not between percentage NHB and health outcomes. Findings are consistent with the thesis that health-promoting effects of homeownership may be contingent upon house values. These results add to a limited body of evidence suggesting that variations in homeownership may contribute to persistent racial and socioeconomic health inequities.
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Affiliation(s)
| | - Amy J Schulz
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Barbara A Israel
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Graciela Mentz
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Alexa Eisenberg
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Carmen Stokes
- School of Nursing, University of Detroit Mercy, Detroit, MI 48221, USA.
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36
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Atalay K, Edwards R, Liu BYJ. Effects of house prices on health: New evidence from Australia. Soc Sci Med 2017; 192:36-48. [PMID: 28961481 DOI: 10.1016/j.socscimed.2017.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 09/04/2017] [Accepted: 09/07/2017] [Indexed: 10/18/2022]
Abstract
Recent house price variation has strongly affected households' housing wealth and debt, yet the non-economic consequences of these changes in housing wealth are still poorly understood. Using a sample of 19,000 individuals from the Household, Income and Labour Dynamics in Australia Survey (HILDA) for 2001-2015, we examine the relationship between house price fluctuations and individual health by exploiting large exogenous changes in house prices in Australia. We find that an increase in local house prices is associated with a positive effect on the physical health of outright owners and a negative effect on the physical and mental health of renters. Improvements in physical health for outright owners can be partially attributed to health-related investments and behaviours such as a reduction in weight, an increase in physical exercise and an increase in time allocated to home production. These findings support the presence of a health-wealth gradient through the wealth mechanism distinct from the effects of local area amenities and macroeconomic conditions. Our findings highlight some of the often-overlooked social impacts - both positive and negative - of fluctuations in the housing market.
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Affiliation(s)
- Kadir Atalay
- School of Economics, Merewether Building, University of Sydney, NSW 2006, Australia
| | - Rebecca Edwards
- School of Economics, Merewether Building, University of Sydney, NSW 2006, Australia.
| | - Betty Y J Liu
- School of Economics, Merewether Building, University of Sydney, NSW 2006, Australia
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Pool LR, Needham BL, Burgard SA, Elliott MR, de Leon CFM. Negative wealth shock and short-term changes in depressive symptoms and medication adherence among late middle-aged adults. J Epidemiol Community Health 2017; 71:758-763. [PMID: 28416571 DOI: 10.1136/jech-2016-208347] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/01/2017] [Accepted: 03/27/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Experiencing a negative wealth shock in late middle age may cause high levels of stress and induce reductions in health-related consumption. METHODS We used data on late middle age individuals (51-64 years) from the longitudinal US-based Health and Retirement Study (N=19 281) to examine the relationship between negative wealth shock and short-term outcomes that serve as markers of the pathways from wealth shock to health: elevated depressive symptoms, as a marker of the stress pathway and cost-related medication non-adherence (CRN), as a marker of the consumption pathway. Negative wealth shock was considered to be a loss of total net worth of 75% or more. RESULTS Using a nested cross-over approach-a within-person design among exposed individuals only that adjusts by design for all time-invariant individual characteristics-we found that negative wealth shock was significantly associated with increased odds of elevated depressive symptoms (OR=1.50, CI 1.10 to 2.05), but was not significantly associated with higher odds of CRN (OR=1.18, CI 0.76 to 1.82), even after further adjustment for time-varying sociodemographic and health covariates. CONCLUSIONS Negative wealth shock during late middle age confers an increased risk of elevated depressive symptoms, but does not change levels of CRN. Personal and policy factors that may buffer the mental health risks of negative wealth shock, such as social support and social welfare policy, should be considered.
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Affiliation(s)
- Lindsay R Pool
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Sarah A Burgard
- Departments of Sociology and Epidemiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michael R Elliott
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
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38
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A Statewide Effort to Implement Collaborative Care for Depression: Reach and Impact for All Patients With Depression. Med Care 2017; 54:992-997. [PMID: 27479596 DOI: 10.1097/mlr.0000000000000602] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Little is known about the reach and impact of collaborative care for depression outside of clinical trials. OBJECTIVE The objective of this study was to examine the effect of a collaborative care intervention for depression on the rates of depression diagnosis, use of specific depression codes, and treatment intensification. RESEARCH DESIGN Evaluation of a staggered, multiple baseline implementation initiative. SUBJECTS Patients receiving depression care in primary care clinics throughout Minnesota from February 2008 through March 2011. MEASURES Data regarding depression diagnosis rates and codes, and measures of antidepressant intensification were provided by health insurers. RESULTS Depression Improvement Across Minnesota: Offering a New Direction (DIAMOND) affected neither rates of depression recognition nor use of depression diagnostic codes, and the overall reach of DIAMOND was disappointingly small. Patients in DIAMOND had more episodes of treatment intensification than non-DIAMOND patients, but we were unable to account for depression severity in our analysis. CONCLUSIONS DIAMOND did not affect depression recognition or diagnostic coding, but may have affected treatment intensification. Our results suggest that even strongly evidence-based interventions may have little contamination effects on patients not enrolled in the new care model.
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Vásquez-Vera H, Palència L, Magna I, Mena C, Neira J, Borrell C. The threat of home eviction and its effects on health through the equity lens: A systematic review. Soc Sci Med 2017; 175:199-208. [DOI: 10.1016/j.socscimed.2017.01.010] [Citation(s) in RCA: 81] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 11/22/2016] [Accepted: 01/06/2017] [Indexed: 10/20/2022]
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40
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Lê-Scherban F, Brenner AB, Schoeni RF. Childhood family wealth and mental health in a national cohort of young adults. SSM Popul Health 2016; 2:798-806. [PMID: 28584861 PMCID: PMC5455782 DOI: 10.1016/j.ssmph.2016.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 10/17/2016] [Accepted: 10/17/2016] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Mental health is critical to young adult health, as the onset of 75% of psychiatric disorders occurs by age 24 and psychiatric disorders early in life predict later behavioral health problems. Wealth may serve as a buffer against economic stressors. Family wealth may be particularly relevant for young adults by providing them with economic resources as they make educational decisions and move towards financial and social independence. METHODS We used prospectively collected data from 2060 young adults aged 18-27 in 2005-2011 from the Panel Study of Income Dynamics, a national cohort of US families. We examined associations between nonspecific psychological distress (measured with the K-6 scale) and childhood average household wealth during ages 0-18 years (net worth in 2010 dollars). RESULTS In demographics-adjusted generalized estimating equation models, higher childhood wealth percentile was related to a lower prevalence of serious psychological distress: compared to below-median wealth, prevalence ratio (PR) = 0.56 (0.36-0.87) for 3rd quartile and PR = 0.46 (0.29-0.73) for 4th quartile. The associations were attenuated slightly by adjustment for parent education and more so by adjustment for childhood household income percentile. CONCLUSIONS Understanding the lifelong processes through which distinct aspects of socioeconomic status affect mental health can help us identify high-risk populations and take steps to minimize future disparities in mental illness.
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Affiliation(s)
- Félice Lê-Scherban
- Dornsife School of Public Health, Drexel University, Department of Epidemiology and Biostatistics, 3215 Market Street, 5th Floor, Philadelphia, PA 19104, USA
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, 3rd Floor Tower, Ann Arbor, MI 48109, USA
| | - Allison B. Brenner
- Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, 1415 Washington Heights, 3rd Floor Tower, Ann Arbor, MI 48109, USA
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, USA
| | - Robert F. Schoeni
- Institute for Social Research, University of Michigan, 426 Thompson Street, Ann Arbor, MI 48104, USA
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41
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The health effects of the foreclosure crisis and unaffordable housing: A systematic review and explanation of evidence. Soc Sci Med 2016; 162:88-96. [PMID: 27343818 DOI: 10.1016/j.socscimed.2016.06.014] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/27/2016] [Accepted: 06/10/2016] [Indexed: 11/24/2022]
Abstract
The foreclosure crisis was detrimental to the financial well-being of many households, yet the non-economic consequences are still poorly understood. This systematic review aims to understand the direct and spillover effect of foreclosures on several health-related outcomes by synthesizing evidence from 40 studies. First, this study identifies research gaps using a schema to organize studies by line of inquiry, health-related outcome, and measure of homeowner financial distress. In order to provide context for the findings, four pathways - stress, effect-budgeting, frustration-aggression, and trust - evoked in the literature are described to explain the relationship between foreclosures and health. The research suggests that experiencing a foreclosure and living near foreclosures are associated with poor psychological and behavioral morbidities, namely anxiety and violent behavior, and declining health utilization. Evidence is sparse on suicide, substance abuse, somatic morbidities, and mortality. Future research is needed to fill the gaps and explicitly test the mechanisms proposed.
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42
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Karanikolos M, Heino P, McKee M, Stuckler D, Legido-Quigley H. Effects of the Global Financial Crisis on Health in High-Income Oecd Countries. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 46:208-40. [DOI: 10.1177/0020731416637160] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
A growing body of evidence documents how economic crises impact aspects of health across countries and over time. We performed a systematic narrative review of the health effects of the latest economic crisis based on studies of high-income countries. Papers published between January 2009 and July 2015 were selected based on review of titles and abstracts, followed by a full text review conducted by two independent reviewers. Ultimately, 122 studies were selected and their findings summarized. The review finds that the 2008 financial crisis had negative effects on mental health, including suicide, and to a varying extent on some non-communicable and communicable diseases and access to care. Although unhealthy behaviors such as hazardous drinking and tobacco use appeared to decline during the crisis, there have been increases in some groups, typically those already at greatest risk. The health impact was greatest in countries that suffered the largest economic impact of the crisis or prolonged austerity. The Great Recessions in high-income countries have had mixed impacts on health. They tend to be worse when economic impacts are more severe, prolonged austerity measures are implemented, and there are pre-existing problems of substance use among vulnerable groups.
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Affiliation(s)
- Marina Karanikolos
- Europe an Observatory on Health Systems and Policies, London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Pia Heino
- London School of Hygiene and Tropical Medicine, London, United Kingdom
- University of Helsinki, Helsinki, Finland
| | - Martin McKee
- Europe an Observatory on Health Systems and Policies, London, United Kingdom
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - David Stuckler
- Department of Sociology, University of Oxford, Oxford, United Kingdom
| | - Helena Legido-Quigley
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- London School of Hygiene and Tropical Medicine, London, UK
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43
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Downing J, Karter A, Rodriguez H, Dow WH, Adler N, Schillinger D, Warton M, Laraia B. No Spillover Effect of the Foreclosure Crisis on Weight Change: The Diabetes Study of Northern California (DISTANCE). PLoS One 2016; 11:e0151334. [PMID: 26985671 PMCID: PMC4795787 DOI: 10.1371/journal.pone.0151334] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 02/26/2016] [Indexed: 11/23/2022] Open
Abstract
The emerging body of research suggests the unprecedented increase in housing foreclosures and unemployment between 2007 and 2009 had detrimental effects on health. Using data from electronic health records of 105,919 patients with diabetes in Northern California, this study examined how increases in foreclosure rates from 2006 to 2010 affected weight change. We anticipated that two of the pathways that explain how the spike in foreclosure rates affects weight gain-increasing stress and declining salutary health behaviors- would be acute in a population with diabetes because of metabolic sensitivity to stressors and health behaviors. Controlling for unemployment, housing prices, temporal trends, and time-invariant confounders with individual fixed effects, we found no evidence of an association between the foreclosure rate in each patient's census block of residence and body mass index. Our results suggest, although more than half of the population was exposed to at least one foreclosure within their census block, the foreclosure crisis did not independently impact weight change.
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Affiliation(s)
- Janelle Downing
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Andrew Karter
- Division of Research, Kaiser Permanente, Oakland, California, United States of America
| | - Hector Rodriguez
- School of Public Health, University of California, Berkeley, California, United States of America
| | - William H Dow
- School of Public Health, University of California, Berkeley, California, United States of America
| | - Nancy Adler
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
| | - Dean Schillinger
- Department of Medicine, University of California San Francisco, San Francisco, California, United States of America
| | - Margaret Warton
- Division of Research, Kaiser Permanente, Oakland, California, United States of America
| | - Barbara Laraia
- School of Public Health, University of California, Berkeley, California, United States of America
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Margerison-Zilko C, Goldman-Mellor S, Falconi A, Downing J. Health Impacts of the Great Recession: A Critical Review. CURR EPIDEMIOL REP 2016; 3:81-91. [PMID: 27239427 DOI: 10.1007/s40471-016-0068-6] [Citation(s) in RCA: 134] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The severity, sudden onset, and multipronged nature of the Great Recession (2007-2009) provided a unique opportunity to examine the health impacts of macroeconomic downturn. We comprehensively review empirical literature examining the relationship between the Recession and mental and physical health outcomes in developed nations. Overall, studies reported detrimental impacts of the Recession on health, particularly mental health. Macro- and individual-level employment- and housing-related sequelae of the Recession were associated with declining fertility and self-rated health, and increasing morbidity, psychological distress, and suicide, although traffic fatalities and population-level alcohol consumption declined. Health impacts were stronger among men and racial/ethnic minorities. Importantly, strong social safety nets in some European countries appear to have buffered those populations from negative health effects. This literature, however, still faces multiple methodological challenges, and more time may be needed to observe the Recession's full health impact. We conclude with suggestions for future work in this field.
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Affiliation(s)
- Claire Margerison-Zilko
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Rd., Rm 601, East Lansing, MI 48824, Ph: 517-353-8623
| | - Sidra Goldman-Mellor
- Department of Public Health, University of California, Merced, 5200 N. Lake Rd., Merced, CA 95342, Ph: (209) 228-2498
| | - April Falconi
- General Internal Medicine, Stanford University, Palo Alto, CA 94305, Ph: (703) 328-4851
| | - Janelle Downing
- School of Public Health, University of California, Berkeley, 545 University Hall, University of California, Berkeley, CA 94720-7360, Ph: (510) 643-8571
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