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Belon AP, Yashadhana A, Kongats K, Atkey K, Glenn NM, Jaques K, Nieuwendyk L, Harris P, de Leeuw E, Nykiforuk CI. Australian and Canadian financial wellbeing policy landscape during COVID-19: An equity-informed policy scan. Health Policy Open 2024; 6:100114. [PMID: 38213762 PMCID: PMC10776654 DOI: 10.1016/j.hpopen.2023.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/27/2023] [Accepted: 12/09/2023] [Indexed: 01/13/2024] Open
Abstract
Background This targeted and comprehensive policy scan examined how different levels of governments in Australia and Canada responded to the financial crisis brought on by the COVID-19 pandemic. We mapped the types of early policy responses addressing financial strain and promoting financial wellbeing. We also examined their equity considerations. Methods Through a systematic search, snowballing, and manual search, we identified Canadian and Australian policies at all government levels related to financial strain or financial wellbeing enacted or amended in 2019-2020. Using a deductive-inductive approach, policies were categorized by jurisdiction level, focal areas, and target population groups. Results In total, 213 and 97 policies in Canada and Australia, respectively, were included. Comparisons between Canadian and Australian policies indicated a more diversified and equity-targeted policy landscape in Canada. In both countries, most policies focused on individual and family finances, followed by housing and employment areas. Conclusions The policy scan identified gaps and missed opportunities in the early policies related to financial strain and financial wellbeing. While fast, temporary actions addressed individuals' immediate needs, we recommend governments develop a longer-term action plan to tackle the root causes of financial strain and poor financial wellbeing for better health and non-health crisis preparedness. Statement on Ethics and Informed Consent This research reported in this paper did not require ethical clearance or patient informed consent as the data sources were published policy documents. This study did not involve data collection with humans (or animals), nor any secondary datasets involving data provided by humans (or from animal studies).
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Affiliation(s)
- Ana Paula Belon
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Aryati Yashadhana
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Krystyna Kongats
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Kayla Atkey
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Nicole M. Glenn
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
- PolicyWise for Children & Families, 1000 – 9925, 109 Street NW, Edmonton, AB T5K 2J8, Canada
| | - Karla Jaques
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Laura Nieuwendyk
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
| | - Patrick Harris
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Evelyne de Leeuw
- Centre for Primary Health Care & Equity, University of New South Wales, Sydney, Australia
- Healthy Urban Environments Collaboratory, Maridulu Budyari Gumal SPHERE, Sydney, Australia
| | - Candace I.J. Nykiforuk
- Centre for Healthy Communities, School of Public Health, University of Alberta, 3-035 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta T6G 1C9, Canada
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Greenwald SJ, Yokanovich L, Kourelis R, Parsons HM. Patient and family preferences in referral to legal services after a cancer diagnosis. Patient Educ Couns 2024; 122:108141. [PMID: 38237530 DOI: 10.1016/j.pec.2024.108141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/04/2024] [Accepted: 01/07/2024] [Indexed: 02/25/2024]
Affiliation(s)
- Samuel J Greenwald
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | | | | | - Helen M Parsons
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA.
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Chen X, Yan Q, Tang Y, Zhu J, Zhang W, Zhang J. Financial toxicity, family resilience and negative emotions among young and middle-aged breast cancer patients: A multicentre cross-sectional study. Breast 2024; 75:103735. [PMID: 38640552 PMCID: PMC11031793 DOI: 10.1016/j.breast.2024.103735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/22/2024] [Accepted: 04/15/2024] [Indexed: 04/21/2024] Open
Abstract
PURPOSE To determine financial toxicity in young and middle-aged women with breast cancer and examine the associations between family resilience and negative emotions. METHODS A multicentre cross-sectional study was conducted, 538 women with breast cancer were recruited from four hospitals. FT, family resilience, and negative emotions were collected using the Comprehensive Score for FT, the Chinese version of the Family Resilience Assessment in Breast Cancer Patients, Patient Health Questionnaire-9 item, and Generalized Anxiety Disorder-7. This study adhered to the STROBE guidelines. RESULTS The valid response rate was 96.8 % (N = 521). Overall, the score for FT was 19.63 ± 10.13. FT was significantly correlated with family resilience (r = 0.30, p < 0.010) and depression (r = -0.11, p < 0.050). The hierarchical multiple linear regression analysis showed that career status, monthly income, religion, and family resilience were the main factors influencing FT in patients with breast cancer (R2 = 0.37; F = 6.83; p < 0.001). CONCLUSIONS FT was more prevalent among women from low-income career. Women with poor family resilience, no religious also suffer greater financial toxicity. It is necessary to pay more attention of the financial toxicity of female' low-income career, no religious belief and poor family resilience. Developing effective interventions based on family resilience might be helpful in promoting their well-being.
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Affiliation(s)
- Xuelei Chen
- Nursing Psychology Research Center, Xiangya School of Nursing, Central South University, Changsha, China; Nursing School, Guilin Medical University, Guilin, China
| | - Qilin Yan
- Guilin Municipal Hospital of Traditional Chinese Medicine, Guilin, China
| | - Youjuan Tang
- Nursing School, Guilin Medical University, Guilin, China
| | - Jianing Zhu
- Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China
| | - Wenlu Zhang
- Nursing Psychology Research Center, Xiangya School of Nursing, Central South University, Changsha, China
| | - Jingping Zhang
- Nursing Psychology Research Center, Xiangya School of Nursing, Central South University, Changsha, China.
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Navas Huerga R, Salcedo de Diego I, de Miguel Jiménez C, Muñoz Martínez C, Kwon M, Pedraza García N, Calbacho M, Royuela Vicente A, Serrano Gallardo P. Financial toxicity in allogeneic haematopoietic stem cell transplant patients from a social determinants of health perspective. Eur J Oncol Nurs 2024; 70:102584. [PMID: 38631123 DOI: 10.1016/j.ejon.2024.102584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 03/25/2024] [Accepted: 03/30/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Financial toxicity (FT) refers to the subjective perception of financial distress resulting from objective economic strain due to illness, exerting a detrimental influence on health outcomes. This study aimed to describe FT among allogeneic haematopoietic stem cell transplant (allo-HSCT) recipients within a public health framework, employing a social determinants of health approach. METHODS A multi-centre cross-sectional study involving adult allo-HSCT patients was conducted across three public hospitals in Madrid. FT was assessed using a validated COST scale (range 0-44; lower scores indicating higher FT). Patient-administered paper/online questionnaires were utilized to collect data on sociodemographic, socioeconomic, clinical, and healthcare access variables. Descriptive, non-parametric univariate statistical analysis and multiple linear regression models were performed. RESULTS Sixty-six patients, with a mean age: 52.5 years (SD: 11.5), 50% women, 28.7% displaced to Madrid for HSCT, and 71.4% lacking financial support were included. The median FT score was 20 points (IQR 12-27.25). Independent factors associated with higher FT included being females (Coef = -3.26; p = 0.079), perceived income loss after HSCT (Coef = -6.81; p < 0.001) and a monthly household income of ≤1000 € compared to 1001-2500€ (Coef = 8.29; p = 0.005) or >2500 € (Coef = 15.75; p < 0.001). CONCLUSIONS Despite the limited sample size, our findings underscore the presence of financial toxicity among allo-HSCT patients, shaped by social determinants of health. Recognizing and addressing FT within the HSCT process is essential to mitigate social inequalities in health.
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Affiliation(s)
| | - Isabel Salcedo de Diego
- Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain; IDIPHISA (Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana, Majadahonda, Majadahonda, Spain.
| | - Carlos de Miguel Jiménez
- Department of Hematology, Hospital Universitario Puerta de Hierro Majadahonda, Majadahonda, Spain; IDIPHISA (Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana, Majadahonda, Majadahonda, Spain
| | | | - Mi Kwon
- Department of Hematology, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain
| | | | - María Calbacho
- Department of Hematology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ana Royuela Vicente
- IDIPHISA (Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana, Majadahonda, Majadahonda, Spain; Biostatistics Unit, Hospital Universitario Puerta de Hierro Majadahonda, Spain; CIBERESP, ISCIII, Madrid, Spain
| | - Pilar Serrano Gallardo
- Department of Nursing, Universidad Autónoma de Madrid, Madrid, Spain; IDIPHISA (Instituto de Investigación Sanitaria Puerta de Hierro-Segovia Arana, Majadahonda, Majadahonda, Spain; INAECU (Instituto Interuniversitario de Investigación Avanzada Sobre Evaluación de la Ciencia y la Universidad), Madrid, Spain
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Lewis TT, Parker R, Erving CL, Udaipuria S, Murden RJ, Fields ND, Booker B, Moore RH, Vaccarino V. Financial responsibility, financial context, and ambulatory blood pressure in early middle-aged African-American women. Soc Sci Med 2024; 345:116699. [PMID: 38412624 PMCID: PMC11014723 DOI: 10.1016/j.socscimed.2024.116699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/06/2024] [Accepted: 02/15/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND African-American women have excess rates of elevated blood pressure (BP) and hypertension compared to women of all other racial/ethnic backgrounds. Several researchers have speculated that race and gender-related socioeconomic status (SES) stressors might play a role. OBJECTIVE To examine the association between a novel SES-related stressor highly salient among African-American women, financial responsibility for one's household, and 48-h ambulatory BP. We further examined whether aspects related to African-American women's financial context (e.g., single parenthood, household income, marital status) played a role. METHODS Participants were N = 345 employed, healthy African-American women aged 30-46 from diverse SES backgrounds who underwent 48-h ambulatory BP monitoring. Linear regression analyses were conducted to examine associations between self-reported financial responsibility and daytime and nighttime BP, adjusting for age, SES and other sociodemographics, cardiovascular risk factors, financial strain and depressive symptoms. Interactions between financial responsibility and single parenthood, household income, and marital/partnered status were tested. RESULTS In age-adjusted analyses, reporting financial responsibility was associated with higher daytime systolic (β = 4.42, S.E. = 1.36, p = 0.0013), and diastolic (β = 2.82, S.E. = 0.98, p = 0.004) BP. Associations persisted in fully adjusted models. Significant associations were also observed for nighttime systolic and diastolic BP. There were no significant interactions with single parenthood, household income, nor marital/partnered status. CONCLUSION Having primary responsibility for one's household may be an important driver of BP in early middle-aged African-American women, independent of SES, financial strain, and across a range of financial contexts. Future studies examining prospective associations are needed, and policy interventions targeting structural factors contributing to financial responsibility in African-American women may be warranted.
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Affiliation(s)
- Tené T Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
| | - Rachel Parker
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christy L Erving
- Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Shivika Udaipuria
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Raphiel J Murden
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nicole D Fields
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bianca Booker
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Reneé H Moore
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology and Biostatistics, Drexel University, Dornsife School of Public Health, Philadelphia, PA, USA
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Baako KT, Mintah K, Churchill SA, Farrell L. Betting on the House: The Impact of Gambling on Homeownership in Australia. J Gambl Stud 2024; 40:159-179. [PMID: 37284991 PMCID: PMC10246535 DOI: 10.1007/s10899-023-10217-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/08/2023]
Abstract
Gambling is commonly associated with social and economic disadvantage. In this paper we examine the impact of gambling on homeownership, using Australian panel data. We find that gambling is associated with a lower probability of homeownership. Specifically, our endogeneity corrected estimates show that an increase in problem gambling is associated with between 1.6 and 1.8 percentage point decrease in the probability of owning a home depending on the model. Our result show that financial stress and social capital are channels through which gambling influences the probability of homeownership.
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Affiliation(s)
- Kingsley Tetteh Baako
- School of Property, Construction and Project Management, RMIT University, Melbourne, VIC, Australia.
| | - Kwabena Mintah
- School of Property, Construction and Project Management, RMIT University, Melbourne, VIC, Australia
| | | | - Lisa Farrell
- School of Economics, Finance and Marketing, RMIT University, Melbourne, VIC, Australia
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Bather JR, McSorley AMM, Rhodes-Bratton B, Cuevas AG, Rouhani S, Nafiu RT, Harris A, Goodman MS. Love after lockup: examining the role of marriage, social status, and financial stress among formerly incarcerated individuals. Health Justice 2024; 12:7. [PMID: 38400934 PMCID: PMC10893755 DOI: 10.1186/s40352-024-00264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 02/15/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Upon reintegration into society, formerly incarcerated individuals (FIIs) experience chronic financial stress due to prolonged unemployment, strained social relationships, and financial obligations. This study examined whether marriage and perceived social status can mitigate financial stress, which is deleterious to the well-being of FIIs. We also assessed whether sociodemographic factors influenced financial stress across marital status. We used cross-sectional data from 588 FIIs, collected in the 2023 Survey of Racism and Public Health. The financial stress outcome (Cronbach's [Formula: see text] = 0.86) comprised of five constructs: psychological distress, financial anxiety, job insecurity, life satisfaction, and financial well-being. Independent variables included marital and social status, age, race/ethnicity, gender identity, educational attainment, employment status, and number of dependents. Multivariable models tested whether financial stress levels differed by marital and perceived social status (individual and interaction effects). Stratified multivariable models assessed whether social status and sociodemographic associations varied by marital status. RESULTS We found that being married/living with a partner (M/LWP, b = -5.2) or having higher social status (b = -2.4) were protective against financial stress. Additionally, the social status effect was more protective among divorced, separated, or widowed participants (b = -2.5) compared to never married (NM, b = -2.2) and M/LWP (b = -1.7) participants. Lower financial stress correlated with Black race and older age, with the age effect being more pronounced among M/LWP participants (b = -9.7) compared to NM participants (b = -7.3). Higher financial stress was associated with woman gender identity (overall sample b = 2.9, NM sample b = 5.1), higher education (M/LWP sample b = 4.4), and having two or more dependents (overall sample b = 2.3, M/LWP sample b = 3.4). CONCLUSIONS We provide novel insights into the interrelationship between marriage, perceived social status, and financial stress among FIIs. Our findings indicate the need for policies and programs which may target the family unit, and not only the individual, to help alleviate the financial burden of FIIs. Finally, programs that offer legal aid to assist in expungement or sealing of criminal records or those offering opportunities for community volunteer work in exchange for vouchers specific to legal debt among FIIs could serve to reduce financial stress and improve social standing.
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Affiliation(s)
- Jemar R Bather
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA.
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, 10003, USA.
| | - Anna-Michelle Marie McSorley
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
| | - Brennan Rhodes-Bratton
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
| | - Adolfo G Cuevas
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
- Department of Social and Behavioral Sciences, New York University School of Global Public Health, New York, NY, 10003, USA
| | - Saba Rouhani
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, 10003, USA
- Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, 10003, USA
| | - Ridwan T Nafiu
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, 10003, USA
| | - Adrian Harris
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
| | - Melody S Goodman
- Center for Anti-Racism, Social Justice & Public Health, New York University School of Global Public Health, 708 Broadway, 9th Floor, New York, NY, 10003, USA
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, 10003, USA
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Swarup SS, P AK, Padhi BK, Satapathy P, Shabil M, Bushi G, Gandhi AP, Khatib MN, Gaidhane S, Zahiruddin QS, Rustagi S, Barboza JJ, Sah R. Cardiovascular consequences of financial stress: A systematic review and meta-analysis. Curr Probl Cardiol 2024; 49:102153. [PMID: 37979897 DOI: 10.1016/j.cpcardiol.2023.102153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 10/14/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Cardiovascular diseases (CVD), notably coronary artery disease (CAD) and coronary heart disease (CHD), are predominant contributors to global morbidity and mortality. Financial stress is recognized as a non-traditional risk factor for CVD. The objective of this study is to conduct a systematic review and meta-analysis on the association between financial stress and the incidence of major cardiac outcomes. METHODS A literature search was conducted across multiple databases up until September 20, 2023. Primary studies reporting the association between financial stress and the incidence of CAD, CHD, or major cardiovascular outcomes were included. The quality of the incorporated studies was evaluated using the Newcastle-Ottawa Scale. Statistical analysis was performed using R version 4.3, employing a random-effects model. RESULTS Out of 2,740 identified studies, seven satisfied the inclusion criteria, displaying a diverse range in design, settings, and participant demographics. A significant association was found between financial stress and major cardiac outcomes, with a combined hazard ratio (HR) of 1.191 (95% CI: 1.00 to 1.47), p<0.001 from five studies. Possible publication bias and variations in definitions and measurements of financial stress were noted among the studies. CONCLUSION The available literature substantiates an association between financial stress and the incidence of CAD/CHD or major cardiac outcomes, underscoring an urgent need for standardized definitions and measurements of financial stress. Our findings support the integration of financial stress assessments in patient care and the development of health policies emphasizing economic strains to enhance cardiovascular health outcomes and overall well-being.
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Affiliation(s)
- Shiba Sai Swarup
- Department of Community Medicine, District Headquarter Hospital, Koraput, India
| | - Asha K P
- Department of Community Medicine, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Bijaya Kumar Padhi
- Department of Community Medicine, School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Prakasini Satapathy
- Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India; School of Pharmacy, Graphic Era Hill University, Dehradun 248001 India
| | - Muhammed Shabil
- Evidence Synthesis Lab, Kolkata 700156, India; Global Center for Evidence Synthesis, Chandigarh 160036, India
| | - Ganesh Bushi
- Evidence Synthesis Lab, Kolkata 700156, India; Global Center for Evidence Synthesis, Chandigarh 160036, India
| | - Aravind P Gandhi
- Evidence Synthesis Lab, Kolkata 700156, India; Department of Community Medicine, ESIC Medical College & Hospital, Sanathnagar, Hyderabad 500038, India
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Global Health Academy, Division of Evidence Synthesis, School of Epidemiology and Public Health and Research, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher education and Research, Wardha. India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - Joshuan J Barboza
- Escuela de Medicina, Universidad César Vallejo, Trujillo 13007, Peru
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Kathmandu 46000, Nepal; Department of Clinical Microbiology, DY Patil Medical College, Hospital and Research Centre, DY Patil Vidyapeeth, Pune, Maharashtra 411000, India
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Maiya S, Dotterer AM, Serang S, Whiteman SD. COVID-19 Pandemic-Related Financial Hardships and Adolescents' Adjustment: A Longitudinal Family Stress Approach. J Youth Adolesc 2024; 53:432-445. [PMID: 37794286 DOI: 10.1007/s10964-023-01875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
Restrictions associated with the onset of the COVID-19 pandemic created a host of short- and long-term economic challenges for families. Despite their ubiquity during the early pandemic, knowledge on the developmental impacts of pandemic-related financial hardships on adolescents' adjustment is lacking. Guided by family stress and life course perspectives, this study investigated direct and indirect relations between pandemic-related financial hardships and adolescents' later depressive symptoms, delinquency, and academic performance via parents' depressive symptoms and acceptance. Data were drawn from three waves of a longitudinal study; participants completed online surveys at Wave 1, COVID-19 Wave (seven months later) and Wave 2 (five months later). Participants were two adolescent-aged siblings (n = 1364; 50% female; Mage = 14.45, SD = 1.55 years) and one parent (n = 682; 85% female; Mage = 45.15, SD = 5.37 years) from 682 families (N = 2048). Structural equation modeling results indicated that pandemic-related financial hardships were indirectly linked to greater adolescent delinquency and lower academic performance by adversely shaping parents' mental health and parent-adolescent relationship quality. The findings highlight financial hardships as critical family stressors for adolescent adjustment during the COVID-19 pandemic.
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Affiliation(s)
- Sahitya Maiya
- University of New Hampshire, 309 Pettee Hall, 55 College Road, Durham, NH, 03824, USA.
| | - Aryn M Dotterer
- Utah State University, 2905 Old Main Hill, Logan, UT, 84322, USA
| | - Sarfaraz Serang
- University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Shawn D Whiteman
- Utah State University, 2905 Old Main Hill, Logan, UT, 84322, USA
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10
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Kim C, Lee H, Jung-Choi K, Park H. Changes in Adolescent Health Behavior and the Exacerbation of Economic Hardship During the COVID-19 Pandemic: A Cross-sectional Study From the Korea Youth Risk Behavior Survey. J Prev Med Public Health 2024; 57:18-27. [PMID: 38327013 PMCID: PMC10861325 DOI: 10.3961/jpmph.23.306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 02/09/2024] Open
Abstract
OBJECTIVES This study investigated the association between exacerbated economic hardship during the coronavirus disease 2019 (COVID-19) pandemic and changes in the health behaviors of Korean adolescents. METHODS We analyzed data from the 2021 Korea Youth Risk Behavior Survey and included 44 908 students (22 823 boys and 22 085 girls) as study subjects. The dependent variables included changes in health behaviors (breakfast habits, physical activity, and alcohol use) that occurred during the COVID-19 pandemic. The aggravation of economic hardship by COVID-19 and the subjective economic status of the family were used as exposure variables. Multiple logistic regression analysis was utilized to calculate the prevalence odds ratios (PORs). RESULTS Severe exacerbation of a family's economic hardship due to COVID-19 was negatively associated with the health behaviors of adolescents, including increased breakfast skipping (POR, 1.85; 95% confidence interval [CI], 1.55 to 2.21 for boys and POR, 1.56; 95% CI, 1.27 to 1.92 for girls) and decreased physical activity (POR, 1.37; 95% CI, 1.19 to 1.57 for boys and POR, 1.38; 95% CI, 1.19 to 1.60 for girls). These negative changes in health behaviors were further amplified when combined with a low subjective family economic status. CONCLUSIONS The experience of worsening household hardship can lead to negative changes in health behavior among adolescents. It is crucial to implement measures that address the economic challenges that arise from stressful events such as COVID-19 and to strive to improve the lifestyles of adolescents under such circumstances.
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Affiliation(s)
- Chaeeun Kim
- Ewha Womans University College of Medicine, Seoul, Korea
| | - Haeun Lee
- Ewha Womans University College of Medicine, Seoul, Korea
| | - Kyunghee Jung-Choi
- Department of Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Graduate Program in Health System Science & Engineering, Ewha Womans University College of Medicine, Seoul, Korea
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Banerjee K, Sahoo H, Govil D. Financial stress, health and malnourishment among older adults in India. BMC Geriatr 2023; 23:861. [PMID: 38102552 PMCID: PMC10724991 DOI: 10.1186/s12877-023-04532-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 11/29/2023] [Indexed: 12/17/2023] Open
Abstract
As India's elderly population grows rapidly, there is a demand for robust policy tools for geriatric health management. This study focuses on unveiling the impact of financial stress and insecurity in diverse economic sectors on adult malnutrition in India. Further, we explore the connections of adult malnourishment with mental and physical health outcomes. Analysis has been done using data of 59,764 respondents aged 45 years and above from the Longitudinal Ageing Study in India (LASI- Wave I) (2017-19). A modified Malnutrition Universal Screening Tool (MUST) has been used to assess the risk of adult malnutrition. It categorizes malnutrition into Low Risk, High Risk Group 1 (HRG1-undernourished), and High Risk Group 2 (HRG2-over-nourished). Approximately 26% of adults were classified in HRG1, characterized by low body mass index, recent hospital admissions, and affiliation with food-insecure households. Around 25% adults belonged to HRG2 characterized by high body mass index and waist-to-hip ratio. The relative risk ratios from the multinomial logit generalized structural equation model indicate that the risk of being in HRG1 was 20-40% higher among respondents not presently working or receiving pension benefits, as well as those involved in agricultural work. The risk of being in HRG2 doubles if the respondent was diagnosed with some chronic disease during the last 12 months. A higher composite cognition score reduces the risk of being in HRG1 by 4%, while it increases the risk of being in HRG2 by 3%. Additionally, experiencing episodic depression raises the risk of being in HRG1 by 10%. Financial insecurity, particularly in the informal and agricultural sectors, coupled with poor mental health, hinders positive nutritional outcomes. Extending universal pro-poor policies to fortify food security in resource poor households and integrating mental health variables in nutrition policies can be beneficial to address adult malnourishment in India.
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Affiliation(s)
- Kajori Banerjee
- Department of Quantitative Techniques, Anil Surendra Modi School of Commerce (ASMSOC), SVKM's Narsee Monjee Institute of Management Studies (NMIMS) Deemed-to-University, Mumbai, Maharashtra, 400056, India.
| | - Harihar Sahoo
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
| | - Dipti Govil
- Department of Family & Generations, International Institute for Population Sciences (IIPS), Mumbai, Maharashtra, 400088, India
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12
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Stith BR, Jiang X. Personal growth Initiative as a protective factor between the relation of practical stress and life satisfaction. J Am Coll Health 2023:1-9. [PMID: 38039412 DOI: 10.1080/07448481.2023.2277196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Accepted: 10/22/2023] [Indexed: 12/03/2023]
Abstract
Objective: Stress stemming from practical or financial obstacles is among the top sources of stress for college students. The current study examined if one new positive psychological strength factor, personal growth initiative, functioned as a buffer to protect young adults' life satisfaction, anxiety, and depression from practical stress. Participants: Undergraduate students (N = 353, age range 18-23, 73.9% female) at a public university. Method: Participants were recruited through classes and on campus via flyers and completed self-report surveys online. Results: Personal growth initiative significantly moderated the relation between practical stressors and life satisfaction. Specifically, the negative effect of practical stressors on life satisfaction decreased as personal growth initiative levels increased. Practical stress significantly predicted anxiety and depression, though no significant interactions were identified in this model. Conclusion: Overall, results highlighted the protective function of personal growth initiative for life satisfaction in the context of practical stressors faced by young adults in college. Implications and future directions for research are discussed.
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Affiliation(s)
| | - Xu Jiang
- Temple University, Philadelphia, Pennsylvania, USA
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13
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Stone BV, Labban M, Filipas DK, Beatrici E, Lipsitz SR, Reis LO, Feldman AS, Kibel AS, Cole AP, Morgans AK, Trinh QD. The Risk of Catastrophic Healthcare Expenditures Among Prostate and Bladder Cancer Survivors in the United States. Clin Genitourin Cancer 2023; 21:617-625. [PMID: 37316413 DOI: 10.1016/j.clgc.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Little is known about the rates of catastrophic health care expenditures among survivors of prostate and bladder cancer or the factors that place patients at highest risk for undue cost. MATERIALS AND METHODS The Medical Expenditure Panel Survey was utilized to identify prostate and bladder cancer survivors from 2011 to 2019. Rates of catastrophic health care expenditures (out-of-pocket health care spending >10% household income) were compared between cancer survivors and adults without cancer. A multivariable regression model was used to identify risk factors for catastrophic expenditures. RESULTS Among 2620 urologic cancer survivors, representative of 3,251,500 (95% CI 3,062,305-3,449,547) patients annually after application of survey weights, there were no significant differences in catastrophic expenditures among respondents with prostate cancer compared to adults without cancer. Respondents with bladder cancer had significantly greater rates of catastrophic expenditures (12.75%, 95% CI 9.36%-17.14% vs. 8.33%, 95% CI 7.66%-9.05%, P = .027). Significant predictors of catastrophic expenditures in bladder cancer survivors included older age, comorbidities, lower income, retirement, poor health status, and private insurance. Though White respondents with bladder cancer had no significantly increased risk of catastrophic expenditures, among Black respondents the risk of catastrophic expenditures increased from 5.14% (95% CI 3.95-6.33) without bladder cancer to 19.49% (95% CI 0.84-38.14) with bladder cancer (OR 6.41, 95% CI 1.28-32.01, P = .024). CONCLUSIONS Though limited by small sample size, these data suggest that bladder cancer survivorship is associated with catastrophic health care expenditures, particularly among Black cancer survivors. These findings should be taken as hypothesis-generating and warrant further investigation with larger sample sizes and, ideally, prospective investigation.
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Affiliation(s)
- Benjamin V Stone
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Muhieddine Labban
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Dejan K Filipas
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Edoardo Beatrici
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Stuart R Lipsitz
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Leonardo O Reis
- UroScience, School of Medical Sciences, University of Campinas, UNICAMP, and Pontifical Catholic University of Campinas, PUC-Campinas, Campinas, Sao Paulo, Brazil
| | - Adam S Feldman
- Department of Urology, Massachusetts General Hospital, Boston, MA
| | - Adam S Kibel
- Division of Urological Surgery, Brigham and Women's Hospital, Boston, MA
| | - Alexander P Cole
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alicia K Morgans
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Quoc-Dien Trinh
- Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
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Paoletti J, Phetmisy CN, Lai VD, Fagundes CP. Perceived income inadequacy is associated with Epstein-Barr Virus latency and mental health outcomes in informal caregivers who are also employed in the healthcare industry. Psychoneuroendocrinology 2023; 158:106388. [PMID: 37729703 DOI: 10.1016/j.psyneuen.2023.106388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/24/2023] [Accepted: 09/10/2023] [Indexed: 09/22/2023]
Abstract
Finances are a prevalent source of stress. In a sample of 799 nursing home workers measured multiple times over 18 months, we found that higher perceived income inadequacy, the perception that one's expenses exceeds one's incomes, was associated with poorer self-reported mental health indicators and Epstein-Barr Virus antibody titers (a marker of cell-mediated immune function). Perceived income inadequacy predicted outcomes over and above the role of other socioeconomic status variables (objective household income and education). Mental health variables were not related to Epstein-Barr Virus antibody titers. Additionally, we found an interaction between perceived income inadequacy and informal caregiver status on our mental health outcomes; informal caregivers with higher perceived income inadequacy had poorer mental health than non-caregivers with the same perceived income inadequacy. Our findings may add nuance to the reserve capacity model, which states that those at lower socioeconomic levels are at higher risk of adverse health outcomes partly because they have fewer resources to address demands and strain. Perceived income inadequacy may significantly predict mental and physical well-being beyond other socioeconomic status variables, especially among lower-income employees. Caregiving stress and perceived income inadequacy may have synergistic effects on mental health.
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Affiliation(s)
| | | | | | - Christopher P Fagundes
- Rice University, USA; University of Texas MD Anderson Cancer Center, USA; Baylor College of Medicine, USA
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15
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Allen LA, Lowe EF, Matlock DD. The Economic Burden of Heart Failure with Reduced Ejection Fraction: Living Longer but Poorer? Cardiol Clin 2023; 41:501-510. [PMID: 37743073 DOI: 10.1016/j.ccl.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Treatment of heart failure with reduced ejection fraction (HFrEF) has benefitted from a proliferation of new medications and devices. These treatments carry important clinical benefits, but also come with costs relevant to payers, providers, and patients. Patient out-of-pocket costs have been implicated in the avoidance of medical care, nonadherence to medications, and the exacerbation of health care disparities. In the absence of major health care policy and payment redesign, high-quality HFrEF care delivery requires transparent integration of cost considerations into system design, patient-clinician interactions, and medical decision making.
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Affiliation(s)
- Larry A Allen
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Academic Office One, #7019, Mailstop B130, Aurora, CO 80045, USA.
| | - Emily Fryman Lowe
- Department of Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Mailstop B177, Aurora, CO 80045, USA
| | - Dan D Matlock
- Adult and Child Center for Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine, Children's Hospital Colorado, 1890 North Revere Court, Mailstop F44, Aurora, CO 80045, USA
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Sears-Smith M, Knight TG. Financial Toxicity in Patients with Hematologic Malignancies: a Review and Need for Interventions. Curr Hematol Malig Rep 2023; 18:158-166. [PMID: 37490228 DOI: 10.1007/s11899-023-00707-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Financial toxicity is a developing research area to quantify the financial stress experienced by patients and caregivers, as well as the mechanisms by which they manage the costs associated with treatment and the very real harms that this stress can inflict upon cancer care. Patients with blood malignancies experience increased costs associated with their diagnosis due to possible inpatient admissions for treatment, frequent office visits, and even more frequent lab evaluations and testing. PURPOSE OF REVIEW Multiple studies have examined the causes and effects of financial toxicity on patient care and outcomes, and there have been several validated tools developed to identify patients experiencing or at risk for financial harm. DISCUSSION However, few studies to date have focused on implementing successful interventions to assist in mitigating financial difficulties for patients diagnosed with hematologic malignancies and their families. In this review, we examine the current literature with an emphasis on levels of care, including providers, systems, and policies. Specifically, we discuss published interventions including physician education about treatment costs, financial navigation in cancer centers, and novel institutional multidisciplinary review of patients' financial concerns. We also discuss the urgent need for societal and governmental interventions to lessen financial distress experienced by these highly vulnerable blood cancer patients.
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Affiliation(s)
- Megan Sears-Smith
- Levine Cancer Institute, Atrium Health, 1020 Morehead Medical Drive, Charlotte, NC, 28204, USA
| | - Thomas G Knight
- Levine Cancer Institute, Atrium Health, 1021 Morehead Medical Drive, LCI Building 2, Suite 60100, Charlotte, NC, 28204, USA.
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17
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Jaffar N, Mohd Faizal S, Selamat Z, Alias N. Muslim young adults' financial strain and financial stress during the COVID-19 pandemic: The moderating role of religiosity. Heliyon 2023; 9:e21047. [PMID: 37876443 PMCID: PMC10590929 DOI: 10.1016/j.heliyon.2023.e21047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 10/12/2023] [Accepted: 10/13/2023] [Indexed: 10/26/2023] Open
Abstract
The COVID-19 pandemic affected everyone's lives and general well-being worldwide, including young adults. Young adulthood is marked by a shift in various social areas including acquiring financial independence. As the pandemic was an exceptional scenario in all nations, there is a research gap in analysing how it would affect financial experiences of young adults, particularly the Muslim young adults. These individuals may face financial stress as a result of the COVID-19 pandemic due to their high level of financial strain. Furthermore, little is still known about the role that religiosity may play in the relationship between the financial strain and financial stress, notably during the pandemic. The objectives of this study were to examine the level of financial strain and financial stress of Muslim young adults, assess the effect of financial strain on financial stress of Muslim young adults and investigate the moderating effect of religiosity on the relationship between Muslim young adults' financial strain and financial stress during the COVID-19 pandemic. A survey of 230 Muslim young adults was conducted in Malaysia. Results showed that thirty percent of Muslim young adults fell under high level of financial strain while majority of them fell under high level of financial stress. Additionally, financial strain had a significant positive effect on the financial stress of Muslim young adults. This means that the more financially strained, the more Muslim young adults experienced financial stress during the COVID-19 pandemic. Religiosity, however, did not moderate the relationship between financial strain and financial stress. These results highlighted the significance of comprehending the level of financial strain and financial stress experienced by Muslim young adults during the COVID-19 pandemic. The results provided relevant parties insights in developing strategies for Muslim young adults to manage financial strain and financial stress to reduce the negative effect of the COVID-19 pandemic.
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Affiliation(s)
- Nahariah Jaffar
- School of Economics and Management, Xiamen University Malaysia, 43900 Sepang, Selangor, Malaysia
| | - Sellywati Mohd Faizal
- Faculty of Management, Multimedia University, Persiaran Multimedia, 63100 Cyberjaya, Selangor, Malaysia
| | - Zarehan Selamat
- Faculty of Management, Multimedia University, Persiaran Multimedia, 63100 Cyberjaya, Selangor, Malaysia
| | - Norazlan Alias
- Faculty of Economics and Management, Universiti Kebangsaan Malaysia, 43600 Bandar Baru Bangi, Selangor, Malaysia
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Sud P, Munjal SK, Panda N. Challenges faced by Indian parents in raising a child with a cochlear implant - Impact on communication outcomes. Int J Pediatr Otorhinolaryngol 2023; 172:111695. [PMID: 37567086 DOI: 10.1016/j.ijporl.2023.111695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023]
Abstract
OBJECTIVES The objectives of the present study were to understand the parental views regarding stress, and its affect language, and auditory outcomes. The study also aims to understand the relationship between parental stress, and child's age. DESIGN, SETTING AND PARTICIPANTS A retrospective study was performed at a tertiary medical hospital. 50 parents of cochlear implant recipients were recruited for the study. The parents were interviewed and the children were tested using a test battery. The average age of implantation was 4.29 years, and the average hearing age was 3.23 years. MAIN OUTCOME MEASURES The parents were interviewed about their child's needs, and experience with the cochlear implant using the Strength, and Difficulty questionnaire in Hindi, Questionnaire on Resources, and Stress-Short Form, and the Family Environment Scale, Closed - format Questionnaire to understand parental views, and experiences. The language outcomes were studied using the Integrated Scales of Development (ISD), Revised Categories of Auditory Performance. Factor analysis, and Chi-square tests were performed to understand potential relationships between parental stress, and child language, and/or auditory outcomes. RESULTS The results provide five main factors that accounted for significant variance including financial stress (30.1%), hyperactivity (15.2%), lack of personal rewards (13%), peer problems (10.9%), and emotional problems (9.2%). Acquisition of language was highly influenced by stress and caregiver's 'lack of personal rewards. 'Financial stress', and 'hyperactive behavior' of the child significantly affected the receptive language acquisition of a HI child. The most concerning factors for parents were well-being, and happiness (0.885), followed by social relationships (0.830), communication (0.736), the process of implantation (0.695), and the decision to implant (0.681). The stress regarding finance among parents increased marginally (0.024) as the child's age progressed. CONCLUSION Parental stress is ongoing. The impact on the expressive language development of the child is significant. The maximum concern of parents is regarding the financial aspects of a cochlear implant, and the lifespan care of their child. Hence, professionals should provide regular, and context-specific counseling to parents after implantation to understand the parents' concerns, and provide appropriate remediation.
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Affiliation(s)
- Parul Sud
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Sanjay Kumar Munjal
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Naresh Panda
- Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Bixby TJ, Brittle CJ, Mangan PA, Stadtmauer EA, Kallenbach LR. Patient Perceptions of CAR-T Therapy in the USA: Findings from In-Depth Interviews. Oncol Ther 2023; 11:303-312. [PMID: 37210682 PMCID: PMC10200031 DOI: 10.1007/s40487-023-00232-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/03/2023] [Indexed: 05/22/2023] Open
Abstract
INTRODUCTION Chimeric antigen receptor-T cell (CAR-T) therapy has revolutionized advanced blood cancer treatment. However, preparation, administration, and recovery from these therapies can be complex and burdensome to patients and their care partners. Utilization of an outpatient setting for CAR-T therapy administration could help improve convenience and quality of life. METHODS In-depth qualitative interviews were conducted with 18 patients in the USA with relapsed/refractory multiple myeloma or relapsed/refractory diffuse large B-cell lymphoma, 10 of whom had completed investigational or commercially approved CAR-T therapy and 8 of whom had discussed it with their physicians. We aimed to better understand inpatient experiences and patient expectations regarding CAR-T therapy and to ascertain patient perspectives on the possibility of outpatient care. RESULTS CAR-T offers unique treatment benefits, particularly high response rates with an extended treatment-free period. All study participants completing CAR-T were very positive about their inpatient recovery experience. Most reported mild-to-moderate side effects; two experienced severe side effects. All said that they would opt to undergo CAR-T therapy again. Participants felt that the primary advantage of inpatient recovery was immediate access to care and on-going monitoring. Perceived advantages of the outpatient setting were comfort and familiarity. Because immediate access to care was seen as crucial, patients recovering in an outpatient setting would seek either a direct contact person or phone line for assistance if needed. CONCLUSION As institutions become more experienced with CAR-T therapies, outpatient care may help reduce financial strain. Patient input can help institutions improve the outpatient experience and ensure safety and effectiveness of CAR-T programs.
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Affiliation(s)
- Todd J Bixby
- Janssen Scientific Affairs, LLC, 800 Ridgeview Dr, Horsham, PA, 19044, USA.
| | | | - Patricia A Mangan
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Edward A Stadtmauer
- Perelman School of Medicine, University of Pennsylvania, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Lisa R Kallenbach
- Janssen Scientific Affairs, LLC, 800 Ridgeview Dr, Horsham, PA, 19044, USA
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20
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Gaston SA, Strassle PD, Alhasan DM, Pérez-Stable EJ, Nápoles AM, Jackson CL. Financial hardship, sleep disturbances, and their relationship among men and women in the United States during the COVID-19 pandemic. Sleep Health 2023; 9:551-559. [PMID: 37280141 PMCID: PMC10239652 DOI: 10.1016/j.sleh.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE In the United States (US), the health and financial consequences of COVID-19 have disproportionately impacted women and minoritized racial-ethnic groups. Yet, few US studies have investigated financial hardship during the COVID-19 pandemic and sleep health disparities. Our objective was to investigate associations between financial hardship and sleep disturbances during the COVID-19 pandemic by gender and race and ethnicity in the United States. METHODS We used the nationally representative COVID-19's Unequal Racial Burden cross-sectional survey data collected among 5339 men and women from 12/2020 to 2/2021. Participants reported financial hardship (eg, debt, employment/work loss) since the pandemic began and completed the Patient-Reported Outcomes Management Information System Short Form 4a for sleep disturbances. Prevalence ratios (PRs) and 95% confidence intervals were estimated using adjusted, weighted Poisson regression with robust variance. RESULTS Most (71%) participants reported financial hardship. Prevalence of moderate to severe sleep disturbances was 20% overall, higher among women (23%), and highest among American Indian/Alaska Native (29%) and multiracial adults (28%). Associations between financial hardship and moderate to severe sleep disturbances (PR = 1.52 [95% confidence interval: 1.18, 1.94]) did not differ by gender but varied by race and ethnicity: associations were strongest among Black/African American (PR = 3.52 [1.99,6.23]) adults. CONCLUSIONS Both financial hardship and sleep disturbances were prevalent, and their relationships were strongest among certain minoritized racial-ethnic groups, particularly Black/African American adults. Interventions that alleviate financial insecurity may reduce sleep health disparities.
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Affiliation(s)
- Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA
| | - Eliseo J Pérez-Stable
- Office of the Director, National Institute on Minority Health and Health Disparities and the Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Anna M Nápoles
- Office of the Scientific Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland, USA.
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21
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Patel MR, Anthony Tolentino D, Smith A, Heisler M. Economic burden, financial stress, and cost-related coping among people with uncontrolled diabetes in the U.S. Prev Med Rep 2023; 34:102246. [PMID: 37252071 PMCID: PMC10209691 DOI: 10.1016/j.pmedr.2023.102246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 01/02/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023] Open
Abstract
Granular information on material deprivation including financial and economic well-being among people with diabetes can better inform policy, practice and interventions to support diabetes management. The purpose of this study was to describe in-depth the state of economic burden, financial stress, and coping among people with high A1c. Data came from the 2019-2021 baseline assessment in an ongoing U.S. trial that addresses social determinants of health among people with diabetes and high A1c who report at least one financial burden or cost-related non-adherence (CRN) (n = 600). Mean age of participants was 53 years. Planning behaviors were the most common financial well-being behavior, while savings was least frequently endorsed. Nearly a quarter of participants report spending more than $300 per month out-of-pocket to manage all of their health conditions. Participants reported spending the most out-of-pocket on medications (52%), special foods (40%), doctor's visits (27%), and blood glucose supplies (22%). Along with health insurance, these were also the most cited as sources of financial stress and where assistance. Seventy-two percent reported high levels of financial stress. Maladaptive coping was evident through CRN, and less than half engaged in adaptive coping such as talking to a doctor about cost or using a resource to address their needs. Economic burden, financial stress, and cost-related coping are highly relevant constructs among people with diabetes and high A1cs. More evidence-generation is needed for diabetes self-management programs to address sources of financial stress, facilitate behaviors to enhance financial well-being, and address unmet social needs to alleviate economic burdens.
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Affiliation(s)
- Minal R. Patel
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, United States
| | | | - Alyssa Smith
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, United States
| | - Michele Heisler
- Department of Health Behavior & Health Education, University of Michigan School of Public Health, United States
- Department of Internal Medicine, Michigan Medicine, United States
- U.S. Department of Veterans Affairs VA Ann Arbor Healthcare System, United States
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22
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Kovski N, Pilkauskas NV, Michelmore K, Shaefer HL. Unconditional cash transfers and mental health symptoms among parents with low incomes: Evidence from the 2021 child tax credit. SSM Popul Health 2023; 22:101420. [PMID: 37151915 PMCID: PMC10148983 DOI: 10.1016/j.ssmph.2023.101420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 03/18/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023] Open
Abstract
The COVID-19 pandemic increased anxiety and depression in the U.S. population, particularly among low-income households, parents, and Black and Hispanic adults. To address the negative impacts of the pandemic, Congress temporarily expanded the Child Tax Credit (CTC) in 2021, providing a near-universal, unconditional cash transfer to families with children. Using a quasi-experimental, parameterized difference-in-differences research design, we examine the effects of the 2021 monthly CTC on symptoms of anxiety and depression in a large, national sample of parents with low incomes (N∼15,000). We study potential differences in the associations by race/ethnicity and consider whether CTC effects were stronger after a longer treatment period (for instance, due to greater dosage or delayed effects). We find some evidence that the monthly credit reduced parental anxiety and depression symptoms, although the results were not robust throughout all model specifications. Analyses stratified by race/ethnicity show stronger associations for non-Hispanic Black parents than for non-Hispanic White parents or Hispanic parents, although differences were small. We also find the credit reduced anxiety (but not depression) symptoms after three months of payments, suggesting that it took some time for the CTC to affect mental health symptoms. Overall, this study suggests that recurring cash transfers to families in poverty in the U.S. may have small beneficial effects on parental mental health.
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Affiliation(s)
- Nicole Kovski
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - Natasha V Pilkauskas
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - Katherine Michelmore
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - H Luke Shaefer
- Gerald R. Ford School of Public Policy, University of Michigan, Ann Arbor, MI, USA
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23
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Pail O, Knight TG. Financial toxicity in patients with leukemia undergoing hematopoietic stem cell transplantation: A systematic review. Best Pract Res Clin Haematol 2023; 36:101469. [PMID: 37353293 DOI: 10.1016/j.beha.2023.101469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/25/2023]
Abstract
Financial toxicity (FT) is a term used to describe the objective financial burden of cancer care including the associated coping behaviors used by patients and their caregivers. FT has been shown to result in both direct financial burdens and in clinically relevant outcomes, such as non-adherence with care, diminished quality of life, and even decreased overall survival. Much of the data has been described in solid tumors, with limited investigations in the malignant hematology population. Patients with hematologic malignancies undergoing hematopoietic stem cell transplantation (HSCT) face a unique financial burden driven by lengthy hospitalizations and acute and chronic morbidity that have downstream implications on their income and costs. In this review, we discuss the prevalence of FT in patients with leukemia who are eligible for HSCT. We review the impact of FT on financial and clinical outcomes and the role of various interventions that have been studied within this population.
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Affiliation(s)
- Orrin Pail
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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24
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Odai-Afotey A, Lederman RI, Ko NY, Gagnon H, Fikre T, Gundersen DA, Revette AC, Hershman DL, Crew KD, Keating NL, Freedman RA. Breast cancer treatment receipt and the role of financial stress, health literacy, and numeracy among diverse breast cancer survivors. Breast Cancer Res Treat 2023; 200:127-137. [PMID: 37178432 PMCID: PMC10182756 DOI: 10.1007/s10549-023-06960-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/26/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE Disparities in breast cancer treatment for low-income and minority women are well documented. We examined economic hardship, health literacy, and numeracy and whether these factors were associated with differences in receipt of recommended treatment among breast cancer survivors. METHODS During 2018-2020, we surveyed adult women diagnosed with stage I-III breast cancer between 2013 and 2017 and received care at three centers in Boston and New York. We inquired about treatment receipt and treatment decision-making. We used Chi-squared and Fisher's exact tests to examine associations between financial strain, health literacy, numeracy (using validated measures), and treatment receipt by race and ethnicity. RESULTS The 296 participants studied were 60.1% Non-Hispanic (NH) White, 25.0% NH Black, and 14.9% Hispanic; NH Black and Hispanic women had lower health literacy and numeracy and reported more financial concerns. Overall, 21 (7.1%) women declined at least one component of recommended therapy, without differences by race and ethnicity. Those not initiating recommended treatment(s) reported more worry about paying large medical bills (52.4% vs. 27.1%), worse household finances since diagnosis (42.9% vs. 22.2%), and more uninsurance before diagnosis (9.5% vs. 1.5%); all P < .05. No differences in treatment receipt by health literacy or numeracy were observed. CONCLUSION In this diverse population of breast cancer survivors, rates of treatment initiation were high. Worry about paying medical bills and financial strain were frequent, especially among non-White participants. Although we observed associations of financial strain with treatment initiation, because few women declined treatments, understanding the scope of impact is limited. Our results highlight the importance of assessments of resource needs and allocation of support for breast cancer survivors. Novelty of this work includes the granular measures of financial strain and inclusion of health literacy and numeracy.
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Affiliation(s)
- Ashley Odai-Afotey
- Department of Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ruth I Lederman
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Naomi Y Ko
- Section of Hematology and Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Haley Gagnon
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Tsion Fikre
- Section of Hematology and Medical Oncology, Department of Medicine, Boston Medical Center, Boston, MA, USA
| | - Daniel A Gundersen
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Anna C Revette
- Survey and Qualitative Methods Core, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Dawn L Hershman
- Department of Medicine and Epidemiology, Columbia University Irving Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Katherine D Crew
- Department of Medicine and Epidemiology, Columbia University Irving Medical Center, Herbert Irving Comprehensive Cancer Center, New York, NY, USA
| | - Nancy L Keating
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
- Division of General Internal Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Rachel A Freedman
- Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
- Breast Oncology Program, Dana-Farber Brigham Cancer Center, Boston, MA, USA.
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25
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Forbes K, Friedrich C, Reinhardt D. Stress relief? Funding structures and resilience to the covid shock. J Monet Econ 2023; 137:S0304-3932(23)00044-2. [PMID: 37363636 PMCID: PMC10156383 DOI: 10.1016/j.jmoneco.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 06/28/2023]
Abstract
How did funding structures-the source, instrument, currency, and counterparty location of financing-relate to the financial stress experienced in different countries and sectors during Covid-19? Banks and corporates with a higher share of funding from non-bank financial institutions (NBFIs) or in US dollars experienced significantly greater stress, while more funding in debt instruments (versus loans) or cross-border (versus domestically) did not affect resilience. Policies targeting these structural vulnerabilities (US$ swap lines and NBFI policies) were more effective at mitigating stress than policies supporting banks, even controlling for macroeconomic policies. Macroprudential regulations should prioritize exposures to NBFI and dollar funding.
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Affiliation(s)
- Kristin Forbes
- MIT-Sloan School of Management, NBER and CEPR, United States
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26
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White N, Packard K, Kalkowski J, Walters R, Haddad AR, Flecky K, Rusch L, Furze J, Black L, Peterson J. Improving Health through Action on Economic Stability: Results of the Finances First Randomized Controlled Trial of Financial Education and Coaching in Single Mothers of Low-Income. Am J Lifestyle Med 2023; 17:424-436. [PMID: 37304747 PMCID: PMC10248371 DOI: 10.1177/15598276211069537] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
OBJECTIVES Evaluate the health impact of a novel financial education and coaching program in single mothers of low-income in Omaha, Nebraska. METHODS Employed, single mothers earning no more than 200% of the 2017 Federal Poverty Level (n = 345) enrolled in the study between April 2017 and August 2020 and were randomized to receive a novel financial education and coaching program, the Financial Success Program (FSP) or no intervention control. Demographics, biometrics, financial strain, health behaviors and healthcare utilization were assessed at baseline and the 12-month study visits. RESULTS Participants who completed the FSP demonstrated significantly reduced financial strain, an increased rate of smoking cessation, and a reduction in avoidance of medical care due to cost compared to participants in the control group. CONCLUSIONS The FSP represents an effective model in promoting economic stability in vulnerable individuals through a reduction in financial strain. Health behavior changes including an increased rate of smoking cessation were demonstrated within the first 12 months of intervention.
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Affiliation(s)
- Nicole White
- Nicole White, Pharmacy Practice Creighton
University School of Pharmacy and Health Professions, 2500 California Plaza,
Omaha, NE 68178, USA.
| | - Kathleen Packard
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Julie Kalkowski
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Ryan Walters
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Ann Ryan Haddad
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Kathy Flecky
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Lorraine Rusch
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Jennifer Furze
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Lisa Black
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
| | - Julie Peterson
- School of Pharmacy and Health
Professions, Creighton University, Omaha, NE, USA (NW, KP, ARH, KF, JF, LB, JP)
- Creighton University College of
Nursing, Omaha, NE, USA (LR)
- Financial Hope Collaborative, Creighton University, Omaha, NE, USA (JK)
- Creighton University School of
Medicine, Omaha, NE, USA (RW)
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27
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Cwalina TB, Jella TK, Tripathi R, Carroll BT. Financial stress among skin cancer patients: a cross-sectional review of the 2013-2018 National Health Interview Survey. Arch Dermatol Res 2023; 315:1003-1010. [PMID: 35192005 PMCID: PMC8861625 DOI: 10.1007/s00403-022-02330-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/20/2022] [Accepted: 02/07/2022] [Indexed: 11/12/2022]
Abstract
Financial stress among skin cancer patients may limit treatment efficacy by forcing the postponement of care or decreasing adherence to dermatologist recommendations. Limited information is available quantifying the anxiety experienced by skin cancer patients from both healthcare and non-healthcare factors. Therefore, the present study sought to perform a retrospective cross-sectional review of the 2013-2018 cycles of the National Health Interview Survey (NHIS) to determine the prevalence, at-risk groups, and predictive factors of skin cancer patient financial stress. Survey responses estimated that 11.45% (95% Cl 10.02-12.88%) of skin cancer patients experience problems paying medical bills, 20.34% (95% Cl 18.97-21.71%) of patients worry about the medical costs, 13.73% (95% Cl 12.55-14.91%) of patients worry about housing costs, and 37.48% (95% Cl 35.83-39.14%) of patients worry about money for retirement. Focusing on at-risk groups, black patients, uninsured patients, and patients with low incomes (< 200% poverty level) consistently experienced high rates of financial stress for each of the four measures. Multivariable logistic regression revealed low education, lack of insurance, and low income to be predictive of financial stress. These findings suggest that a considerable proportion of skin cancer patients experience financial stress related to both healthcare and non-healthcare factors. Where possible, the additional intricacy of treating patients at risk of high financial stress may be considered to optimize patient experience and outcomes.
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Affiliation(s)
- Thomas B Cwalina
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
- Department of Dermatology, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA.
| | - Tarun K Jella
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Department of Dermatology, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
| | - Raghav Tripathi
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Department of Dermatology, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
- The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Bryan T Carroll
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Department of Dermatology, University Hospitals Case Medical Center, 11100 Euclid Ave, Cleveland, OH, 44106, USA
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28
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Meyer D, Sumner PJ, Tan EJ, Neill E, Hielscher E, Blake JA, Scott JG, Phillipou A, Toh WL, Van Rheenen TE, Rossell SL. Comparing the impact of high versus low lockdown severity on the mental health of young people in Australia during the COVID-19 pandemic. Psychiatry Res 2023; 322:115121. [PMID: 36854222 PMCID: PMC9946783 DOI: 10.1016/j.psychres.2023.115121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/16/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023]
Abstract
Young Australians have been differentially affected by lockdowns and social restrictions during the COVID-19 pandemic. This study compared the mental health impacts of the COVID-19 pandemic and associated restrictions for young people in two Australian states, Victoria and Queensland, with Victoria experiencing more days in lockdown and greater infection rates. An online survey was completed between 01/04/2021 and 31/07/2021 by 687 young people, aged 16 to 24 years; 337 from Victoria and 350 from Queensland. Levels of negative emotion feelings (as measured by the Depression Anxiety Stress Scale), and COVID-19 risk factors for negative emotions (such as financial hardship, education disruption, loneliness and household conflict), as well as protective factors (resilience and self-esteem) were compared between the Victorian and Queensland samples, also considering some early pandemic data and pre-pandemic norms. No significant differences in negative emotions were found between young people living in the two states, despite substantial differences in pandemic restrictions. The results indicated that young people in Queensland and Victoria had experienced similarly high levels of negative emotions, at levels also seen at the start of the pandemic in Victoria. This is of grave concern, requiring urgent attention as the pandemic continues.
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Affiliation(s)
- Denny Meyer
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia.
| | - Philip J Sumner
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Eric J Tan
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Memory Ageing & Cognition Centre, National University Health System, Singapore; Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Erica Neill
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Emily Hielscher
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Julie A Blake
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia; School of Public Health, Faculty of Medicine, University of Queensland, Herston, QLD, Australia
| | - James G Scott
- QIMR Berghofer Medical Research Institute, Herston, QLD, Australia; Metro North Mental Health, Royal Brisbane and Women's Hospital, Herston, QLD, Australia; Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Wacol, QLD, Australia
| | - Andrea Phillipou
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia; Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia; Department of Mental Health, Austin Hospital, Melbourne, VIC, Australia
| | - Wei Lin Toh
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Tamsyn E Van Rheenen
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Melbourne, VIC, Australia
| | - Susan L Rossell
- Centre for Mental Health and Brain Sciences, School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, VIC, Australia
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29
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Herrera CD, Guerra CE, Narayan V, Guzzo TJ, Mamtani R, Lee DJ, Tasian GE, Talwar R. Financial toxicity in prostate cancer survivors: A national cross-sectional assessment of subjective financial burden. Urol Oncol 2023; 41:105.e1-105.e8. [PMID: 36372635 DOI: 10.1016/j.urolonc.2022.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/06/2022] [Accepted: 10/13/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND In prostate cancer (CaP) survivorship, subjective financial burden (SFB), an aspect of financial toxicity, has not been studied using a national sample. Our goal was to explore and identify factors associated with patient-reported SFB in CaP survivors. MATERIALS AND METHODS We conducted a retrospective, cross-sectional study of 264 adult individuals with a history of CaP that completed the AHRQ - Medical Expenditures Panel Survey - Household Component and Cancer Self-Administered Questionnaire Supplement in 2016 or 2017. Primary outcomes were the presence of cancer-related SFB and the severity of this burden. Multivariable ordinal logistic regression and logistic regression models were used to identify factors associated with the severity of SFB and different domains of burden. RESULTS Most participants were non-Hispanic white, had 3 or more comorbidities and had a median age of 72 years. 62.1% of survivors indicated SFB associated with their CaP care and long-term effects. 49.2% of CaP survivors indicated coping SFB, 27.7% psychological, and 29.2% material. Older (OR: 0.95, 95%CI 0.92-0.98) was associated with less SFB. Low-income level (OR: 2.1, 95%CI 1.01-4.36) was associated with higher SFB. Hispanic survivors (OR: 2.8 95%CI 1.1-7.4) indicated more psychologic SFB. Presence of a caregiver was noted as a predictor of material (OR 2.6, 95%CI 1.45-4.49) and psychological (OR: 2.2, 95%CI 1.13-3.91) SFB. CONCLUSIONS Many CaP survivors experience SFB and associated factors differ in domain of financial burden. This provides evidence and groundwork for understanding financial burden and improving the quality of counseling and care for this population.
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Affiliation(s)
- Christopher D Herrera
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
| | - Carmen E Guerra
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Abramson Cancer Center of the University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
| | - Vivek Narayan
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Thomas J Guzzo
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ronac Mamtani
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Daniel J Lee
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Ruchika Talwar
- Division of Urology, Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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30
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Ghosh I, Dragan P. Can financial stress be anticipated and explained? Uncovering the hidden pattern using EEMD-LSTM, EEMD-prophet, and XAI methodologies. COMPLEX INTELL SYST 2022; 9:1-25. [PMID: 36589898 PMCID: PMC9791977 DOI: 10.1007/s40747-022-00947-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 12/03/2022] [Indexed: 12/27/2022]
Abstract
Global financial stress is a critical variable that reflects the ongoing state of several key macroeconomic indicators and financial markets. Predictive analytics of financial stress, nevertheless, has seen very little focus in literature as of now. Futuristic movements of stress in markets can be anticipated if the same can be predicted with a satisfactory level of precision. The current research resorts to two granular hybrid predictive frameworks to discover the inherent pattern of financial stress across several critical variables and geography. The predictive structure utilizes the Ensemble Empirical Mode Decomposition (EEMD) for granular time series decomposition. The Long Short-Term Memory Network (LSTM) and Facebook's Prophet algorithms are invoked on top of the decomposed components to scrupulously investigate the predictability of final stress variables regulated by the Office of Financial Research (OFR). A rigorous feature screening using the Boruta methodology has been utilized too. The findings of predictive exercises reveal that financial stress across assets and continents can be predicted accurately in short and long-run horizons even at the time of steep financial distress during the COVID-19 pandemic. The frameworks appear to be statistically significant at the expense of model interpretation. To resolve the issue, dedicated Explainable Artificial Intelligence (XAI) methods have been used to interpret the same. The immediate past information of financial stress indicators largely explains patterns in the long run, while short-run fluctuations can be tracked by closely monitoring several technical indicators.
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Affiliation(s)
- Indranil Ghosh
- IT and Analytics Area, Institute of Management Technology Hyderabad, Shamshabad, Hyderabad, Telangana 501218 India
| | - Pamucar Dragan
- Department of Operations Research and Statistics, Faculty of Organizational Sciences, University of Belgrade, 11000 Belgrade, Serbia
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32
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Santoso M, Milliren CE, Woods ER, Forman SF, Richmond TK. COVID-19 related familial economic disruptions and eating disorder patients' mental health concerns and motivation to recover. J Eat Disord 2022; 10:197. [PMID: 36539850 PMCID: PMC9764300 DOI: 10.1186/s40337-022-00709-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Family support has been shown to be important for adolescents and young adults (AYA) in eating disorder (ED) treatment. Many families were impacted by the pandemic, potentially altering their ability to support individuals in ED treatment. This study examined the association of COVID-19 related familial economic change with self-reported mental health (MH) and ED concerns in AYA seeking treatment for ED. METHODS AYA patients with EDs aged 10-27 years enrolled in the Registry of Eating Disorders and their Co-morbidities OVER time in Youth (RECOVERY) completed an additional COVID-19-specific survey (n = 89) that assessed their perception of the effects of the pandemic on their lives and their ED. Participants self-reported on familial economic disruptions, measured through a composite score of four markers: (1) family member's work hours cut, (2) family member was required to stop working, (3) family member lost job permanently, and (4) family lost health insurance/benefits. In bivariate analyses, we examined the association between self-reporting any familial economic disruption and self-reported changes in intrusive ED thoughts, feelings of anxiety, feelings of depression, feelings of isolation, and motivation to recover from their ED. Logistic regression models were used to examine the association between familial economic disruptions on self-reported changes in ED/MH affect and motivation to recover adjusting for age and ED diagnosis. RESULTS Forty-six percent of participants self-reported that the pandemic had resulted in at least one economic familial disruption. Of patients reporting any familial economic disruption, 29% reported decreased motivation for ED recovery, and over 75% reported worsening feelings of depression, anxiety, isolation, and/or intrusive eating disorder thoughts. Reporting any COVID-19 familial economic disruption was marginally associated with feelings of isolation (p = 0.05). Though the findings were only marginally significant, the odds of reporting worsening feelings of depression, anxiety, intrusive ED thoughts or motivation to recover were nearly twice in those who reported a COVID-19-related familial economic disruption compared to those who did not report such a disruption. CONCLUSIONS Family-related economic disruptions are associated with ED/MH-related concerns and motivation to recover from an ED during the COVID-19 pandemic in AYA patients.
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Affiliation(s)
- Monique Santoso
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.
| | - Carly E Milliren
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Institutional Centers for Clinical and Translational Research, Boston Children's Hospital, Boston, USA
| | - Elizabeth R Woods
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Sara F Forman
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, USA.,Department of Pediatrics, Harvard Medical School, Boston, USA
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33
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Echeverri-Herrera S, Nowels MA, Qin B, Grafova IB, Zeinomar N, Chanumolu D, Duberstein PR, Bandera EV. Spirituality and financial toxicity among Hispanic breast cancer survivors in New Jersey. Support Care Cancer 2022; 30:9735-9741. [PMID: 36205780 DOI: 10.1007/s00520-022-07387-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 10/02/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Cancer survivors often incur significant out-of-pocket costs; this can result in financial toxicity, defined as the adverse financial impact of cancer due to direct or indirect costs related to the disease. There has been little research on whether spirituality is associated with the experience of financial toxicity. In this study, we tested the hypothesis that spirituality would be inversely associated with financial toxicity. METHODS We evaluated these associations in a cross-sectional study of Hispanic breast cancer survivors (n = 102) identified through the New Jersey State Cancer Registry. Participants completed the FACIT-Sp-12, which has two spirituality subscales (meaning/peace; faith). Financial toxicity was assessed using the 11-item COST measure; lower scores suggest worse toxicity. In multivariable linear regression analyses, we examined the associations between spirituality scores and financial toxicity, adjusting for age, race, education, household income, and insurance status. RESULTS The spirituality total score (β = 0.49, 95% confidence interval (CI): 0.17, 0.8), meaning/peace subscale score (β = 0.71, 95% CI: 0.12, 1.31), and faith (β = 0.71, 95% CI: 0.2, 1.21) subscale score were all inversely associated with financial toxicity. CONCLUSIONS Spirituality may be an important factor in ameliorating the detrimental effects of financial toxicity among Hispanic breast cancer survivors and should be considered in interventions for financial toxicity in this population.
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Affiliation(s)
- Susana Echeverri-Herrera
- Rutgers School of Public Health, Piscataway, NJ, USA.
- Department of Sociology and Criminology, University of New Mexico, MSC05 3080, 1915 Roma NE Ste. 1103, Albuquerque, NM, USA.
| | - Molly A Nowels
- Rutgers School of Public Health, Piscataway, NJ, USA
- Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ, USA
| | - Bo Qin
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, NJ, New Brunswick, USA
| | | | - Nur Zeinomar
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, NJ, New Brunswick, USA
| | - Dhanya Chanumolu
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, NJ, New Brunswick, USA
| | | | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, Robert Wood Johnson Medical School, NJ, New Brunswick, USA
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34
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Botha F, Butterworth P, Wilkins R. Protecting mental health during periods of financial stress: Evidence from the Australian Coronavirus Supplement income support payment. Soc Sci Med 2022; 306:115158. [PMID: 35751987 PMCID: PMC9212744 DOI: 10.1016/j.socscimed.2022.115158] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 06/13/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022]
Abstract
This paper investigates whether the Australian government's Coronavirus Supplement, a temporary income support payment for unemployed jobseekers during the height of the COVID-19 pandemic, protected mental health (frequency of feeling anxious or depressed during the past week) by lowering financial stress (how comfortable people are in paying for essential services). We use unique nationally representative repeated cross-sectional data on 3843 unemployed Australian adults over the period April 6, 2020 to May 10, 2021. We find that the Coronavirus Supplement payment significantly reduced reported financial stress, and lower financial stress was associated with lower mental distress. Though the Coronavirus Supplement was designed to reduce financial stress, we find the Supplement was also successful in protecting community mental health indirectly via its ability to reduce financial stress. The findings provide support for income support packages to protect mental health during economic shocks. However, transitory support measures also tend have short-lived positive effects on mental health, suggesting that more permanent income support reform may have longer-term mental health benefits.
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Affiliation(s)
- Ferdi Botha
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; ARC Centre of Excellence for Children and Families over the Life Course, Australia.
| | - Peter Butterworth
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; Research School of Population Health, Australian National University, Australia
| | - Roger Wilkins
- Melbourne Institute: Applied Economic & Social Research, The University of Melbourne, Australia; Institute of Labor Economics (IZA), Bonn, Germany
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35
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Martins PS, Caldas F, Oliveira C, Mota J, Gonçalves M. A 10-year mirror-image study of effectiveness and cost of long-acting paliperidone palmitate injectable in patients with schizophrenia or schizoaffective disorder. Psychiatry Res 2022; 312:114581. [PMID: 35509132 DOI: 10.1016/j.psychres.2022.114581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/24/2022] [Accepted: 04/25/2022] [Indexed: 11/29/2022]
Abstract
Acute episodes of Schizophrenia and Schizoaffective Disorder often require hospitalizations and/or psychiatry emergency room (PER) visits, with significant economic burden. Long-acting injectables (LAI), such as the once-monthly Palmitate Paliperidone LAI (1MPP) are effective in suppressing symptoms and raise treatment adherence. This study is the first aimed at evaluating long-term efficacy of initiation of 1MPP. This was a mirror-image study with a total 10 year observational length. Sample was divided into five different groups according to time span of observation: 2,4,6,8, and 10 years. Number of participants per group was 162, 129, 95, 77 and 35, respectively. Main outcomes were number and length of hospitalizations and number of PER visit. Significant reductions in these outcomes after initiation of 1MPP were found in all groups. Subgroups consisting only of patients with full adherence were evaluated, and these had better outcomes. A cost evaluation was also performed, which demonstrated decreases every year, for all main outcomes. Sensitivity analysis in the 2-year group showed results in this time-frame are independent of gender, diagnosis, previous LAI or 1MPP initiation setting. Initiation of 1MPP reduces number and length of hospitalizations up to 5 years, decreasing associated costs. This study increases evidence supporting use of 1MPP in patients with Schizophrenia or Schizoaffective disorder.
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Affiliation(s)
| | | | | | - Jorge Mota
- Hospital de Magalhães Lemos. Porto, Portugal
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36
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Upadhyay V, Parashar Y. A Study of Parental Stressors, Financial Issues as Stress Factor, and the Coping Strategies in the PICU. Indian J Pediatr 2022; 89:563-569. [PMID: 35099716 DOI: 10.1007/s12098-021-04003-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 09/21/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the stressors in parents of critically ill children admitted in PICU and the coping strategies used by them. METHOD Parents of children admitted to the PICU (at least 48 h) were administered Modified PSS: PICU scale (total 8 subscales, 42 items) and coping questionnaire (8 questions). A total score (Modified PSS: PICU score) and subscales mean scores were used to describe the stressors. The questionnaire was verbally administered to either one of the parents, in English or Hindi. The responses were assessed and analyzed. RESULTS Either of the parents (age 20 to 50 y, 29 mothers) of 102 children responded. The Modified Parental Stress Scale: PICU (PSS: PICU) score was 44 (± 11.2). Parental stress was related to severity of illness (p < 0.001). Procedures done on their child and the appearance of the child were most stressful. Fathers were more stressed about the procedures compared to mothers (p = 0.004). Middle-class parents were more stressed about financial issues compared to upper and lower socioeconomic class in response to the open-ended question. The most used coping strategies were "Trust in your God" (99%), "Communication with doctors and nurses" (97.1%), and "Sharing feelings with spouse" (94.1%). Mothers found sharing feelings with the spouse more helpful. CONCLUSION Parents of critically ill children are very stressed. Middle-class parents should also be taken care of in financial aspects. More attention should be given to the parents of children with severe illness. Parents should be communicated frequently. Encouraging faith in God and good communication can be helpful.
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Affiliation(s)
- Vaibhava Upadhyay
- Department of Pediatrics, Holy Family Hospital, New Delhi, India.
- G-14, Keshav Nagar, Sawai Madhopur, Rajasthan, 322001, India.
- IAP fellowship, Pediatric intensive care unit (IDPCCM), Pramukhswami Medical College, Karamsad, Gujarat, India.
| | - Yogesh Parashar
- Department of Pediatrics, Holy Family Hospital, New Delhi, India
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Pulvera R, Altman E, Avina L, Thompson H, Schillinger D, Madsen K. Pandemic-related financial hardship and disparities in sugar-sweetened beverage consumption and purchasing among San Francisco Bay Area residents during COVID-19. Prev Med Rep 2022; 26:101759. [PMID: 35287282 PMCID: PMC8917297 DOI: 10.1016/j.pmedr.2022.101759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/12/2022] Open
Abstract
Some reports suggest that the COVID-19 pandemic resulted in shifts to unhealthier diets. These unhealthier diets may include sugar-sweetened beverages (SSBs), which strongly contribute to diabetes and other chronic diseases. Using cross-sectional surveys in the San Francisco Bay Area, California, USA we sought to assess self-reported SSB consumption during the pandemic's shelter-in-place and self-reported changes in SSB purchasing from before to during the pandemic's shelter-in-place, stratifying by indices of pandemic-related financial hardship. Nearly 60% of our diverse sample (N = 943) reported that it was harder to pay for basics (like food and utilities) during shelter-in-place. Among those who found it harder to pay for basics and received financial assistance during shelter-in-place, we found a ten-fold higher frequency of daily SSB consumption compared to those not facing new financial hardship (2.76 [95% CI: 1.78, 3.74] versus 0.30 [95% CI: 0.23, 0.37] times/day). There were no statistically significant increases in reported purchasing of any SSB, but those with new financial hardship during shelter-in-place reported greater purchasing of regular soda relative to those with no new hardship (0.20 on a 3-point scale [95% CI: 0.03, 0.37]). Our findings suggest that new hardship may increase unhealthy behaviors and worsen existing disparities in SSB consumption. Such disparities are a reminder of the urgent need to reduce economic inequity and improve the quality of our emergency food system in order to mitigate the impact of public health crises like the COVID-19 pandemic.
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Affiliation(s)
- Richard Pulvera
- School of Public Health, University of California, Berkeley, CA, USA
| | - Emily Altman
- School of Public Health, University of California, Berkeley, CA, USA
| | - Lizette Avina
- School of Public Health, University of California, Berkeley, CA, USA
| | - Hannah Thompson
- School of Public Health, University of California, Berkeley, CA, USA
| | - Dean Schillinger
- Division of General Internal Medicine at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
- Center for Vulnerable Populations at San Francisco General Hospital, University of California San Francisco, San Francisco, CA, USA
| | - Kristine Madsen
- School of Public Health, University of California, Berkeley, CA, USA
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Abstract
Lockdowns in Australia have been strict and lengthy. Policy-makers appear to have given the preservation of quantity of lives strong priority over the preservation of quality of lives. But thought-experiments in population ethics suggest that this is not always the right priority. In this paper, I'll discuss both negative impacts on quantity of lives caused by the lockdowns themselves, including an increase in domestic violence, and negative impacts on quality of lives caused by lockdowns, in order to raise the question of whether we each had reason to choose quantity over quality in our own lives in a way that would justify the lockdowns we had.
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Blanco L, Cruz V, Frederick D, Herrera S. Financial Stress Among Latino Adults in California During COVID-19. J Econ Race Policy 2022; 5:134-148. [PMID: 35300316 PMCID: PMC8327043 DOI: 10.1007/s41996-021-00087-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/11/2021] [Accepted: 07/20/2021] [Indexed: 11/29/2022]
Abstract
We study the impact of COVID-19 on stress, and especially on financial stress, among Latino adults in California. We take a mixed methods approach and rely on quantitative and qualitative data for our analysis. We recruited 84 low- and moderate-income (LMI) Latino adults in California through the Understanding America Study (UAS) Internet Panel who also participated in the Mobile Financial Diary (MFD) project, which took place during 2018 − 2019. We analyze data about personal experiences during COVID-19 in October 2020 and compare this to data collected during the period from August to October 2018. Our study portrays the experiences of California Latino adults who were predominantly born in the USA and are likely to be working and speak English. We also observe that a large percentage of our participants had health insurance and relatively high levels of educational attainment. We find contradictory results from our quantitative measures, where one of our indicators of financial behavior and well-being showed a significant increase (Financial Health Score), and the other (Financial Well-Being Scale) showed a significant decrease during COVID-19. Anxiety (GAD-7) and depression (PHQ) measures show no significant changes during COVID-19 in comparison to 2018. Nonetheless, our qualitative data analysis shows that many of our participants were experiencing major stressors during the pandemic associated with labor market experiences and family circumstances. In our qualitative data analysis, we also observe that women seemed to have been affected the most by the pandemic.
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Affiliation(s)
- Luisa Blanco
- Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA 90265 USA
| | - Vanessa Cruz
- Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA 90265 USA
| | - Deja Frederick
- Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA 90265 USA
| | - Susie Herrera
- Pepperdine University, 24255 Pacific Coast Highway, Malibu, CA 90265 USA
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Hall L, Moray J, Gross E, Lichtenberg PA. Financial Stressors and Resources Associated With Financial Exploitation. Innov Aging 2022; 6:igac010. [PMID: 35527983 PMCID: PMC9071222 DOI: 10.1093/geroni/igac010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background and Objectives The prevalence of older adult financial exploitation (FE) is increasing. Population-based survey estimates of FE in the older adult population range from 5% to 11%. Given the growing prevalence of FE victimization in older adult populations, understanding the population's vulnerability to FE has increased in importance. This study investigates a conceptual framework in an attempt to understand how financial stressors and resources are associated with substantiated FE in a sample consisting largely of Black older adults. Research Design and Methods The study uses a cross-sectional design to investigate group differences among a total sample of 142 community-dwelling older adult participants, 62 of whom sought services to address FE and 80 with no history of FE. Results The group of older adults who sought services to address FE was more likely to be unmarried and had fewer years of education. Measures of financial literacy and perceived financial vulnerability had protective and risk effects, respectively. Discussion and Implications The present study found that sociodemographic and financial stress and resource measures have significant relationships with FE. These findings support the conceptual framework describing their relationship. This new conceptual framework provides a guiding factor in better understanding vulnerability to FE in older adults. The study also adds to the paucity of research completed on FE with Black older adults.
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Affiliation(s)
- LaToya Hall
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Juno Moray
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
| | - Evan Gross
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
- Department of Psychology, Wayne State University, Detroit, Michigan, USA
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Kelley HH, Lee Y, LeBaron-Black A, Dollahite DC, James S, Marks LD, Hall T. Change in Financial Stress and Relational Wellbeing During COVID-19: Exacerbating and Alleviating Influences. J Fam Econ Issues 2022; 44:34-52. [PMID: 36820278 PMCID: PMC9931994 DOI: 10.1007/s10834-022-09822-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/12/2022] [Indexed: 06/02/2023]
Abstract
Guided by the family adjustment and adaptation response (FAAR) model and using a panel survey of 1510 adults in the US administered during the summer of 2020 and a mixed methods approach, we explored associations between changes in financial stress related to COVID-19 and relational wellbeing. Regression analyses showed that, compared to those who maintained their levels of financial stress, those who reported increased financial stress reported increased conflict and those who reported decreased financial stress reported decreased conflict. However, decreased financial stress was also associated with decreases in emotional closeness and relationship happiness, suggesting that changes in financial stress can lead to both maladaptation and bonadaptation in families. Qualitative findings provide insights into factors that may exacerbate or help alleviate financial stress related to COVID-19.
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Affiliation(s)
- Heather H. Kelley
- Department of Human Development and Family Studies, Utah State University, Logan, USA
| | - Yoon Lee
- Department of Human Development and Family Studies, Utah State University, Logan, USA
| | | | | | - Spencer James
- School of Family Life, Brigham Young University, Provo, USA
| | - Loren D. Marks
- School of Family Life, Brigham Young University, Provo, USA
| | - Tyler Hall
- School of Child and Family Sciences, University of Southern Mississippi, Hattiesburg, MS USA
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Abstract
This study develops a conceptual framework that provides a broad understanding of financial well-being. Using the 2018 National Financial Capability Study and structural equation modeling methods, this study provides empirical evidence for the proposed framework by identifying significant direct and indirect determinants of financial well-being. Previous personal financial wellness and financial satisfaction-related research provides a theoretical rationale for the construction of the conceptual framework in the current study. The results reported the relationships among these determinants, including financial perceptions and knowledge factors, financial stress, short- and long-term positive financial behavior, and financial satisfaction. The findings indicate that financial satisfaction, short-term financial behavior, perceived financial capability showed positive and direct associations with financial well-being, whereas financial stress and long-term financial behavior were negatively and directly associated with financial well-being. Financial perception and knowledge factors, financial stress, and short-term financial behavior also showed significant indirect relationships with financial well-being. The findings of this study contribute to the literature on financial well-being and provide significant policy and practical implications. Implications for financial practitioners and policy makers are discussed.
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Affiliation(s)
- Lu Fan
- Program of Personal Financial Planning, Division of Applied Social Sciences, University of Missouri, 125B Mumford Hall, 1100 University Avenue, Columbia, MO 65211 USA
| | - Robin Henager
- Economics and Finance, Whitworth School of Business, 300 W Hawthorne Rd, Spokane, WA 99251 USA
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43
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Harter CL, Harter JFR. The Link Between Adverse Childhood Experiences and Financial Security in Adulthood. J Fam Econ Issues 2021; 43:832-842. [PMID: 34522076 PMCID: PMC8428486 DOI: 10.1007/s10834-021-09796-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/30/2021] [Indexed: 05/26/2023]
Abstract
This study provides an evidence-based link between adverse childhood experiences (ACEs) and adult financial wellbeing. Drawing on a comprehensive financial wellbeing framework that was developed by the Consumer Financial Protection Bureau, we analyze data from the Behavioral Risk Factor Surveillance System, a survey designed primarily to measure health behaviors and outcomes, but which also asks about financial wellbeing aspects such as food and housing security. We use ordered probit analysis to investigate how respondents' self-reported levels of food security and housing security are influenced by demographics that include remembered ACEs and find that, at various income levels, financial stress in adulthood is related to childhood trauma. This interdisciplinary approach to studying financial outcomes extends work in public health and psychology that establishes a link between ACEs and adult physical and mental health measures. The finding is timely as policy makers craft responses to global public health, financial, and other shocks. Recognizing this link between ACEs and adult financial wellbeing provides additional evidence that educators, therapists, social workers, and other professionals should collaborate and develop integrated practices to prevent or reduce ACEs and promote resilience.
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Crocker RM, Palmer KNB, Marrero DG, Tan TW. Patient perspectives on the physical, psycho-social, and financial impacts of diabetic foot ulceration and amputation. J Diabetes Complications 2021; 35:107960. [PMID: 34059410 PMCID: PMC8316286 DOI: 10.1016/j.jdiacomp.2021.107960] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/22/2023]
Abstract
AIMS Diabetic foot ulcers (DFUs) and ulceration are complex and lifelong problems for patients with diabetes which dramatically increase mortality rates. This qualitative study sought to capture detailed personal accounts and insights from patients with a clinical history of DFUs and amputations to better understand patient experiences. METHODS Fifteen patients from a tertiary referral center that treats diabetic foot problems were approached for participation. Inclusion criteria included having at least one DFU and being of white, Native American, or Hispanic background. Interviews were conducted by telephone by study staff trained in qualitative data gathering and audio recorded. RESULTS The main themes that emerged around impacts included the heavy burden of managing care, significant loss of ambulatory function, economic stress due to medical care costs and job loss, and emotional suffering tied to these stressors. CONCLUSIONS These data illuminate common social and personal impacts of diabetic foot problems across an ethnically and racially diverse and predominantly low-income US sample that expand our understanding of related declines in well-being. Our results indicate a need for proactive mental health assessment post DFUs diagnosis and the diversification of hospital and community-based support systems.
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Affiliation(s)
- Rebecca M Crocker
- Center for Border Health Disparities, University of Arizona Health Sciences, 1295 N Martin Ave., PO Box 210202, Tucson, AZ 85719, United States of America.
| | - Kelly N B Palmer
- Center for Border Health Disparities, University of Arizona Health Sciences, United States of America
| | - David G Marrero
- Center for Border Health Disparities, University of Arizona Health Sciences, United States of America
| | - Tze-Woei Tan
- Division of Vascular and Endovascular Surgery, University of Arizona College of Medicine-Tucson, Southern Arizona Limb Salvage Alliances (SALSA), United States of America
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Jiang Y, Farrell AK, Tobin ET, Mair-Meijers H, Wildman DE, Luca F, Slatcher RB, Zilioli S. Socioeconomic status, financial stress, and glucocorticoid resistance among youth with asthma: Testing the moderation effects of maternal involvement and warmth. Brain Behav Immun 2021; 96:92-99. [PMID: 34015429 PMCID: PMC8319072 DOI: 10.1016/j.bbi.2021.05.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/11/2021] [Accepted: 05/15/2021] [Indexed: 10/21/2022] Open
Abstract
OBJECTIVES Children who grow up in more socioeconomically disadvantaged homes experience greater levels of inflammation and worse asthma symptoms than children from more advantaged families. However, recent evidence suggests that certain family-level factors can mitigate health disparities associated with socioeconomic status (SES). In a sample of youth with asthma, we investigated the potential buffering effects of maternal involvement and warmth on SES disparities in asthma-related immune responses, assessed via glucocorticoid resistance (GR) of immune cells. METHODS One hundred and forty-three youth (10-16 years of age) with asthma completed measures of maternal involvement and warmth, and their primary caregivers reported their levels of education, income, and financial stress. Peripheral blood mononuclear cells from youth's blood were isolated, cultured, and assayed to determine mitogen-stimulated (PMA/INO + Etho) and mitogen/hydrocortisone-stimulated (PMA/INO + Cort) levels of two Th-2 cytokines (i.e., interleukin-5, interleukin-13) and one Th-1 cytokine (i.e., interferon-γ). GR was calculated by subtracting log-transformed cytokine concentration in the PMA/INO + Etho samples from log-transformed cytokine concentration in the PMA/INO + Cort samples. RESULTS Both maternal involvement and warmth moderated the indirect pathway from family SES to GR of Th-2 cytokines via financial stress. Specifically, we found that low family SES was associated with elevated GR of Th-2 cytokines via increased financial stress among youth reporting low levels of maternal involvement and warmth, but not among those reporting high levels of maternal involvement or warmth. CONCLUSIONS These results highlight the protective role of maternal involvement and warmth in health-related biological processes modulated by family SES among youth with asthma.
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Affiliation(s)
- Yanping Jiang
- Department of Psychology, Wayne State University, United States.
| | | | - Erin T. Tobin
- Behavioral Health and General Internal Medicine, Henry Ford Health System
| | | | - Derek E. Wildman
- Genomics Program, College of Public Health, University of South Florida
| | - Francesca Luca
- Center for Molecular Medicine and Genetics, Wayne State University,Department of Obstetrics and Gynecology, Wayne State University
| | | | - Samuele Zilioli
- Department of Psychology, Wayne State University, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, United States.
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Moore A, Nguyen A, Rivas S, Bany-Mohammed A, Majeika J, Martinez L. A qualitative examination of the impacts of financial stress on college students' well-being: Insights from a large, private institution. SAGE Open Med 2021; 9:20503121211018122. [PMID: 34094560 PMCID: PMC8141976 DOI: 10.1177/20503121211018122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 04/26/2021] [Indexed: 11/17/2022] Open
Abstract
Objective: This qualitative research aims to provide deeper insight into college students’ experiences by examining the impact of financial stress on their well-being. Methods: Four focus groups were conducted at a large, private, urban university in the United States over the course of 1 month, each lasting approximately 1 h. Facilitators used a structured moderator guide to maintain consistency. Four focus groups were conducted and a total of 30 students participated. Students were primarily Asian (66.7%) and White (30.0%), and a majority were female (86.7%). Student participants were 43.3% undergraduate and 56.6% graduate. Transcripts were analyzed in Atlas.ti 8 software using line-by-line open coding guided by the principles of qualitative content analysis. An inductive approach was utilized to code the data. Emergent categories and concepts were then organized hierarchically into themes and subthemes. Results: Two overarching themes emerged from the focus group analysis. In these students’ perspectives, financial stress impedes their ability to succeed academically. Another major theme is the impact of finances on students’ social lives. Students experiencing financial stress find it challenging to navigate relationships with wealthier peers, often leading to feelings of isolation and embarrassment. Conclusion: Given the reported negative impact on students’ well-being, further research is needed to determine methods for mitigating financial stress.
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Affiliation(s)
- Andrea Moore
- University of Southern California, Los Angeles, CA, USA
| | - Annie Nguyen
- University of Southern California, Los Angeles, CA, USA
| | - Sabrina Rivas
- University of Southern California, Los Angeles, CA, USA
| | | | - Jarod Majeika
- University of Southern California, Los Angeles, CA, USA
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Xiao JJ, Kim KT. The Able Worry More? Debt Delinquency, Financial Capability, and Financial Stress. J Fam Econ Issues 2021; 43:138-152. [PMID: 33976522 PMCID: PMC8101082 DOI: 10.1007/s10834-021-09767-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
Research on the link between debt and financial stress is emerging. This study was one of the first attempts to examine the association between debt delinquency and financial stress and the moderating role of financial capability in the association. Delinquencies in three types of debts were examined: (a) mortgage, (b) credit card, and (c) student loan. With data from the 2018 U.S. National Financial Capability Study, multivariate regression results showed that payment delinquencies of mortgage, credit card and student loans were positively, while financial capability was negatively associated with financial stress. Further, surprisingly, the results implied that among consumers with debt delinquencies, financial capability may increase financial stress. If both financial capability's direct and interactive effect were considered, financial capability may decrease financial stress at much smaller rates than those without debt delinquencies. The situation was the worst among consumers with multiple delinquencies, in which the potential net effect of financial capability on financial stress was positive. The results of this study have implications for consumer financial service practices.
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Affiliation(s)
- Jing Jian Xiao
- Department of Human Development and Family Science, University of Rhode Island, Transition Center, 2 Lower College Road, Kingston, RI 02881 USA
| | - Kyoung Tae Kim
- Department of Consumer Sciences, University of Alabama, 316-C Adams Hall, Box 870158, Tuscaloosa, AL 35487 USA
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48
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Sorgente A, Totenhagen CJ, Lanz M. The Use of the Intensive Longitudinal Methods to Study Financial Well-Being: A Scoping Review and Future Research Agenda. J Happiness Stud 2021; 23:333-358. [PMID: 33841044 PMCID: PMC8017902 DOI: 10.1007/s10902-021-00381-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/16/2021] [Indexed: 06/01/2023]
Abstract
Financial well-being is a positive financial condition that has an objective (e.g., income) and a subjective (e.g., financial satisfaction) side. Much research has examined financial well-being using cross-sectional and classic longitudinal designs. More recently, researchers have begun to examine financial well-being using intensive longitudinal designs, collecting data in a repeated (at least five measurements) and intensive (short time interval between measurements) way. The goal of the current study was to systematically review all published research on financial well-being using intensive longitudinal methods, summarize themes from this work, and suggest future research directions. Searching three databases (Scopus, PsycINFO, Econpapers), we found nine articles that respected inclusion and exclusion criteria. From each selected article, we extracted information about (1) research field diffusion, (2) data collection methods, (3) financial well-being's definition and operationalization, (4) research questions addressed and (5) data analysis. Findings showed that most of the studies adopted an interval-contingent research design, collecting data once a day; that both the objective and subjective sides of the construct were assessed, and that, most of the time, the construct was conceptualized as financial stress (lack of financial well-being). Different kinds of research questions were addressed across studies and these were often analyzed using multilevel analysis. In the discussion section, future research directions are suggested.
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Affiliation(s)
- Angela Sorgente
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Casey J. Totenhagen
- Department of Human Development and Family Studies, University of Alabama, Tuscaloosa, AL USA
| | - Margherita Lanz
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
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Ali M, Uddin Z, Hossain A. Economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals: A cross-sectional study amid COVID-19 pandemic. Heliyon 2021; 7:e06715. [PMID: 33898834 PMCID: PMC8056424 DOI: 10.1016/j.heliyon.2021.e06715] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/04/2021] [Accepted: 03/31/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Mental health symptoms are considered a public health concern by many professionals and are frequently impacted by factors related to occupation, employment opportunities, and economic stressors. This study investigated the relationship between economic stressors and mental health symptoms among Bangladeshi rehabilitation professionals. METHODS We conducted a cross-sectional survey of 420 rehabilitation professionals between July 2020 and October 2020. Economic stressors were measured using Economic Hardship Questionnaire, Financial Threat Scale, and Financial Well-Being Scale. Mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Multivariable logistic regression analysis was performed to find associated factors on mental health problems after adjusting confounders. RESULTS Among 420 rehabilitation professionals 62.1% were male, 38.6% were post-graduated and 75% were in practice. The overall prevalence of depression, anxiety, and stress was 51.0%, 58.6%, and 33.6%, respectively. The multivariable regression analysis indicated that without a high professional degree, lack of opportunity to practice, and loss of income were the associated factors for mental health symptoms. The modelling of the structural equation showed that financial threat is significantly associated with mental health symptoms. CONCLUSION During the era of COVID-19, a high prevalence of mental health symptoms was observed among rehabilitation professionals. To minimize the burden of mental health, we recommend that all rehabilitation organizations and the government come together to create equal opportunities to practice and enable individuals to obtain high professional degrees.
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Affiliation(s)
- Mohammad Ali
- Department of Physiotherapy and Rehabilitation, Uttara Adhunik Medical College and Hospital, Dhaka 1230, Bangladesh
- Hasna Hena Pain, Physiotherapy and Public Health Research Center (HPRC), Dhaka 1230, Bangladesh
| | - Zakir Uddin
- Bangladesh University of Health Sciences, Mirpur, Dhaka 1216, Bangladesh
| | - Ahmed Hossain
- Department of Public Health, North South University, Basundhara, Dhaka 1229, Bangladesh
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Cao H, Zhou N, Li X, Serido J, Shim S. Temporal dynamics of the association between financial stress and depressive symptoms throughout the emerging adulthood. J Affect Disord 2021; 282:211-218. [PMID: 33418369 DOI: 10.1016/j.jad.2020.12.166] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 11/10/2020] [Accepted: 12/23/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emerging adulthood is a life stage with elevated risk for both mental disorders and financial distress. Although a positive link between financial stress and depressive symptoms has been identified, there is a lack of delineation on the temporal dynamics of this link spanning the entire stage of emerging adulthood (roughly ages 18 to 29). METHODS Using a statistical approach that partitions between-person from within-person variation and based on four waves of data from a college cohort (N = 2,098) throughout emerging adulthood, this study addresses this gap. RESULTS Latent growth curve model analyses indicate that the trajectory of financial stress throughout emerging adulthood followed an inverted "U" shape, whereas that of depressive symptoms displayed a linear, decreasing trend. The positive correlations of both intercepts and slopes between financial stress and depressive symptoms indicated a co-development pattern. Classical, cross-lagged panel model analyses (i.e., a model aggregating between-person and within-person variation) demonstrated a reciprocal positive association between financial stress and depressive symptoms across waves. Random intercept, cross-lagged panel model analyses (i.e., a model disaggregating between-person and within-person effects) indicated a unidirectional positive within-person effect from depressive symptoms to financial stress across waves, controlling for between-person effects. LIMITATIONS Shared-method and shared-informant variance may inflate the identified associations, and the correlational data precludes casual inferences. CONCLUSION Improving young adults' mental well-being, specifically intervening depressive symptoms, could be an avenue for reducing their financial stress. Future research is pressing to examine mechanisms via which depression symptoms manifest as financial stress during transition to adulthood.
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Affiliation(s)
- Hongjian Cao
- Institute of Early Childhood Education, Faculty of Education, Beijing Normal University. 512 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing 100875, China.
| | - Nan Zhou
- Department of Educational Psychology and School Counseling, Faculty of Education, Beijing Normal University. 528 Ying Dong Building, No. 19 Xin Jie Kou Wai Street, Hai Dian District, Beijing 100875, China.
| | - Xiaomin Li
- Department of Family Studies and Human Development, University of Arizona, 650 N. Park Avenue PO Box 210078, Tucson, AZ, 85721-0078, USA.
| | - Joyce Serido
- Department of Family Social Science, University of Minnesota-Twin Cities, 299b McNeal Hall, 1985 Buford Ave, Saint Paul, MN, 55108, USA.
| | - Soyeon Shim
- School of Human Ecology, University of Wisconsin-Madison, Office 2135, Nancy Nicholas Hall, 1300 Linden Drive, Madison, WI, 53706, USA.
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