Abstract TP114: Financial Well-Being Among US Adults the Impact of Vascular Conditions and Social Disadvantage

Abstract

Background: “Financial toxicity” refers to the deleterious impact of healthcare expenditures or conditions. Using the Consumer Financial Protection Bureau’s (CFPB) Financial Well-Being (FWB) Scale, this study evaluated the impact of cardiovascular disease (CVD), stroke, high blood pressure (BP), and high cholesterol on individual FWB. Methods: Using data from the Understanding America Survey—a nationally representative, longitudinal panel of approximately 6,000 adults—we identified adults with self-reported diagnoses of high cholesterol, high BP, stroke, and CVD between 2014 and 2020. Scored between 0 and 100, the FWB Scale can be used to compare a person’s self-assessed financial circumstances including income, savings, debt, financial distress, and preparedness. To assess the potential financial toxicity of these conditions, we used separate stratified, longitudinal mixed regression models for each condition. Model covariates included sex, age, marital status, household size, household income, education, race/ethnicity, insurance, body mass index (BMI), and an indicator of the condition of interest. Differential financial toxicity was captured through interactions between sociodemographic characteristics and condition indicators. Results: Whites had the highest FWB scores (69.0, SD=21.8), followed by other (i.e., Asian, American Native, Hawaiian/Pacific Islander, multiracial) racial groups (66.7, SD=21.0), Hispanics (59.3, SD=21.6), and Blacks (56.2, SD=21.4). After controlling for income, education, and household characteristics, average FWB of individuals with vascular conditions was not statistically different from those without. However, compared to Whites, Blacks with CVD (-7.4, SD=1.0), stroke (-8.1, SD=1.5), high cholesterol (-5.7, SD=0.7), and high BP (6.1, SD=0.7) had significantly lower FWB. Similarly, Hispanics with high BP (-3.0, 0.6) and CVD (-6.3, 1.3) had lower FWB. Income, education, insurance, and marital status were also significantly correlated with FWB for each condition. Conclusions: Findings indicated that FWB was lower among Blacks and Hispanics diagnosed with vascular conditions. These results indicate the potential financial toxicity of vascular conditions.