Abstract
Financial health, understood as one's ability to manage expenses, prepare for and recover from financial shocks, have minimal debt, and ability to build wealth, underlies all facets of daily living such as securing food and paying for housing, yet there is inconsistency in measurement and definition of this critical concept. Most social determinants research and interventions focus on siloed solutions (housing, food, utilities) rather than on a root solution such as financial health. In light of the paucity of public health research on financial health, particularly among low-income populations, this study seeks to: 1) introduce the construct of financial health into the domain of public health as a useful root term that underlies other individual measures of economic hardship and 2) demonstrate through outcomes on financial, physical and mental health among low-income caregivers of young children that the construct of financial health belongs in the canon of social determinants of health. In order to extract features of financial health relevant to overall well-being, principal components analysis were used to assess survey data on banking and personal finances among caregivers of young children who participate in public assistance. Then, a series of logistic regressions were utilized to examine the relationship between components of financial health, depression and self-rated health. Components aligned with other measures of financial health in the literature, and there were strong associations between financial health and health outcomes. Financial health can be conceived of and measured as a key social determinant of health.
Highlights
Exposure to prolonged economic hardship has detrimental impacts on individual health and well-being [1,2,3,4,5,6,7,8]
Despite the widespread acceptance of economic hardship as a social determinant of health, the way it has been measured is restricted to income in relation to the federal poverty line (FPL) or to issues related to housing insecurity, food insecurity, healthcare tradeoffs, and other measures related to tangible basic needs [2, 9,10,11,12]
Comprehensive solutions, such as efforts to improve financial capability [13], build assets to protect from financial shocks, and reduce income volatility are missing from public health research [14,15,16,17]
Summary
Exposure to prolonged economic hardship has detrimental impacts on individual health and well-being [1,2,3,4,5,6,7,8]. Despite the widespread acceptance of economic hardship as a social determinant of health, the way it has been measured is restricted to income in relation to the federal poverty line (FPL) or to issues related to housing insecurity, food insecurity, healthcare tradeoffs, and other measures related to tangible basic needs [2, 9,10,11,12] Comprehensive solutions, such as efforts to improve financial capability (known as a combination of self-efficacy, skill, attitude, and knowledge needed to make financial decisions) [13], build assets to protect from financial shocks, and reduce income volatility are missing from public health research [14,15,16,17]. Building on research on associations between income and physical health [8, 20, 21], this work demonstrates that financial health is an important, independent social determinant of health that can be defined, measured, and influenced to improve health and wellbeing
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