Severe Financial Stress Research Articles

Addressing Financial Toxicity in Head and Neck Cancer—A Crucial Imperative

This Viewpoint calls for consideration of the financial costs of head and neck cancer care when choosing treatment strategies for patients who may face severe financial stress or insolvency due to cancer treatment.

Time and frequency spillovers and drivers between rare earth and energy, metals, green, and agricultural markets

This study investigates the time and frequency return and volatility spillover relationship between rare earth markets and oil, clean energy, gold, base metal, green bond, ESG, and agricultural markets by adopting the spillover indices introduced by Diebold and Yilmaz (2014) and Baruník and Křehlík (2018). As a more comprehensive view of the spillover relationship between rare earth and these industries, this study fills the gap in the existing literature on the relationship between rare earth and energy, metals, or green-related markets. Moreover, we conduct a regression analysis to reveal the drivers of the connectedness network. The empirical results suggest that the rare earth metals (REM) market is a net spillover receiver from the base metal, clean energy, and ESG markets, which are the top three net risk emitters. The network connectedness results shed light on the connections and strengths at different time horizons throughout the sample. The regression results indicate that financial condition and investor sentiment play the most significant roles in driving connectedness and have different effects at different frequencies. Furthermore, severe financial stress may increase short-term risk spillover, which indicates that investors sell out risky assets in stressful times. However, financial stress decreases long-term spillover, which implies that it damages the long-term operation of the financial market. The results could guide investors holding REM assets to balance risk and return and also provide references for policymakers to monitor market conditions and adopt policies to foster the health of the REM market.

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Financial well-being is a complex concept that represents a state in which individuals are currently able to afford the necessities of life, pay utility bills on time, meet the responsibilities for credit use, and sustain financial resilience for the future. People with improved levels of financial well-being can be more free from mental and psychological distress arising from personal financial problems and maintain a more secure life. This study uses survey data collected by the Korea Financial Consumer Protection Foundation to measure financial well-being of residents of Incheon, the first-phase, and the second-phase New Towns in Gyeonggi-do, and to examine their characteristics and differences. While the financial well-being level is the highest in the second-phase New Town area, that of Incheon is low. In particular, the financial well-being score of Incheon residents is not only lower than the national average, but falls short of half of the maximum possible score of 100. The share of people suffering severe financial stress ranges from 5% to 8%, depending on the region, and that of people with financial insecurity ranges from 38% to 49%. Gender, age, and education are largely unrelated to financial well-being scores, but respondents aged 55 to 64 score significantly lower than other age groups, indicating that the elderly are exposed to financial pains. Regression analysis shows that factors such as positive thinking, residential satisfaction, restful personality, and financial attitudes are significant factors influencing the financial well-being score. In order to more accurately understand regional financial well-being, it is recommended to identify Korea-specific elements that reflect financial markets as well as economic and cultural characteristics, and to regularly collect data through large-scale surveys, hopefully at the government level.

Shadow banking business and firm risk-taking: Evidence from China

This paper uses annual firm-level data from China, spanning 2003–2019, to explore the impact of the shadow banking business of non-financial firms on their risk-taking. The results show that the shadow banking business significantly increases firm risk-taking. Furthermore, the impact of firms’ shadow banking business on their risk-taking is particularly pronounced in firms with greater financing constraints, and poorer corporate governance and in times of loose monetary condition and severe financial stress. Moreover, increasing commercial credit, reducing main business performance, and eroding the quality of information disclosure are channels through which shadow banking affects firms’ risk-taking. Our findings suggest that improving external supervision and internal governance are vital for alleviating firms’ short-sighted involvement in shadow banking and the ensuing financial risks.

A cross sectional survey to assess knowledge, attitude, and practice of Yoga among cancer patients at a tertiary care hospital in Rishikesh, India.

e24040 Background: The global cancer burden continues to rise, putting individuals under severe physical, mental, and financial stress. Yoga may aid chemotherapy patients to improve their quality of life. The purpose of this survey is to learn more about the gaps in knowledge, attitude, and practice of Yoga and barriers. Methods: The cross-sectional time-bound survey was conducted on cancer patients of age 18 years and above receiving cancer treatment at the outpatient clinic of AIIMS Rishikesh. We collected data of 738 cancer patients, bivariate and multivariate analysis was done to understand the level of awareness of the importance of Yoga as an alternative therapy. Results: Of 738 cancer patients who participated, 90.2% had heard about Yoga. Among those aware of yogic practices, only 15.9% knew that Yoga is an alternative therapy across the world. Knowledge of yogic importance was associated with age (OR = 1.16, 95% CI = 1.07-1.26, p = 0.002), education (OR = 0.5, 95%CI = 0.4-0.6, p < < .001), religion (OR = 1.16, 95%CI = 1.1-1.2, p < < .001). Attitude towards Yoga with the belief that it helps maintain mental health has a positive association with education (OR = 0.9, 95% CI = 0.8-0.9, p = 0.03). Almost 56% of cancer patients had never practiced Yoga. The identified barriers in yogic kriya practice were lack of time, interest, and facilities. Conclusions: The knowledge of the benefits of Yoga on health was high in adolescent young cancer patients. Still, the motivation towards yoga practice is limited due to various factors like lack of infrastructure, time, belief. The gap between knowledge, attitude, practice, and barriers can be overcome by conducting effective yogic programs for this population.

Can Central Banks circumvent the impossible trinity within their operational frameworks? Theory and evidence

AbstractCentral Bank operational frameworks can be challenged during times of severe financial stress. Typical of such an instance is where policymakers attempt to heavily manage or fix a domestic exchange rate whilst faced with balance of payments pressures. However, it is claimed to be impossible for policymakers to achieve both monetary independence and exchange rate stability if the domestic economy were to post a balance of payment surplus, otherwise known as the ‘impossible trinity’. The purpose of this paper is to investigate the European Monetary System crisis through the lens of Institutional Practice, that is the day‐to‐day operations of key institutions, such as the Central Bank, Treasury and commercial banks, with a view to demonstrate why global imbalances are able to occur and persist across the international monetary system. Through both a theoretical and an empirical appraisal, this paper shows how Central Banks in economies with a balance of payments surplus can circumvent the binding constraints of the trinity within their operational frameworks.

Economic Distress of Breast Cancer Patients Seeking Treatment at a Tertiary Cancer Center in Mumbai during COVID-19 Pandemic: A Cohort Study.

Background:Cancer treatment during nationwide lockdown due to the COVID-19 pandemic has posed several challenges in the delivery of cancer care and carries tremendous potential sequel of impoverishing the households. This study aims to examine the economic distress faced by breast cancer patients receiving treatment at Tata Memorial Center (TMC) Mumbai, India during the nationwide lockdown initiated in March 2020 following the outbreak of COVID-19. Methods:A total of 138 non-metastatic breast cancer patients who were accrued in this study at TMC before imposing of lockdown, and their treatment was impacted because of the COVID-19 outbreak, were interviewed. Telephonic interviews were conducted using a structured schedule which contained information on household and demographic characteristics of the patients, knowledge about COVID-19, their daily expenditure for treatment, difficulties faced during lockdown and how they met expenditures. Descriptive statistics and logistic regression were used in the analyses. Results:The average monthly expenditure of cancer patients had increased by 32% during the COVID-19 period while the mean monthly household income was reduced by a quarter. More than two-thirds of the patients had no income during the lockdown. More than half of the patients met their expenditure by borrowing money, 30% of the patients used their savings, 28% got charity and 25% used household income. About 81% of the patients had reported shortage of money, 32% reported shortage of food and 28% reported shortage of medicine. The distress financing was significantly higher among patients receiving treatment in Mumbai compared to those receiving treatment at their native cities (67% vs. 46%), patients under 40 years of age, illiterate, currently married, Muslim and staying at a rented house. Conclusion:The incremental expenditure coupled with reduced or no income due to the closure of economic activities in the country imposed severe financial stress on breast cancer patients.

Assessing the Safety of Central Counterparties

We propose a general framework for empirically assessing a central counterparty's capacity to cope with severe financial stress. Using public disclosure data for global central counterparties (CCPs), we show how to estimate the probability that a CCP could cover any specified fraction of payment defaults by its members. This framework supplements conventional standards of assessing risk protection across CCPs that is not predicated on a specific number of member defaults. We apply the approach to a wide range of CCPs in different geographical jurisdictions and asset classes and find that there are substantial differences in protection coverage. In particular, large European CCPs appear to be significantly safer than their counterparts in Asia-Pacific and North America. These differences are also reflected in supervisory data that provide CCP members' risk assessments of the CCPs to which they belong.

Assessing the Safety of Central Counterparties

We propose a general framework for empirically assessing a central counterparty's capacity to cope with severe financial stress. Using public disclosure data for global central counterparties (CCPs), we show how to estimate the probability that a CCP could cover any specified fraction of payment defaults by its members. This framework supplements conventional standards of risk management such as Cover 2, and provides a comparative and comprehensive approach to assessing risk protection across CCPs that is not predicated on a specific number of member defaults. We apply the approach to a wide range of CCPs in different geographical jurisdictions and asset classes and find that there are substantial differences in protection coverage. In particular, large European CCPs appear to be significantly safer than their counterparts in Asia-Pacific and North America. These differences are also reflected in supervisory data that provide CCP members' risk assessments of the CCPs to which they belong.

Performance Information Use under Financial Stress: How Do Public, Nonprofit, and Private Organizations Differ?

Performance management is becoming increasingly important in long-term health care because of rising quality standards and scarce resources. The ongoing Coronavirus pandemic illustrates the dynamic nature of emerging events in the health sector and underscores the importance of managing for results in suboptimal conditions. This study investigates whether managers in public, nonprofit, and private sector nursing homes differ in how they use performance information when their organizations are under severe financial stress. Based on the survey and archival data for 579 organizations in Switzerland, this study reveals substantial cross-sector differences in the use of performance information for managing efficiency and service quality. Our key findings suggest that managers in all three sectors utilize performance information differently when under financial stress. While financial stress hampers managers’ use of performance information for managing efficiency in the public sector, it fosters greater use in the nonprofit and private sectors, with the latter being even more responsive. Nonprofit organizations give more attention to preserving the quality of care, apparently fearing that increased emphasis on efficiency could undercut quality. The implications for theory and practice are discussed.

Psychological stress, cardiac symptoms, and cardiovascular risk in women with suspected ischaemia but no obstructive coronary disease.

This paper evaluated cross-sectional relationships between psychological stress and coronary artery disease (CAD) risk among women with suspected ischaemia and no obstructive coronary artery disease (INOCA). Between 1996 and 2000, 551 women with INOCA were enrolled in the Women's Ischemia Syndrome Evaluation (WISE) cohort from four U.S. institutions. Between 2009 and 2012, 376 women with INOCA were recruited from two U.S. institutions for an independent cohort study titled WISE-Coronary Vascular Dysfunction (WISE-CVD). Participants underwent coronary angiography and testing for CAD symptoms and risk factors at baseline. Psychological stress was assessed in the form of home/work stress in WISE and home/work stress and financial stress in WISE-CVD. Results showed that home/work stress predicted greater depression, functional impairment, CAD symptoms, and lower self-rated health in WISE but was inconsistent as a predictor in WISE-CVD. In contrast, >60% of WISE-CVD women reported moderate or severe financial stress. Financial stress levels predicted more CAD risk factors and cardiac symptoms, poorer self-rated health, and greater depression and functional impairment. Among women with INOCA, psychological stress was associated with CAD symptoms and CAD risk factors. The prevalence and predictive value of psychological stress in this population supports the inclusion of stress measures in future CAD research.

Bank Leverage and Capital Bias Adjustment Through the Macroeconomic Cycle

We assess the quantitative effects of the recent proposal for more robust bank capital adequacy (Admati and Hellwig, 2013; Myerson, 2014). Our theoretical proof and evidence accord with the core thesis that banks become more stable by increasing its equity capital cushion to absorb extreme losses in times of severe financial stress. This analysis contributes to the ongoing policy debate on total capital adequacy. Our Monte Carlo simulation helps develop an analytical solution for the default probability adjustment through the macroeconomic cycle. This study poses a conceptual challenge to the normative view that banks should maintain high leverage over time.

Bank leverage and capital bias adjustment through the macroeconomic cycle

We assess the quantitative effects of the recent proposal for more robust bank capital adequacy. Our theoretical proof and evidence accord with the core thesis that banks become more stable by increasing their equity capital cushion to absorb extreme losses in times of severe financial stress. This analysis contributes to the ongoing policy debate on total capital adequacy. Our Monte Carlo simulation helps develop an analytical solution for the default probability adjustment through the macroeconomic cycle. This study poses a conceptual challenge to the normative view that banks should maintain high leverage over time.

Why Extended Time on Newstart is Unsuitable for Aboriginal and Torres Strait Islander Australians Living with a Disability

ABSTRACTMany Australians living with a disability find themselves recipients of Newstart Allowance when applying for the Disability Support Pension (DSP). Newstart Allowance is designed as a short-term payment for people looking for work, with a lower fortnightly payment and limited medical and transport subsidies compared to the DSP. This paper describes the financial challenges of living with a disability while on Newstart Allowance. With a focus on the experiences of Aboriginal and Torres Strait Islander (Indigenous) Australians from two regional towns, qualitative semistructured interviews and focus groups documented experiences of 39 community members and 21 medical and nonmedical service providers supporting clients living with a disability on Newstart Allowance. Four themes were identified: (i) living with severe financial hardship, (ii) challenges complying with the DSP application, (iii) being financially penalised for not complying with Newstart Allowance conditions, and (iv) supporting community members to manage severe financial stress. Although people living with a disability on Newstart were experiencing severe hardship and poverty, there was limited participation of Centrelink-employed social workers within their described experiences with Centrelink. We argue that social workers can work to humanise human service settings and potentially help to mitigate these financial challenges.IMPLICATIONSIndigenous Australians living with a disability experience severe disadvantage and poverty while living on Newstart Allowance.Social workers must be easily accessible at Centrelink customer service centres and to Newstart Allowance recipients to help coordinate service engagement.Newstart Allowance should be increased to ensure recipients can respond to cost of living pressures.

Cancer and how the patients see it; prevalence and perception of risk factors: a cross-sectional survey from a tertiary care centre of Karachi, Pakistan

BackgroundThe incidence of cancer is rising but data available regarding prevalence of cancer and patient perception of the disease in Pakistan is limited. It is difficult to deal with Cancer if the main causes are negligence towards risk factors and bizarre myths. This study was aimed to investigate common cancer presentations at a government sector hospital and to gain insight into patient knowledge of the disease.MethodsThis was a cross-sectional study conducted on cancer patients from Jinnah Postgraduate Medical Centre. A self-made questionnaire was used to assess the norms related to cancer prevalence in our society, associated myths, and the most common risk factors per them.ResultsA total of 402 participants consented to participate in the study (mean age 42.3 ± 15.07 years), 204(50.7%) were females and 190(47.3%) were illiterate. Biomass exposure was found in 147(37%), drug abuse in 132(33%) and smoking in 63(16%). We found 103(25.6%) had positive family histories of cancer. The most common primary tumor site was breast for females 98(48%) and Head and neck 66(33.3%) for males. Patients considered fate 328(82%), gutka 284(71%) and injuries 282(70%) as the most common causes for cancer; while 222(55.5%) considered black magic and 236(58.75%) considered evil eye as a risk factor for cancer. Cancer treatment caused significant financial stress in 376(93.5%) patients.ConclusionBreast and head and neck cancers were found to be prevalent among patients. It was noted that patients are negligent in daily life regarding the consumption of substances that commonly cause cancer. Individuals had diminished knowledge and majority linked cancer to unrelated causes and myths like black magic and fate. Almost all the patients complained of severe financial stress imposed by the disease.

An Early Warning System for Systemic Risks

This paper formulates an Early Warning System (EWS) for tail financial risks based on real-time multi-period forecast \textit{combinations} of %a short-term structure of Value-at-Risk (VaR) and Expected Shortfalls (ES) of portfolio returns of non-financial firms and banks. Forecast combinations include \textit{baseline} (VaR,ES) forecasts conditional on a domestic risk factor, as well as \textit{stress} (sVaR,sES) forecasts conditional on CoVaRs of the risk factor, thereby integrating stress testing into forecasting. Using monthly data of the G-7 economies for the period 1975:01-2018:12, the proposed EWS delivers significant out-of-sample tail financial risk forecasts and reliable vulnerability signals up to a 12-month forecasting horizon, with stress forecasts in the combination improving forecasting ability prior to periods of severe financial stress.

Suicides as a response to adverse market sentiment (1980-2016).

Financial crises inflict significant human as well as economic hardship. This paper focuses on the human fallout of capital market stress. Financial stress-induced behavioral changes can manifest in higher suicide and murder-suicide rates. We find that these rates also correlate with the Gross Domestic Product (GDP) growth rate (negatively associated; a -0.25% drop [in the rate of change in annual suicides for a +1% change in the independent variable]), unemployment rate (positive link; 0.298% increase), inflation rate (positive link; 0.169% increase in suicide rate levels) and stock market returns adjusted for the risk-free T-Bill rate (negative link; -0.047% drop). Suicides tend to rise during periods of economic turmoil, such as the recent Great Recession of 2008. An analysis of Centers for Disease Control and Prevention (CDC) data of more than 2 million non-natural deaths in the US since 1980 reveals a positive correlation with unemployment levels. We find that suicides and murder-suicides associated with adverse market sentiment lag the initial stressor by up to two years, thus opening a policy window for government/public health intervention to reduce these negative outcomes. Both our models explain about 73 to 76% of the variance in suicide rates and rate of change in suicide rates, and deploy a total of four widely available independent variables (lagged and/or transformed). The results are invariant to the inclusion/exclusion of 2008 data over the 1980–2016 time series, the period of our study. The disconnect between rational decision making, induced by cognitive dissonance and severe financial stress can lead to suboptimal outcomes, not only in the area of investing, but in a direct loss of human capital. No economic system can afford such losses. Finance journal articles focus on monetary alpha, which is the return on a portfolio in excess of the benchmark; we think it is important to be aware of the loss of human capital as a consequence of market instability. This study makes one such an attempt.

International financial spillovers to emerging market economies: How important are economic fundamentals?

We assess the importance of economic fundamentals in the transmission of international shocks to financial markets in various emerging market economies (EMEs), covering the so-called taper-tantrum episode of 2013 and seven other episodes of severe EME-wide financial stress since the mid-1990s. Cross-country regressions lead us to the following results: (1) EMEs with relatively better economic fundamentals suffered less deterioration in financial markets during the 2013 taper-tantrum episode. (2) Differentiation among EMEs set in relatively early and persisted through this episode. (3) During the taper tantrum, while controlling for the EMEs’ economic fundamentals, financial conditions also deteriorated more in those EMEs that had earlier experienced larger private capital inflows and greater exchange rate appreciation. (4) During the EME crises of the 1990s and early 2000s, we find little evidence of investor differentiation across EMEs being explained by differences in their relative vulnerabilities. (5) However, differentiation across EMEs based on fundamentals does not appear to be unique to the 2013 episode; it also occurred during the global financial crisis of 2008 and, subsequently, during financial stress episodes related to the European sovereign crisis in 2011 and China’s financial market stresses in 2015.

Financial Stress and Smoking within a Large Sample of Socially Disadvantaged Australians.

Financial stress is associated with fewer quit attempts and higher relapse rates. This study aimed to compare financial stress among smokers, ex-smokers and never smokers in a highly socioeconomically disadvantaged sample. The study also aimed to determine whether specific indicators of financial stress differ according to smoking status. Adult clients seeking welfare assistance from two Social and Community Service Organisation sites in New South Wales, Australia, were invited to complete a cross-sectional survey between March 2012 and December 2013. Responses to a financial stress scale, smoking status and demographics were collected. Linear and logistic regression modelling was used to examine associations between smoking status and financial stress. A total of 1463 participants completed the survey. Current smokers had significantly higher total financial stress scores than ex-smokers and non-smokers respectively. Current smokers also had higher odds of severe financial stress indicators, such as going without meals (Odds Ratio = 2.2 and 2.0), than both non-smokers and ex-smokers. Even among a highly socioeconomically disadvantaged sample with high levels of financial stress, smoking status further exacerbates experiences of deprivation. Given the relationship between financial stress, socioeconomic disadvantage and difficulty quitting, it is important to provide enhanced cessation support to smokers experiencing financial stress.

A Qualitative Examination of Jim Kemeny’s Arguments on High Home Ownership, the Retirement Pension and the Dualist Rental System Focusing on Australia

ABSTRACTA key aspect of Jim Kemeny’s argument is that in advanced economies that have high levels of home ownership, the age pension is only adequate if you have low accommodation costs. A related argument is that these societies will be dominated by what he calls a dualist rental market. In this rental market regulation is minimal and landlords hold sway. Kemeny’s thesis, was given added support by Castles’ (1998) more extensive comparative analysis. He concluded that his findings were ‘extremely supportive’ of Kemeny’s conclusion. In this paper, I use in-depth interviews to test Kemeny’s thesis. The circumstances of older homeowners and older private renters in Australia are compared. All of the interviewees were dependent solely or primarily on the government age pension. The interviews indicated that almost all of the older homeowners felt that the age pension was adequate. They were able to consume adequately, engage in leisure activities, run a car, go on holiday and they had little anxiety about their financial situation. This was especially so in the case of those interviewees drawing the couples pension. In contrast, most of the older private renters suffered from severe financial stress. Invariably they had to use a large proportion of their income to pay for accommodation, and as a result, they found it difficult to purchase basic items and any unexpected expense precipitated much anxiety. Their limited resources severely impacted on their capacity to sustain social contacts, engage in leisure activities and look after their health. In addition to having limited resources, many had minimal security of occupancy. The interviews strongly substantiated Kemeny’s original thesis. They illustrated that within a dualist rental market the housing tenure and attendant accommodation costs of a person dependent on the government age pension are crucial determinants of their capacity to live a decent life.