Study Clocks High Mortality Risk After Midlife Financial Peril

(CN) – Backing the idea that health and wealth go hand in hand, new research shows that middle-aged and senior adults whose fortunes faded in the wake of the 2008 financial crisis had a significantly increased mortality risk, as compared with the continuously wealthy.

Published Tuesday in the Journal of American Medicine, the study defines the phenomenon of losing 75 percent or more of total net worth over a two-year period as “negative wealth shock.”

Beginning in 1994, a research team led by Lindsay Pool of Northwestern University’s medical school began looking for signs of such shock in a pool of 8,714 adults, aged 51-61.

By the time the study ended in 2014, the researchers found that 2,430 from the participant pool had experienced a negative wealth shock during biennial follow-ups. Another 5,535 had continuously positive wealth, and the final 749 had asset poverty at baseline, defined as 0 or negative total net worth at study entry.

As opposed to those with continuously positive wealth, however, the study participants experienced a marked increase in mortality risk among those who experienced negative wealth shock: 30.6 v. 64.9 deaths per 1,000 person-years.

For those with asset poverty at baseline meanwhile there were 73.4 deaths per 1,000 person-years.

Tuesday’s article notes that the evidence of substantially poorer health outcomes among people with lower socioeconomic status is substantial.

The researchers see negative wealth shocks as another critical component of this measure, since “these shocks are usually stressful life experiences that leave fewer monetary resources for health-enhancing goods and services.”

Among clinically relevant health changes observed in the study population on the heels of the Great Recession, the researchers found an “increased risk of depression and anxiety, suicide, impaired cardiovascular function, and substance abuse.”

Age plays a significant factor, according to the study, since income-earning potential is reduced for older adults, making it increasingly difficult for them to financially recover from the shock.

The study also notes, however, that “medical expenses from major illness can be a primary trigger of negative wealth shock in middle-aged and older adults.”

Yet “it can be difficult to disentangle the effect of negative wealth shocks on subsequent health outcomes from the effect of the medical illness itself,” the article states.

The study found that, especially for individuals whose medical needs triggered a wealth shock, declining financial resources were tied to reduced spending on health-related goods and services.

“Delaying needed medical care and incomplete adherence to prescribed medication can have long-term health consequences, including increased mortality,” the study notes.

Among other findings, the study notes that, “compared with those who had positive wealth without shock, those who had a negative wealth shock were more likely to be women, race/ethnicity other than non-Hispanic white, have lower levels household income and net worth, and have poor health.”

“These differences were even more extreme in the asset poverty group, the majority of whom were not married, not working, and had serious health conditions,” the study continues.

Up until now, according to the article, most research on negative wealth shocks has focused on short-term health outcomes, including depression and anxiety, suicide, impaired cardiovascular function, and substance abuse.

By studying the population here for 20 years, however, the researchers say they “captured both proximal associations with mortality, from causes such as suicide, as well as associations with causes of death that have longer latency.”

“Several studies have focused specifically on foreclosure, hypothesizing this type of loss to be a particularly strong stressor; likewise, in this study, wealth shocks with loss of home had a stronger association with mortality than wealth shocks without loss of home, though these shocks were still associated with increased mortality risk,” the article states.

The study also piggybacks on previous research in chronic disease patient populations that shows a poorer prognosis for those who report financial burden from medical expenses.

And while the psychosocial stress from economic loss meanwhile appears to contribute to all-cause mortality — increasing blood pressure and inflammation, for example — the researchers found no such link when it comes to psychological health and positive wealth shocks.

For those study participants with a greater tolerance of financial risk, meanwhile, the researchers found that such personality traits “may buffer the stress of the shock.”

“In post hoc subgroup analysis, there was suggestion of an interaction between financial risk aversion and negative wealth shock,” the article continues.

Tuesday’s study concludes with numerous limitations, including the challenge of discerning negative-wealth-shock causes with certainty.

“Even in recession periods, it is unknown whether the wealth shock was triggered due to macroeconomic causes or personal circumstances,” the report states. “Likewise, follow-up in this study occurred prior to the implementation of the Affordable Care Act (ACA), which has significantly reduced the number of uninsured adults and lowered out-of-pocket costs. It is possible that increased insurance coverage through the ACA has reduced the prevalence of negative wealth shocks driven by medical issues, and there may also be a reduced prevalence of delaying needed medical care after experiencing wealth shock.”

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