The price of mental well-being in later life: the role of financial hardship and debt

Abstract

Objective

This study investigated the associations between various financial hardship and debt indicators and mental health status among older adults.

Methods

Using data from the Health and Retirement Study (HRS), we considered the association between different forms of financial hardship and debt of those who were identified as having high levels of depressive symptoms (N = 7678) and anxiety (N = 8079). Financial hardship indicators: difficulty paying bills, food insecurity, and medication need; debt indicators: credit card and medical debt. Associations were tested using multiple logistic regression analyses and are reported as relative risk (RR) ratios and 95% confidence intervals (CIs).

Results

Participants who had difficulty paying bills were more likely to have high levels of depressive symptoms (RR = 2.06, CI = 1.75–2.42, p < 0.001) and anxiety (RR = 1.46, CI = 1.02–2.05, p < 0.001) compared to those who did not have financial difficulty. Similarly, medical debt was associated with depressive symptoms (RR = 1.43, CI = 1.14–1.74, p < 0.01) and anxiety (RR = 1.20, CI = 0.96–1.50, p < 0.01). Credit card debt was not significantly associated with either mental health outcome.

Conclusion

Indicators of financial hardship and medical debt were associated with depressive symptoms and anxiety in a cohort of older adults. In contrast, the influence of credit card debt appeared to be more complex and vary by individual. These findings indicate that doing without meeting personal salient needs has a particularly adverse effect on psychological well-being.

Keywords:

• Anxiety
• debt
• depression
• financial hardship
• mental health

Disclosure statement

None of the authors have a conflict of interest and no financial disclosures were reported by the authors of this paper.

Additional information

Funding

The research conducted for this manuscript was supported by the National Institutes of Health. Dr. Marshall is funded by a K01 career development award (Grant# 5K01AG048416-03) from the National Institutes of Aging.