181378 How hard is it for you to make ends meet?: A multi-method exploration of financial stress and psychosocial health outcomes among North Carolinian women

Monday, October 27, 2008

Kathryn Remmes Martin, MPH , Health Behavior and Health Education, University of North Carolina - Chapel Hill, Chapel Hill, NC
Britta Schoster, MPH , Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
Josephine E. A. Boyington, PhD, MPH, RN , Institute for Health, Social and Community Research, Shaw University, Raleigh, NC
Leigh F. Callahan, PhD , Medicine, Orthopedics and Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
Background: Financial stress poses a major barrier to health and well being, particularly among women.

Methods: 23 North Carolinian women completed a telephone survey, a written survey, and participated in qualitative discussions (focus groups and in-depth individual interviews). The telephone survey assessed health status and chronic conditions (Health Related Quality of Life (BRFSS HRQOL), Satisfaction with Life Scale (SWLS), and CES-D measuring depression), qualitative discussions explored the relationship between place and health, and the written survey assessed financial well-being. Multivariate logistic regressions were conducted adjusting for age, race, education, and number of co-morbid conditions. Atlas.ti and STATA v. 8 were utilized.

Results: Participants were an average of 53 years old, non-Hispanic white (65.2%), and had annual household incomes < 30k (60.8%). 39.1% perceived their current health status as fair or poor, 52% found it somewhat hard or very hard to make ends meet in the 6 months preceding the study. Top financial stressors were transportation (56.5%), access to a doctor (52.2%), prescriptions, and food costs (43.5%). 17.4% went without medical services due to cost, yet all had health insurance. Those finding it harder to make ends meet had greater depressive symptoms. Financial stress regarding food cost significantly predicted SWL and HRQOL. Financial stress emerged as a main theme in qualitative discussions, particularly regarding the stress of the high cost of fresh fruits and vegetables, and health insurance and prescriptions.

Conclusion: This study is exploratory, yet suggests financial stress may be an important factor in examining psychosocial health outcomes.

Learning Objectives:
1.Discuss how financial stress is related to psychosocial health outcomes in this group of North Carolinian women. 2.Recognize the importance of examining factors beyond standard socioeconomic status measures.

Keywords: Stress, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was a part of the data collection, data analyses, and abstract writing.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

See more of: Poverty as a Barrier to Health and Well-being
See more of: APHA-Committee on Women's Rights