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      Social determinants of financial stress and association with psychological distress among young adults 18–26 years in the United States

      brief-report

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          Abstract

          Introduction

          Financial stress (FS) during young adulthood may have lasting effects on financial security, physical health, and overall wellbeing. This study examines the burden, social determinants and mental health consequences of experienced FS among young adults in the United States, based on objective measures of financial stress.

          Methods

          We studied young adults aged 18–26 years using pooled data from the 2013–18 National Health Interview Survey. FS was assessed as an aggregate score (6–24) based on worry about six life tasks: paying for: monthly bills, housing expenses, healthcare, illness/accident, maintaining standard of living, saving money for retirement. Individuals in the highest quartile of the score were defined as having high FS. Psychological distress (PD) was measured using the six-item Kessler Psychological Distress Scale (K6); high PD was defined as total K6 score ≥13. Multivariable ordinal and logistic regression models were used to assess key social determinants of FS and the association between FS and PD, respectively.

          Results

          Study sample included 19,821 individuals aged 18–26 years (34 million annualized). Overall, 17% (5.8 million nationally) of young adults reported high FS. Female, non-Hispanic Black and Hispanic, low income/low education, uninsured, non-citizen and comorbidities were associated with high FS burden. In fully adjusted models, high FS was associated with over 6-fold (OR = 6.17, 95% CI 4.43–8.61) higher risk of high PD.

          Discussion

          One in six young adults in the US experiences high FS, which portends high risk of PD. These findings should inform stakeholder deliberations to identify and mitigate the unintended mental health consequences of FS in this vulnerable population.

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          Most cited references24

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          Screening for Serious Mental Illness in the General Population

          Ronald C Kessler, Peggy R. Barker, Lisa Colpe … (2003)
          Public Law 102-321 established a block grant for adults with "serious mental illness" (SMI) and required the Substance Abuse and Mental Health Services Administration (SAMHSA) to develop a method to estimate the prevalence of SMI.
          Article 0 comments Cited 938 times – based on 0 reviews     Review now
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            The Gender Wage Gap: Extent, Trends, and Explanations

            Francine D Blau, Lawrence Kahn (2017)
            Article 0 comments Cited 352 times – based on 0 reviews     Review now
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              Work stress precipitates depression and anxiety in young, working women and men.

              Maria Melchior, Avshalom Caspi, Stephen Milne … (2007)
              Rates of depression have been rising, as have rates of work stress. We tested the influence of work stress on diagnosed depression and anxiety in young working adults. Participants were enrolled in the Dunedin study, a 1972-1973 longitudinal birth cohort assessed most recently in 2004-2005, at age 32 (n=972, 96% of 1015 cohort members still alive). Work stress (psychological job demands, work decision latitude, low work social support, physical work demands) was ascertained by interview. Major depressive disorder (MDD) and generalized anxiety disorder (GAD) were ascertained using the Diagnostic Interview Schedule (DIS) and diagnosed according to DSM-IV criteria. Participants exposed to high psychological job demands (excessive workload, extreme time pressures) had a twofold risk of MDD or GAD compared to those with low job demands. Relative risks (RRs) adjusting for all work characteristics were: 1.90 [95% confidence interval (CI) 1.22-2.98] in women, and 2.00 (95% CI 1.13-3.56) in men. Analyses ruled out the possibility that the association between work stress and disorder resulted from study members' socio-economic position, a personality tendency to report negatively, or a history of psychiatric disorder prior to labour-market entry. Prospective longitudinal analyses showed that high-demand jobs were associated with the onset of new depression and anxiety disorder in individuals without any pre-job history of diagnosis or treatment for either disorder. Work stress appears to precipitate diagnosable depression and anxiety in previously healthy young workers. Helping workers cope with work stress or reducing work stress levels could prevent the occurrence of clinically significant depression and anxiety.
              Article 0 comments Cited 178 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Anaiya Nasir: URI : http://loop.frontiersin.org/people/2866621/overviewRole: Role: Role: Role: Role:
                Umair Javed: URI : http://loop.frontiersin.org/people/2931117/overviewRole: Role: Role: Role:
                Kobina Hagan: Role: Role: Role: Role:
                Ryan Chang: URI : http://loop.frontiersin.org/people/1166828/overviewRole: Role: Role:
                Harun Kundi: URI : http://loop.frontiersin.org/people/2930500/overviewRole: Role:
                Zahir Amin: Role: Role: Role:
                Sara Butt: Role: Role:
                Sadeer Al-Kindi: Role: Role: Role: Role:
                Zulqarnain Javed: URI : http://loop.frontiersin.org/people/2128172/overviewRole: Role: Role: Role: Role: Role: Role: Role: Role:
                Journal
                Journal ID (nlm-ta): Front Public Health
                Journal ID (iso-abbrev): Front Public Health
                Journal ID (publisher-id): Front. Public Health
                Title: Frontiers in Public Health
                Publisher: Frontiers Media S.A.
                ISSN (Electronic): 2296-2565
                Publication date (Electronic): 07 January 2025
                Publication date Collection: 2024
                Volume: 12
                Electronic Location Identifier: 1485513
                Affiliations
                [1] 1St. Agnes Academy , Houston, TX, United States
                [2] 2Combined Military Hospital Medical Center, University of Health Sciences , Lahore, Pakistan
                [3] 3Houston Methodist DeBakey Heart and Vascular Center , Houston, TX, United States
                [4] 4Baylor College of Medicine , Houston, TX, United States
                [5] 5Cardiovascular Research Foundation , New York, NY, United States
                [6] 6University of Texas Medical Branch , Galveston, TX, United States
                [7] 7Center for Health Data Science and Analytics, Houston Methodist , Houston, TX, United States
                [8] 8Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center , Houston, TX, United States
                [9] 9Center for Cardiovascular Computational Health & Precision Medicine (C3-PH), Houston Methodist , Houston, TX, United States
                Author notes

                Edited by: Zhiqiang Feng, University of Edinburgh, United Kingdom

                Reviewed by: Bo Zhou, University of North Texas Health Science Center, United States

                Samson Femi Agberotimi, Covenant University, Nigeria

                *Correspondence: Zulqarnain Javed zjaved@ 123456houstonmethodist.org
                Article
                DOI: 10.3389/fpubh.2024.1485513
                PMC ID: 11752891
                PubMed ID: 39845680
                SO-VID: 9d2b1961-f6ca-4bdf-a858-5d76320ac73e
                Copyright © Copyright © 2025 Nasir, Javed, Hagan, Chang, Kundi, Amin, Butt, Al-Kindi and Javed.
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                Date received : 23 August 2024
                Date accepted : 17 December 2024
                Page count
                Figures: 2, Tables: 2, Equations: 0, References: 24, Pages: 8, Words: 5093
                Funding
                The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.
                Categories
                Subject: Public Health
                Subject: Brief Research Report
                Custom metadata
                section-at-acceptance Life-Course Epidemiology and Social Inequalities in Health

                Keywords: financial stress,mental health,wellbeing,young adults,social determinants of health
                Data availability:
                Keywords: financial stress, mental health, wellbeing, young adults, social determinants of health

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