A cross-sectional study of financial distress in persons with multimorbidity

Steven S Coughlin; Biplab Datta; Adam Berman; Christos Hatzigeorgiou

doi:10.1016/j.pmedr.2021.101464

A cross-sectional study of financial distress in persons with multimorbidity

Prev Med Rep. 2021 Jun 25:23:101464. doi: 10.1016/j.pmedr.2021.101464. eCollection 2021 Sep.

Authors

Steven S Coughlin^{1

2}, Biplab Datta^{1

2}, Adam Berman^{1

3}, Christos Hatzigeorgiou⁴

Affiliations

¹ Department of Population Health Sciences, Augusta University, 1120 15 Street, Augusta, GA 30912, USA.
² Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.
³ Division of Cardiology, Augusta University, 1120 15th Street, Augusta, GA 30912, USA.
⁴ Division of General Internal Medicine, Augusta University, 1120 15 Street, Augusta, GA 30912, USA.

Abstract

Background: Financial distress among persons with multimorbidity is an important topic which has been inadequately addressed to date.

Objective: We examined the extent of financial distress among persons with multimorbidity, using data from the 2017 Behavioral Risk Factor Surveillance System (BRFSS).

Design: Cross-sectional, population-based study.

Participants: Adults ages ≥ 18 years with multimorbidity.

Main measures: Low income and selected social determinants of health that are indicators of financial distress.

Key results: Multimorbidity was more common among those with a household income of less than $15,000 per year (P < 0.001) and among those who were 65 years of age or older (P < 0.001). There was an approximately linear increase in the percentage of individuals who had a household income of less than $15,000 or $25,000 per year with increasing number of morbidities. About one-quarter of individuals who had five or more morbidities had a household income of less than $15,000 per year as compared with 4.49% of individuals with no morbidities (P < 0.001). For all of the social determinants of health examined (Couldn't pay bills, didn't have money for food, didn't have money for balanced meals, didn't have enough money to make ends meet, and felt this kind of stress), there was an approximately linear increase in the percentage of individuals with an indicator of financial distress with increasing number of morbidities. Further research is needed examining the prevalence and correlates of financial distress in this population as well effective strategies for ameliorating its impact on the health and wellbeing of these persons.

Keywords: Cancer; Cardiovascular disease; Costs; Financial distress; Multimorbidity; Social determinants of health.