Linking financial hardship throughout the life-course with psychological distress in old age: Sensitive period, accumulation of risks, and chain of risks hypotheses

Abstract

The primary objective was to investigate the life course hypotheses - sensitive period, chain of risks, and accumulation of risks - in relation to financial hardship and psychological distress in old age. We used two Swedish longitudinal surveys based on nationally representative samples. The first survey includes people 18-75 years old with multiple waves, the second survey is a longitudinal continuation, including people 76 + years old. The analytical sample included 2990 people at baseline. Financial hardship was assessed in childhood (retrospectively), at the mean ages of 54, 61, 70, and 81 years. Psychological distress (self-reported anxiety and depressive symptoms) was assessed at the same ages. Path analysis with WLSMV estimation was used. There was a direct path from financial hardship in childhood to psychological distress at age 70 (0.26, p = 0.002). Financial hardship in childhood was associated with increased risk of psychological distress and financial hardship both at baseline (age 54), and later. Financial hardship, beyond childhood, was not independently associated with psychological distress at age 81. Higher levels of education and employment decreased the negative effects of financial hardship in childhood on the risk of psychological distress and financial hardship later on. There was a bi-directional relationship between psychological distress and financial hardship; support for health selection was slightly higher than for social causation. We found that psychological distress in old age was affected by financial hardship in childhood through a chain of risks that included psychological distress earlier in life. In addition, financial hardship in childhood seemed to directly affect psychological distress in old age, independent of other measured circumstances (i.e., chains of risks). Education and employment could decrease the effect of an adverse financial situation in childhood on later-life psychological distress. We did not find support for accumulation of risks when including tests of all hypotheses in the same model.

Unemployment and Psychological Distress among Young People during the COVID-19 Pandemic: Psychological Resources and Risk Factors

“…Finally, emerging financial strain during the coronavirus outbreak was more prevalent, as expected, among the unemployed and was associated with greater PD. This finding aligns with the accumulated knowledge on the financial strain-PD link [ 56 , 57 , 58 ] and also supports Pearlin’s stress process model [ 54 ], which emphasizes that inadequate financial resources substantially affect one’s PD.…”

“…This loss, along with the limited ability to gain new financial resources in the wake of the pandemic, can in turn increase PD. Previous studies have documented the association between financial strain, particularly when long-lasting, and PD [ 56 , 57 , 58 ].…”

Socioeconomic Disadvantage across the Life Course Is Associated with Diet Quality in Young Adulthood

“…The cumulative effects hypothesis (or accumulation of risks) is based on the premise that the duration and intensity of adverse exposures are most relevant to subsequent health [1,2,5]. The pathways hypothesis posits that the effect of disadvantage is indirect by setting individuals on adverse social trajectories that continue across the life course, where one negative factor increases the possibility of experiencing the same negative factor at a subsequent time point (i.e., low childhood SEP increases the possibility of low adult SEP) [2,6].…”

“…This would provide support for the critical periods hypothesis. We also hypothesized that childhood and young adult SEP would each be independently associated with diet quality in young adulthood which we interpreted as providing evidence in support of the cumulative effects hypothesis as this suggests that repeated exposure to low SEP leads to poor dietary outcomes [6], and that the effects of SEP would be most pronounced for those with the lowest educational attainment (suggesting greater intensity of negative exposures). Finally, we expected that adult SEP would partially mediate associations between childhood SEP and diet quality in young adulthood, thereby demonstrating the relevance of the pathways hypothesis to the socioeconomic patterning of diet quality.…”

A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the Health and Retirement Study

“…Some studies argue that these models are often mutually inclusive, making it difficult to distinguish which models best describe the link between early‐life adversities and health outcomes . A more nuanced approach, perhaps a simultaneous test of life course hypotheses, will help parse out the complex, underlying processes behind this oral health disparity.…”