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. 2022 Jun;70(6):1629-1641.
doi: 10.1111/jgs.17808. Epub 2022 Apr 15.

The effect of COVID-19 pandemic-related financial challenges on mental health and well-being among US older adults

Laura J Samuel  1 , Pallavi Dwivedi  1 , Melissa Hladek  1 , Thomas K M Cudjoe  2 , Brittany F Drazich  1 , Qiwei Li  1 , Sarah L Szanton  1   3
Affiliations

The effect of COVID-19 pandemic-related financial challenges on mental health and well-being among US older adults

Laura J Samuel et al. J Am Geriatr Soc. 2022 Jun.

Abstract

Background: Despite profound financial challenges during the COVID-19 pandemic, there is a gap in estimating their effects on mental health and well-being among older adults.

Methods: The National Health and Aging Trends Study is an ongoing nationally representative cohort study of US older adults. Outcomes included mental health related to COVID-19 (scores averaged across eight items ranging from one to four), sleep quality during COVID-19, loneliness during COVID-19, having time to yourself during COVID-19, and hopefulness during COVID-19. Exposures included income decline during COVID-19 and financial difficulty due to COVID-19. Propensity score weighting produced covariate balance for demographic, socioeconomic, household, health, and well-being characteristics that preceded the pandemic to estimate the average treatment effect. Sampling weights accounted for study design and non-response.

Results: In weighted and adjusted analyses (n = 3257), both income decline during COVID-19 and financial difficulty due to COVID-19 were associated with poorer mental health related to COVID-19 (b = -0.159, p < 0.001 and b = -0.381, p < 0.001, respectively), poorer quality sleep (OR = 0.63, 95% CI: 0.46, 0.86 and OR = 0.42, 95% CI: 0.30, 0.58, respectively), more loneliness (OR = 1.53, 95% CI: 1.16, 2.02 and OR = 2.72, 95% CI: 1.96, 3.77, respectively), and less time to yourself (OR = 0.54, 95% CI: 0.40, 0.72 and OR = 0.37, 95% CI: 0.27, 0.51, respectively) during COVID-19.

Conclusions: Pandemic-related financial challenges are associated with worse mental health and well-being regardless of pre-pandemic characteristics, suggesting that they are distinct social determinants of health for older adults. Timely intervention is needed to support older adults experiencing pandemic-related financial challenges.

Keywords: financial strain; mental health; older adults; pandemic; socioeconomic factors; well-being.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
Strategies used to handle financial difficulty due to the COVID‐19 pandemic by National Health and Aging Trends Study participants who reported experiencing financial difficulty due to the pandemic (n = 175). Sampling weights were applied so that inferences can be drawn to the 2020 population of US adults aged 70 and older. Values represent US population counts and percentages
FIGURE 2
FIGURE 2
Adjusted coefficient estimates with 95% confidence intervals of the associations between income decline during COVID‐19 and financial difficulty due to COVID‐19 with mental health and well‐being outcomes during the COVID‐19 pandemic among National Health and Aging Trends Study participants. Results are also presented in Table 3, except that unexponentiated coefficient values from logistic regression are presented here so that relative comparison can be made across both outcomes and exposures
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References

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