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. 2023 Sep 21;23(1):1845.
doi: 10.1186/s12889-023-16745-x.

The association between material-psychological-behavioral framework of financial hardship and markers of inflammation: a cross-sectional study of the Midlife in the United States (MIDUS) Refresher cohort

Agus Surachman  1   2 , Reginald Tucker-Seeley  3 , David M Almeida  4   5
Affiliations

The association between material-psychological-behavioral framework of financial hardship and markers of inflammation: a cross-sectional study of the Midlife in the United States (MIDUS) Refresher cohort

Agus Surachman et al. BMC Public Health. .

Abstract

Background: Measures of financial hardship have been suggested to supplement traditional indicators of socioeconomic status (SES) to elucidate household economic well-being. This study formally tested the construct validity of financial hardship and examined its association with markers of inflammation.

Methods: This study utilized data from the Midlife Development in the United States Refresher Study (MIDUS-R; Age = 23-76, 53.7% female, 71% white). Participants were divided into exploratory factor analysis (EFA; completed SAQs only; N = 2,243) and confirmatory factor analysis sample (CFA; completed SAQs and biomarker assessment; N = 863). Analysis was divided into three steps. First, exploratory factor analysis (EFA) is used to examine if the three-domain factor (material, psychological, and behavioral) is the best fitting model for financial hardship measures. Second, we conducted CFA to test the hypothesized three-factor measurement model of financial hardship. Third, we tested the association between domains and the general latent factor of financial hardship and inflammation (interleukin 6/IL6, c-reactive protein/CRP, and fibrinogen).

Results: Results from EFA supported the three-domain model of financial hardship. The hypothesized three-domain measurement model fits well in a different sample within MIDUS-R. In the models adjusted for age and sex, higher material hardship was associated with elevated IL6, CRP, and fibrinogen, while higher behavioral hardship was associated with higher CRP. The association between the material domain and IL6 remained significant after adding body mass index, education, and race as additional covariates. The second-order financial hardship measurement model was associated with IL6, CRP, and fibrinogen, adjusted for age, sex, BMI, education, and race.

Conclusion: Explicating the socioeconomic environment to include indicators of financial hardship can help researchers better understand the pathway between SES and the inflammation process, which may help elucidate pathways between SES and age-related chronic diseases associated with inflammation.

Keywords: C-reactive protein; Fibrinogen; Financial hardship; Household economic well-being; Inflammation; Interleukin-6; Material–psychological–behavioral domain.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The association between the general latent factor of financial hardship and IL6, adjusted for age, sex, BMI, education, and race (N = 863). Straight lines represent significant estimates. Estimates indicate standardized estimates with a 95% confidence interval. Circles represent latent variables, and squares represent observed variables
Fig. 2
Fig. 2
The association between the general latent factor of financial hardship and CRP, adjusted for age, sex, BMI, education, and race (N = 863). Straight lines represent significant estimates. Estimates indicate standardized estimates with 95% confidence intervals. Circles represent latent variables, and squares represent observed variables
Fig. 3
Fig. 3
The association between the general latent factor of financial hardship and CRP, adjusted for age, sex, BMI, education, and race (N = 863). Straight lines represent significant estimates. Estimates indicate standardized estimates with 95% confidence intervals. Circles represent latent variables, and squares represent observed variables
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