The grave health consequences of a personal financial catastrophe

Middle-aged people who suffer a massive and sudden loss of wealth also face an increased risk of death — similar to receiving a new diagnosis of coronary heart disease, according to a new study.

A mounting body of evidence suggests a link between financial setbacks and ill health, and there’s growing interest from traditional health care players in the nonmedical factors, such as economic security, that shape people’s well-being. Researchers have used the Great Recession as a natural experiment to study the effects of losing wealth and found losses associated with depression, anxiety, suicide, higher blood pressure and substance abuse.

The study, published in the Journal of the American Medical Association, found that among adults aged 51 to 61 years old, sudden losses of wealth — a 75 percent reduction in net worth over a two-year period — were surprisingly common: more than a quarter of the people they studied experienced such a dramatic loss over two decades. People who experienced financial catastrophe were 50 percent more likely to die than those who did not.

“What’s interesting is we find that someone’s starting point — whether your net worth is $50,000 or $500,000 or $5 million — it doesn’t seem to matter in terms of health risk. Losing 75 percent or more of that creates that increased risk of mortality,” said Lindsay Pool, a research assistant professor of preventive medicine at Northwestern University Feinberg School of Medicine, who led the study.

The researchers utilized the Health and Retirement Study, which tracks people’s net worth over time — including housing, bank accounts, investments and other assets. They found that people who experienced massive losses of wealth were more likely to be women, minorities, sick, and poor.

An important limitation of the study is that it could not determine whether a health loss triggered a wealth loss, or vice versa. A financial slide might cause an increased risk of death, a catastrophic health problem could cause major financial losses or the financial loss might be a symptom of a life change that adversely impacted people’s health. Although the researchers couldn’t discern whether financial catastrophe specifically changed people’s well-being, they theorized that a major hit to people’s financial stability could trigger mental health problems or cause people to delay or forgo medical care or medications.

While researchers hope to examine the possible connection between major wealth losses and mortality in greater detail, the research raises the question of how, or whether, physicians should probe their patients’ finances. Although there is growing interest in social factors that powerfully shape people’s health, it has not been clear how they fit within the purview of traditional medicine.

In an accompanying editorial, Harvard University provost Alan Garber wrote that the study is a warning that middle-aged Americans are at risk of losing most of their financial resources, and possibly dying early as a result — and that physicians should take notice.

“A wealth shock is a severe disruption in the life of any patient that has implications for health behaviors and well-being,” Garber wrote. “An opportunity to build empathy and offer support will elude clinicians who fail to recognize such a profound event and its meaning for their patient’s future.”