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As extensively discussed in the BMJ recently [e.g., 1-7], economic circumstances and financial hits in the aftermath of the COVID-19 pandemic have a critical role in shaping the physical and mental health of millions of people, not just in the UK but also across the world. Goddard wisely alarmed (doi:10.1136/bmj.o1343) this is another clear and important reminder that “our health is shaped by our environment” [8], and is socially and economically determined.
For example, Limb reported that the rapidly rising cost of living had forced hundreds of thousands of cancer patients to cut their treatment and basic consumption (e.g., food, energy, transportation, and housing), and affected their physical and mental health substantially [3]. This is just a specific example of adverse health impacts from cost of living crisis, unemployment, income loss, and poverty on one of the particular populations (cancer patients). More broadly, the number of households receiving food assistance is increasing. Beyond those with chronic poverty, people with above average income also struggle: Some people who used to donate food become new recipients for the first time, and some are returning for nutrition help after a long time [7].
Recognizing the urgency and significance of health consequences of financial hardship, these discussions ask for cross-government actions to provide comprehensive and continued support for vulnerable populations [1-8]. We agree the importance of and call for immediate and urgent public interventions to prevent the devastating impacts of the crisis, but it seems a clear description of individual financial hardship and health consequences is also necessary for the long-term prevention to tackle this finance-health link.
In these discussions, the economic circumstances in the aftermath of the COVID pandemic have been described by a variety of terms----e.g., cost of living crisis, surge in prices, squeeze in living standards, insufficient or stagnant income, poverty, financial strain, material/financial hardship, money worries, and budgetary pressures [1-8]. In our view, these descriptions seem constrained by traditional thinking of poverty and narrowly focus on consumption and income. These are only two specific aspects of household financial life. They ignore many others aspects of household finance and financial capability (e.g., emergency savings, long-term savings, assets and investment, credit and credit scores, insurance, public benefits, informal social support, access to financial products and services, financial knowledge and skills, and financial planning), which are also important determinants of people’s health and mental health [9,10].
The concept of financial health has been proposed to provide a more comprehensive description of household finance [11,12]. It means individuals and families have access to public policies, financial products and services, and knowledge and skills to build their financial capability, and, therefore, they are able to meet financial obligations and basic needs, absorb negative financial shocks, plan for long-term financial future, and achieve their financial well-being. In this regard, income and consumption are important but only partial drivers of financial health; lack of financial health is the root of low income, material hardship, and financial insecurity. To understand the concept of financial health allows us to have a more compressive view to tackle the finance-health link, and not to ignore many other tools we have to address this current crisis. It might be fortunate that the word of “health” has been included in this concept and it can lead to physical and mental health naturally. Financial health should be considered a new and critical social determinant of health [13].
Financial Health as a New Social Determinant of Health Re: The cost of living crisis is another reminder that our health is shaped by our environment
Dear Editor
As extensively discussed in the BMJ recently [e.g., 1-7], economic circumstances and financial hits in the aftermath of the COVID-19 pandemic have a critical role in shaping the physical and mental health of millions of people, not just in the UK but also across the world. Goddard wisely alarmed (doi:10.1136/bmj.o1343) this is another clear and important reminder that “our health is shaped by our environment” [8], and is socially and economically determined.
For example, Limb reported that the rapidly rising cost of living had forced hundreds of thousands of cancer patients to cut their treatment and basic consumption (e.g., food, energy, transportation, and housing), and affected their physical and mental health substantially [3]. This is just a specific example of adverse health impacts from cost of living crisis, unemployment, income loss, and poverty on one of the particular populations (cancer patients). More broadly, the number of households receiving food assistance is increasing. Beyond those with chronic poverty, people with above average income also struggle: Some people who used to donate food become new recipients for the first time, and some are returning for nutrition help after a long time [7].
Recognizing the urgency and significance of health consequences of financial hardship, these discussions ask for cross-government actions to provide comprehensive and continued support for vulnerable populations [1-8]. We agree the importance of and call for immediate and urgent public interventions to prevent the devastating impacts of the crisis, but it seems a clear description of individual financial hardship and health consequences is also necessary for the long-term prevention to tackle this finance-health link.
In these discussions, the economic circumstances in the aftermath of the COVID pandemic have been described by a variety of terms----e.g., cost of living crisis, surge in prices, squeeze in living standards, insufficient or stagnant income, poverty, financial strain, material/financial hardship, money worries, and budgetary pressures [1-8]. In our view, these descriptions seem constrained by traditional thinking of poverty and narrowly focus on consumption and income. These are only two specific aspects of household financial life. They ignore many others aspects of household finance and financial capability (e.g., emergency savings, long-term savings, assets and investment, credit and credit scores, insurance, public benefits, informal social support, access to financial products and services, financial knowledge and skills, and financial planning), which are also important determinants of people’s health and mental health [9,10].
The concept of financial health has been proposed to provide a more comprehensive description of household finance [11,12]. It means individuals and families have access to public policies, financial products and services, and knowledge and skills to build their financial capability, and, therefore, they are able to meet financial obligations and basic needs, absorb negative financial shocks, plan for long-term financial future, and achieve their financial well-being. In this regard, income and consumption are important but only partial drivers of financial health; lack of financial health is the root of low income, material hardship, and financial insecurity. To understand the concept of financial health allows us to have a more compressive view to tackle the finance-health link, and not to ignore many other tools we have to address this current crisis. It might be fortunate that the word of “health” has been included in this concept and it can lead to physical and mental health naturally. Financial health should be considered a new and critical social determinant of health [13].
References
1. Andersen K, Reeves A. The cost of living crisis is harming mental health, partly because of previous cuts to social security. BMJ 2022;377;o1336. http://dx.doi.org/10.1136/bmj.o1336.
2. Iacobucci, G. Rising cost of living is damaging people’s health, says royal college. BMJ 2022;377;o1231. http://dx.doi.org/10.1136/bmj.o1231.
3. Limb M. Cancer patients’ health is at increased risk from cost of living crisis, charity warns. BMJ 2022:377:o1103. http://dx.doi.org/10.1136/bmj.o1103.
4. Patrick R, Pybus K. Cost of living crisis: we cannot ignore the human cost of living in poverty. BMJ 2022:377:o925. http://dx.doi.org/10.1136/bmj.o925.
5. Limb M. failure to protect cost of living will increase poverty and health inequalities, warn analysts. BMJ 2022:377:o794. http://dx.doi.org/10.1136/bmj.o794.
6. Pollard T. food bank use is a canary in the coal mine for mental health services. BMJ 2022:376:o759. http://dx.doi.org/10.1136/bmj.o759.
7. Goodwin S. food aid charities fear the worst as the cost of living crisis takes hold. BMJ 2022:376:o416. http://dx.doi.org/10.1136/bmj.o416.
8. Goddard A. The cost of living crisis is another reminder that our health is shaped by our environment. BMJ 2022:377:o1343. http://dx.doi.org/10.1136/bmj.o1343.
9. Sherraden MM, Huang J. Financial social work. Encyclopaedia of social work. https://doi.org/10.1093/acrefore/9780199975839.013.923
10. Morduch J, Schneider R. The financial diaries: How American families cope in a world of uncertainty. Princeton University Press, 2017.
11. Tescher J, Silberman D. Measuring the financial health of Americans. Brooking Institute, 2021. https://www.brookings.edu/research/measuring-the-financial-health-of-ame...
12. UNCDF. Delivering financial health globally: A collection of insights, approaches and recommendations. https://www.uncdf.org/article/7008/delivering-financial-health-globally-...
13. Center for Hunger-Free Communities, Drexel University. Financial health: The root of economy security. https://drexel.edu/~/media/Files/hunger-free-center/research-briefs/fina...
Competing interests: No competing interests