The Health Consequences of Negative Wealth Shock During Late Middle Age

TitleThe Health Consequences of Negative Wealth Shock During Late Middle Age
Publication TypeThesis
Year of Publication2016
AuthorsPool, L
Academic DepartmentEpidemiological Science
DegreePh.D.
Number of Pages143
UniversityUniversity of Michigan
CityAnn Arbor
Thesis TypeDissertation
ISBN Number9781369082029
KeywordsHealth Conditions and Status, Health Shocks, Income, Medicare/Medicaid/Health Insurance, Older Adults, Wealth Shocks
Abstract

There is robust empirical evidence for a link between lower economic status and adverse health outcomes, but little is known about whether a sudden, unplanned loss of assets – a negative wealth shock – has long-term health consequences. Previous research has shown associations between negative wealth shocks and short-term health declines, primarily from losses of housing and investment wealth, with macroeconomic recession presumed to have triggered these shocks. Even during better economic times, however, negative wealth shocks arise frequently from more individualized circumstances, such as high medical expenses, but causal mechanisms linking subsequent health outcomes to these endogenous shocks can be difficult to establish due to the potential for reverse causality and residual confounding.

Using data from the Health and Retirement Study, a nationally representative study of US adults aged 50 and older, this dissertation examined markers of short-term changes in stress and health care consumption after negative wealth shock in late middle age, a time of particular vulnerability. Then, differences by whether an individual experienced negative wealth shock in late middle age were assessed for three long-term aging-related trajectories – cognitive decline, physical function limitation accumulation, and all-cause mortality. Design and analytic methods addressed bidirectional and time-dependent causation in the relationship between negative wealth shock and health outcomes.

Over 15 percent of late middle-aged adults with existing assets experienced negative wealth shock. The main findings indicated that experiencing a negative wealth shock during late middle age was associated with a higher risk of elevated depressive symptoms, a marker of increased stress, as well as long-term risk of mortality and cognitive decline. However, there was no significant association between negative wealth shock and risk of cost-related medication non-adherence – a marker of reduced health-related consumption, nor accelerated physical function limitation accumulation.

With a substantial proportion of the late middle-aged population experiencing negative wealth shock, targeted interventions to prevent of the occurrence of these shocks and the health consequences thereafter may have a large impact on the health of older Americans

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Citation Key8716