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income affects health

A Volatile Income Can Be Deadly

If you were caught up in the recent government shutdown, if you’re a gig worker, or a server who works mainly for tips, if you’re an entrepreneur or freelance consultant, or if you hold any one of a number of seasonal or irregular jobs, the volatility of income associated with your job could have deadly consequences.


Younger workers impacted

The most recent study that confirms this was published this month in Circulation, the journal of the American Heart Association (AHA). Titled “Coronary Artery Risk Development in Young Adults,” it found a strong association between fluctuating incomes and a higher risk of death. The study, led by public health researchers at the University of Miami Miller School of Medicine, defined a significant income decline as a decrease of 25 percent or more during the study period.

The study followed nearly 4,000 people in four U.S. cities between the ages of 23 and 35 from 1990 to 2005. During that 15-year period, those who showed higher income volatility died at a rate of 5.28 per 1,000 people, vs. a mortality rate of 2.12 deaths per 1,000 people among those with more stable incomes.

According to the AHA news release, researchers found that “the biggest fluctuations in personal income were significantly associated with nearly double the risk of death and more than double the risk for cardiovascular diseases, such as heart attacks, strokes, heart failure, or death during the following 10 years, compared to a similar group of people with less fluctuation in personal income.”

“We were surprised by the strength of the association between income volatility and an increase in cardiovascular and premature mortality,” Tali Elfassy, one of the study’s lead authors, told CBS MoneyWatch.


Older workers also affected

But perhaps they shouldn’t have been so surprised. A Harvard study published last year in the Journal of the American Medical Association (JAMA) uncovered similar results from older workers. Researchers found that among 8,714 adults ages 51 to 61, those who experienced a sudden loss of wealth were 50 percent more likely to die than those who did not. Like the AHA study, this was also a long-term study, following participants over 20 years. It focused on an older cohort than the AHA study and used a 75 percent drop in income—regardless of starting level—as the target income loss. In other words, whether participants were making $20,000 or $200,000, or $2 million, it was the percentage of loss that mattered.

In an editorial accompanying release of the study, Harvard University Provost Alan Garber warned physicians to consider such life impacts as loss of wealth, and especially a resulting loss of home, if that also occurred, when monitoring a patient’s overall health.

“A wealth shock is a severe disruption in the life of any patient that has implications for health behaviors and well-being,” he 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.”


Causes uncertain

While the researchers in both studies speculated that a loss of income correlated with an inability to obtain health care or necessary prescription drugs as a possible cause of increased disease and mortality in participants, that might not apply so much to the younger workers tracked in the AHA study. Another factor is no doubt the normal reactions of those at any age who find themselves in that situation: shock, anxiety, humiliation, helplessness, depression, or despair.

Indeed, the JAMA article notes that, following the Great Recession a decade ago, research conducted in the ensuing years “showed significant associations between negative wealth shocks and short-term clinically relevant health changes, including increased risk of depression and anxiety, suicide, impaired cardiovascular function, and substance abuse.”

If you’re in an occupation in which you regularly experience wild swings in income, or if you find you’ve suddenly lost a large share of your wealth, there’s little you can do to control those facts. But you need to be aware of the resulting threat to your health, and that you can control.

If you find yourself in a situation like this—or in any situation in which you’re experiencing chronic stress—it’s important that you take care of yourself. Maintain a routine incorporating relaxation strategies, including regular exercise, avoid junk food and substance abuse, and contact us to help you monitor the overall state of your health.

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