Journal article
Financial Strain and Child Health: Measures and Evidence from a Systematic Literature Review
AJPM Focus, Vol.4(4), 100337
08/2025
DOI: 10.1016/j.focus.2025.100337
PMCID: PMC12162033
PMID: 40511320
Abstract
•Studies captured difficulty making ends meet and/or lacking money for basic needs•Financial strain was associated with relatively poorer health and well-being•Findings were consistent across settings, samples, measures and methods•A single-item financial strain question demonstrated predictive validity•Greater attention should be paid to financial strain in the pediatric population
Despite attention to pediatric social needs, financial strain, defined as difficulty making ends meet or lacking basic needs, is understudied. This study systematically reviewed the literature on different measures of self-reported financial strain and health outcomes.
A systematic literature search in PubMed, PsychINFO, and Web of Science identified papers that examined relationships between self-reported financial strain and health outcomes among U.S. children or adolescents. Two blinded reviewers screened each paper (65 papers, 39 studies) and extracted data. Financial strain measures were coded for content. Findings were synthesized based on age and type of measure.
Financial strain measures asked about lacking money for basic needs (32 studies), difficulty making ends meet (23 studies), relying on coping strategies (13 studies), experiencing stress/worry about finances (4 studies), anticipating future strain (4 studies) and lacking money for leisure (4 studies). Financial strain was associated with poorer health and well-being and more behavior challenges among children of all ages, poorer academic performance among school-age children, and more depressive symptoms among adolescents. Associations were consistent across diverse samples, when accounting for other socioeconomic factors, and across financial strain measures, including a single-item about difficulty making ends meet. Fourteen studies tested hypothesized mechanistic factors that explain associations, including material, psychosocial and behavioral pathways.
The consistency of associations between financial strain and pediatric health and well-being highlight an urgent need to address financial strain to advance health equity. Results demonstrate predictive validity for a simple financial strain question, similar to one recommended by the National Academy of Medicine.
Details
- Title: Subtitle
- Financial Strain and Child Health: Measures and Evidence from a Systematic Literature Review
- Creators
- Laura J. Samuel - Johns Hopkins UniversityMartha Abshire Saylor - Johns Hopkins UniversityMelissa Lutz - Johns Hopkins University School of MedicineMonica Y. Choe - Veterans Affairs Maryland Healthcare System, Division of Endocrinology, Baltimore, MarylandRhonda Smith Wright - Johns Hopkins UniversityBoeun Kim - Johns Hopkins UniversitySarah L. Szanton - Johns Hopkins UniversityManka Nkimbeng - University of MinnesotaFernando Mena-Carrasco - Johns Hopkins UniversityRachel Austin - Family Health International, FHI 360, Durham, North CarolinaEliana M. Perrin - Johns Hopkins University
- Resource Type
- Journal article
- Publication Details
- AJPM Focus, Vol.4(4), 100337
- DOI
- 10.1016/j.focus.2025.100337
- PMID
- 40511320
- PMCID
- PMC12162033
- NLM abbreviation
- AJPM Focus
- ISSN
- 2773-0654
- eISSN
- 2773-0654
- Publisher
- Elsevier Inc
- Language
- English
- Electronic publication date
- 03/2025
- Date published
- 08/2025
- Academic Unit
- Nursing
- Record Identifier
- 9984805003302771
Metrics
2 Record Views