The Association Between Financial Hardship and Markers of Inflammation: A Cross-Sectional Study of the Midlife Development in the United States (MIDUS) Refresher Cohort

Abstract

Abstract Background Measures of financial hardship have been suggested to supplement traditional measures of socioeconomic status (SES) to elucidate household economic well-being. This study formally tested the construct validity of the financial hardship construct and examined its association with markers of inflammation. Methods This study utilized data from 863 respondents from the Midlife Development in the United States Refresher Study (MIDUS-R) who completed the biomarker assessment (ages 25–76, mean age = 50.8; 52% female; 69% non-Hispanic white). Analysis for this study was divided into three steps. First, using exploratory factor analysis (EFA), we examined if the three-domain factor (material, psychological, and behavioral) is the best fitting model for financial hardship measures. Second, we conducted confirmatory factor analysis (CFA) to test the second-order measurement model of financial hardship with a three-factor first-order domain (material, psychological, and behavioral). Finally, we tested the association between the latent factor of financial hardship and interleukin 6 (IL6), c-reactive protein (CRP), and fibrinogen. Results Results from EFA supported the three-domain model of financial hardship. The hypothesized second-order measurement model for the three-domain model of financial hardship met the overall goodness-of-fit criteria (χ2 = 35.50, df = 11, RMSEA = 0.05; CFI = 0.99; TLI = 0.98; SRMR = 0.02). Finally, higher financial hardship was significantly associated with IL6 and fibrinogen but not CRP. Conclusion Explicating the socioeconomic environment to include indicators of financial hardship can help researchers better understand the pathway between SES and the inflammation process, which may help elucidate pathways between SES and age-related chronic diseases associated with inflammation.