Within-Year Debt Fluctuations, Stress, and Health

PROJECT SUMMARY
Lower-income Americans increasingly rely on a range of unsecured debt sources (e.g., credit
cards, payday loans) to help manage expenses, likely contributing to frequent fluctuations in
debt levels throughout the year. Frequent fluctuations in debt amounts, use of certain debt
sources, or for particular reasons (e.g., managing unexpected expenses) may be adaptive,
helping individuals to reduce stress and anxiety related to financial management. Yet, in some
cases, these fluctuations may be harmful, increasing experiences of stress, anxiety, and
depression. Due to existing survey limitations, we know little about experiences of within-year
changes in debt and their potential role as health stressors or stress-reducers for lower-income
individuals. The R21 project will systematically capture short-term changes in debt amounts and
composition and evaluate associations with generalized stress, anxiety, and depression. The
project has three specific aims: 1) Field a novel smartphone survey that collects biweekly self-
reported health, income, and debt data from 410 lower-income adults for one year. The
development of a biweekly survey on debt is supported by prior research that underscores the
importance of capturing short-term fluctuations in income to understand economic insecurity of
lower-income individuals and families. The proposed survey addresses the lack of short-term
data on debt holdings across a range of unsecured and understudied sources. 2) Develop
standard measures of within-year fluctuations in debt burdens across debt sources using data
collected from the survey. In doing so, we introduce the concept and measurement of within-
year debt fluctuations to the multidisciplinary literature on debt and health. 3) Analyze the data
to provide the first insights on the scope of lower-income individuals’ experiences with short-
term debt fluctuations and consequences for health, with attention to variation by race. The
study is the first to collect high-frequency data on debt and health via mobile surveys, with
implications for advancing data collection efforts in this area. Findings will inform economic and
family policy, with insights on how addressing debt fluctuations in addition to overall debt
burdens in policy design may have positive public health impacts. Data created through this
project will be made publicly available to advance research across disciplines concerning family
functioning, poverty, and health.

Grant Number: 5R21HD113910-02
NIH Institute/Center: NIH
Principal Investigator: Megan Bea