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This study aims to understand the direct and indirect effects of poverty trajectories on maternal depression trajectories mediated by material hardship trajectories. A latent growth mediation model was tested using a predominantly low-income and mostly unmarried sample of mothers from the Fragile Families and Child Wellbeing Study, a national birth cohort of racially diverse mothers (N = 3999). Measures included family poverty, material hardship, and maternal depression from 5 waves of data which tracked mothers starting 1 year after childbirth until the child reached 15 years of age. The results revealed that (1) family poverty was associated with material hardship and maternal depression, and material hardship was related to maternal depression at the trajectory level and the rate of change, with the exception of the relationships between the rate of change in family poverty and the rate of change in maternal depression; (2) material hardship mediated the relationship between family poverty and maternal depression at the initial trajectory levels, and the rate of change in material hardship fully mediated the relationship between the rate of change in poverty and the rate of change in maternal depression. This study provides further evidence that alleviating material hardship might be a promising avenue to reducing maternal depression. [ABSTRACT FROM AUTHOR]

Lower income households are at risk for material hardship, particularly amidst the economic fallout of COVID-19. Where one lives (e.g., suburb, small town) may affect this risk due to variable access to resources, yet the evidence is mixed concerning the influence of place. We used a pooled, national cross-sectional sample of 66,046 lower-income tax filers to examine differences in material hardship in rural, small town, micropolitan, and urban areas. Controlling only for standard demographic variables, hardship risk appears higher in non-urban areas, yet these differences disappear after controlling for financial characteristics such as liquid assets and home ownership. [ABSTRACT FROM AUTHOR]

Objective: Screening for social determinants of health (SDH) has been widely adopted to identify child health risks associated with exposure to material hardship. Whereas SDH screening typically addresses a 12-month span, we sought to compare the prevalence of exposure to present (within the past year) as compared to recent (2–4 years ago) hardship among children in the United States. Methods: We analyzed the 2014 Survey of Income and Program Participation, a nationally representative survey that interviewed participating households annually between 2014 and 2017. We included data from households with children in all waves. As of 2017, households were categorized as (1) experiencing present hardship (within the last year); (2) experiencing recent but not present hardship (any year between 2014 and 2016); and (3) experiencing no hardship over the 4-year period. Results: Of 2422 households, 27% experienced present hardship and 29% experienced recent but not present hardship. Households presently experiencing hardship were more likely to have Medicaid insurance, less likely to be married, and had more children than families who had experienced recent hardship. However, these groups were similar on caregivers' educational attainment, race/ethnicity, language spoken in the home, and age of the youngest child. Conclusions: Our results suggest that clinical screening tools for SDH that use a 12-month time frame risk missing many children who have recently (within the past 4 years) experienced material hardship and may benefit from interventions to improve social support; a longer time frame could provide clinicians with valuable information for understanding social factors that impact child health and development. [ABSTRACT FROM AUTHOR]

Structural equation modelling (SEM) with longitudinal survey data was used to test a proposed developmental model of the association of family income (with children aged 6–9) to parent behaviours (for children at 10 years of age) and adolescent cognitive achievement and behaviour problems (at age 15). Data from the Child Development Supplement and Panel Study of Income Dynamics provided a representative US sample (n = 953). The SEM measurement model of parent behaviours showed two robust latent variables representing parent distress (based on two measures) and parent support (composed of four measures of parent investment, cognitive stimulation, emotional warmth, and educational expectations for the child). The SEM structural model indicated that the relation between average family income between 1998 and 2001 for young children (ages 6–9) and adolescent cognitive achievement and behaviour problems in 2007 (age 15) was almost entirely mediated by parent distress, parent support, and material hardship, all measured in 2002. Results suggested that the structural model was strongest (RMSEA = 0.08) when all three mediating variables were included. These results provide a clearer picture of the developmental mechanisms by which family income becomes associated with adolescent cognitive achievement and behaviour problems over time. [ABSTRACT FROM AUTHOR]

We examine determinants of subjective wellbeing (SWB) for mothers of dependent children in material hardship, using a modification of the New Zealand Treasury's Living Standards Framework (LSF) and data from the General Social Survey. We convert the LSF—an indicator dashboard—into a tool for prioritising social policies by placing SWB at the head of a hierarchy of wellbeing domains. Several determinants of these mothers' SWB conform to standard findings; however, two important differences stand out. One is the lack of a protective effect from employment on SWB for this group (unlike the protective effect for males). The other is a positive relationship between a mother's SWB and satisfaction with her own skills/knowledge; this effect is particularly strong for sole mothers in hardship, dominating any effect of qualifications on SWB. The analysis demonstrates both a practical use of a modified LSF, and the value of taking a gender-specific approach to analysing wellbeing. [ABSTRACT FROM AUTHOR]

This study examines the relationship between nonresident fathers and their children's economic precarity. We use a racially, ethnically, and socioeconomically diverse sample of children in large U.S. cities and consider a comprehensive set of measures of the involvement of nonresident fathers in their lives. We evaluate both voluntary and involuntary (court-ordered child support) involvement of fathers, and we look at material hardship and income-to-poverty ratio as measures of children's economic precarity. We find that only high levels of formal child support have a protective effect on children's economic well-being, while fathers' voluntary involvement (experienced by 70 percent of children) has a more consistent protective effect. Overall, policies to reduce children's economic precarity need to focus on improving nonresident fathers' ability to be involved with and contribute to their children, as well as on direct assistance to custodial mother families. [ABSTRACT FROM AUTHOR]

There are four distinct, related types of material hardship—basic expense hardship, food insecurity, housing hardship, and medical hardship. Extant research has not sufficiently accounted for the complex relationships between these different types of material hardship. Using 1997 and 2002 data from the Panel Study of Income Dynamics Child Development Study on a national sample of 3- to 17-year-old children (N = 3563), this study describes the prevalence of each type of material hardship, their relative correlations, and their associations with children's behavior problems, and reading and math scores. Material hardship is more prevalent than income poverty and the four types of material hardship were only moderately correlated with each other. Only basic expense hardship, food security, and one type of medical hardship were associated with increased behavior problems. Only housing hardship was associated with lower math and reading scores. These findings highlight the need to more carefully investigate the distinctions between material hardship types in childhood and the importance of a diversified set of policy responses to protect children from the possible effects of distinct, but interrelated experiences of material hardship. [ABSTRACT FROM AUTHOR]

The combined supply and demand shocks of the COVID-19 pandemic have created the largest consumer behavior shift in recent history, while exposing millions of households to material hardships like food insecurity and housing instability. In this study, we draw on national surveys conducted early in the pandemic to investigate the pandemic's effects on self-reported consumer spending behaviors and experiences of hardship for households in the US and Israel; two countries that are similar in terms of their development but have had divergent experiences with and responses to the pandemic. We also examine the extent to which racial/ethnic/religious minority status and pre-pandemic employment characteristics predict these outcomes. Using descriptive and logistic regression approaches, we find that housing expenditures were fairly stable in the U.S. and Israel, while food and credit card payment expenditures were relatively volatile. We also find that skipped utility bill payments were much higher in the US than Israel, while rates of skipping housing payments and food insecurity were similar between the two countries. Generally speaking, racial/ethnic/religious minorities in both countries were more likely to experience spending volatility, while Black and Hispanic (in the US) and Arab (in Israel) households were more likely to experience hardships. Employment and financial characteristics also appeared much more predictive of hardship in the US than in Israel. [ABSTRACT FROM AUTHOR]

Millions of households face housing affordability problems as house prices and rents rise faster than incomes. Yet little is known about how high housing expenditures affect well-being. Using data from the Survey of Income and Program Participation, we examine the relationship between housing cost burden, material hardship, and residential satisfaction after the Great Recession. We find that households with higher housing cost burdens were more likely to experience some form of material hardship, controlling for other variables. The probability of material hardship increased with cost burden for households spending up to 50% of their income on housing. However, households that spend more than half of their income on housing are no more likely to experience material hardship than households who spend around 50%. We find some evidence that families with children trade high housing costs for improvements in housing conditions. The findings provide empirical support for using housing cost burden as a measure of affordability and suggest higher housing cost burdens may contribute to decreased well-being through multiple forms of material hardship but also may have threshold effects. [ABSTRACT FROM AUTHOR]

We investigated the relationships between food insecurity (FI) and women's choice of reversible contraceptives, overall and according to the level of method effectiveness, among partnered women of reproductive age in Nigeria. This population-based cross-sectional analysis used nationally representative data from Round 6 of the UNICEF-supported Multiple Indicator Cluster Survey (MICS) conducted in Nigeria. The sample included married or in-union women aged 15-49 years who reported a live birth in the last 2 years preceding the survey (unweighted N = 8496). Survey-weighted multivariable binomial and multinomial logistic regression analyses were performed to generate estimates of the association between FI (none, moderate, and severe) and reversible contraceptive use (overall and by method effectiveness). A Bonferroni correction was used to account for multiple testing. We stratified the models by maternal age to describe the experiences of women aged 15-24 years, 25-34 years, and 35-49 years. Overall, 6438 (74.1%) of the women in the sample experienced food insecurity (moderate, n = 2559, 30.7%; severe, n = 3879, 43.4%). In the adjusted model, we observed no statistically significant association between experiencing MFI and SFI and the use of reversible contraceptives (overall and specific) after adjustment for multiple testing. The stratified analyses showed that among women aged 25-34 years in the sample, those experiencing SFI in the past 12 months, compared to their food-secure counterparts, had significantly lower odds of reporting the use of a least effective contraceptive method (OR, 0.53; 95% CI, 0.34-0.83; p = 0.0052). However, this failed to reach the significance threshold upon adjustment for multiple testing. We found no significant association between the FI levels and use of reversible contraceptives (overall and specific) among partnered women (15-49 years) in Nigeria who were 2 years postpartum following a live birth and who were at risk of pregnancy.

Background: Diaper need is a lack of reliable access to a sufficient quantity of diaper supplies. It is an essential pediatric social determinant of health measure that is useful for exploring the effects of the COVID-19 pandemic on families of young children. Objective: This study aimed to identify the predictors of diaper need and the associations between diaper need and psychosocial outcomes among underresourced families with neurodiverse children. Methods : This cross-sectional study included 129 caregivers of children aged 0-36 months who completed an online survey in early 2021, during the height of the COVID-19 pandemic. Participants completed a diaper need assessment, the Hunger Vital Signs Food Insecurity Screener, the Perceived Stress Scale, and the Infant Behavioral Questionnaire subscale. Relationships were explored using independent-samples t -tests, chi-square tests, and multiple regression analyses. Results : Seventy-six percent of caregivers reported some diaper need, and 87.6% reported food insecurity. Greater than one third (39.5%) reported high diaper need. Common mitigation strategies included using a towel or other cloth like a diaper, not using a diaper, and keeping the child in the same diaper for longer than usual. In multivariate modeling, food insecurity, household size, and parent age were significantly associated with high diaper need. Families experiencing food insecurity were 4.24 times more likely to experience high diaper need than food-secure families. High diaper need compared to low or no diaper need was associated with increased parent perceived stress. Discussion : We found high levels of diaper need and food insecurity for families during the COVID-19 pandemic. The association of high diaper need and stress indicates an inadequate supply of diapers adversely affects parent stress. Nurses may consider including diaper need in social determinants of health screening and prioritize connecting families to appropriate resources. [ABSTRACT FROM AUTHOR]

Much of the literature on household finance tends to focus on relatively objective measures of financial security (e.g., savings, income, financial knowledge), and there has been less research on measures of subjective financial well-being. This gap is due in part to the absence of a common understanding on defining and measuring subjective financial well-being. The Consumer Financial Protection Bureau has recently developed a new Financial Well-Being Scale that provides a comprehensive way to measure this construct. The research on this scale is still scarce and little is known about how subjective financial well-being evolves over time. This paper uses a two-wave survey of low- and moderate-income tax filers to present among the first longitudinal analyses of this scale. Through descriptive analysis and lagged dependent variable regressions, we assess (1) the stability of financial well-being over a six-month period; (2) the extent to which relatively stable household characteristics predict volatility in subjective financial well-being; and (3) the relationship between adverse financial events, including financial shocks and material hardships, and subjective financial well-being. We find that financial well-being scores are extremely stable over the short-term, and that relatively stable household characteristics are not strong predictors of subjective financial well-being changes. We also find that, while adverse financial events like job loss are significantly associated with lower subjective financial well-being scores, the magnitude of these relationships is not large. These results have implications for the use of the financial well-being scale in evaluations of financial security interventions. [ABSTRACT FROM AUTHOR]

Many service, clerical, and technical hospital workers deemed essential during the pandemic have wages that do not reflect the essential nature of their work and do not earn enough income to cover basic expenses. Thus, many experience material hardships related to food, housing, and medical care. Previous studies have shown strong relationships between material hardships and health; however, they do not fully explain the role of stress as an intervening mechanism. This cross-sectional study analyzes an online survey with 257 lower-wage hospital workers to examine the relationships between hardships and health, and how perceived stress mediates these relationships. Path analysis revealed that financial and food hardships were related to mental health through perceived stress, while medical hardship was directly associated with physical health. These findings add to the evidence that workers' hardships either directly or indirectly contribute to negative mental and physical health outcomes through perceived stress. Future investigations should further examine relationships among material hardships, stress, and health, and advocacy efforts should focus on raising wages for essential hospital workers. [ABSTRACT FROM AUTHOR]

COVID‐19 and its related policy measures have increased the psychological distress of individuals, including grandparent kinship caregivers. Guided by the Resilience Model of Family Stress, Adjustment, and Adaptation, this study examines relationships between material hardship, parenting stress, social support, resilience and psychological distress of grandparent kinship caregivers during the COVID‐19 pandemic, as well as the moderating role of kinship license status on these relationships. Kinship care licensing is a prerequisite to receiving financial assistance and other supporting services from the government. We administered a cross‐sectional survey of grandparent kinship caregivers (N = 362) in the United States. Logistic regression results indicated that material hardship was associated with higher odds of experiencing psychological distress, whereas resilience and social support were associated with lower odds. Kinship license status moderated the relationships of social support and resilience with psychological distress. Results suggest that additional emergency funds and more tailored financial services should be provided to meet material needs, and interventions with a focus on resilience and social support are particularly needed. The moderating effects of license status indicate that some interventions should be specifically implemented among licensed kinship caregivers, whereas parallel services should be provided to kinship caregivers regardless of their license status. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent sexual minority males (ASMMs) are disproportionately affected by HIV relative to other youth within the United States. Social determinants of health have been explored among this population; however, economic determinants, such as material hardship, remain understudied. We examined the relationship between material hardship and sexual behavior among ASMMs aged 13–18 years residing in 3 US cities using 2015 data from CDC's National HIV Behavioral Surveillance among Young Men Who Have Sex with Men. Methods: Young men ages 13–18 years residing in 3 US cities were recruited through venue-based, respondent-driven, or Facebook sampling. We estimated adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) for condomless anal intercourse (CAI) with a male sex partner in the past 12 months and with having 4 or more male sex partners in the past 12 months. Results: Of 547 ASMMs, 27% reported experiencing material hardship in the past 12 months. After adjusting for demographics, household characteristics, and city, ASMMs who experienced material hardship were more likely to report CAI with a male partner in the past 12 months (aPR: 1.55, 95% CI: 1.25 to 1.93) and to have had 4 or more male sex partners in the past 12 months (aPR: 1.44, 95% CI: 1.08 to 1.91). Discussion: More than a quarter of ASMMs experienced material hardship that was associated with increased sexual risk behavior among ASMMs. Incorporating services that address all unmet needs is important to consider for HIV prevention efforts for ASMMs. [ABSTRACT FROM AUTHOR]

Purpose: There is a well-established association between poverty and posttraumatic stress disorder (PTSD); however, little research has tested the temporality of the association. Methods: Using data from Waves IV (2008; N = 14,800) and V (2016–2018; N = 10,685) of the National Longitudinal Study of Adolescent to Adult Health, we examined temporal associations between material hardship (a specific operationalization of poverty) and PTSD, as well as assessed for potential gender differences in associations. We conducted logistic regression and generalized structural equation modeling to examine associations between material hardship and PTSD and assess for mediation and moderation by gender. Results: Prior PTSD diagnoses were associated with an increased likelihood of material hardship (OR = 1.64; 95% CI 1.21, 2.21). The indirect effect of gender on material hardship through PTSD diagnoses was significant. Prior material hardship was associated with an increased likelihood of PTSD diagnoses (OR = 1.81; 95% CI 1.35, 2.42). The indirect effect of gender on PTSD diagnoses through material hardship was significant. There was no evidence of moderation by gender for either association. Conclusion: Results suggest reciprocal associations between material hardship and PTSD. Economic policies, as well as improved access to evidence-based PTSD treatments, may reduce the burden of both material hardships and PTSD. [ABSTRACT FROM AUTHOR]

Families with low income experience high levels of economic insecurity, but less is known about how mothers and fathers in such families successfully navigate coparenting and parenting in the context of material hardship. The current study utilized a risk and resilience framework to investigate the underlying family processes linking material hardship and children’s prosocial behaviors in a sample of socioeconomically disadvantaged mother-father families with preschoolers from the Building Strong Families project (N = 452). Coparenting alliance and mothers’ and fathers’ responsive parenting were examined as mediators. Results of structural equation modeling showed that coparenting alliance was associated with higher levels of both mothers’ and fathers’ responsive parenting. Subsequently, both parents’ responsive parenting were associated with higher levels of children’s prosocial behaviors. Material hardship was not associated with coparenting alliance and either parent’s responsive parenting. Tests of indirect effects confirmed that the effects of coparenting alliance on children’s prosocial behaviors were mediated through both mothers’ and fathers’ responsive parenting. Overall, these results suggest that when mothers and fathers have a strong coparenting alliance, they are likely to withstand the negative effects of material hardship and thus engage in positive parenting behaviors that benefit their children’s prosocial development. Family strengthening interventions, including responsible fatherhood programs, would do well to integrate a strong focus on enhancing a positive coparenting alliance between mothers and fathers.

Families with low income experience high levels of economic insecurity, but less is known about how mothers and fathers in such families successfully navigate coparenting and parenting in the context of material hardship. The current study utilized a risk and resilience framework to investigate the underlying family processes linking material hardship and children's prosocial behaviors in a sample of socioeconomically disadvantaged mother-father families with preschoolers from the Building Strong Families project (N = 452). Coparenting alliance and mothers' and fathers' responsive parenting were examined as mediators. Results of structural equation modeling showed that coparenting alliance was associated with higher levels of both mothers' and fathers' responsive parenting. Subsequently, both parents' responsive parenting were associated with higher levels of children's prosocial behaviors. Material hardship was not associated with coparenting alliance and either parent's responsive parenting. Tests of indirect effects confirmed that the effects of coparenting alliance on children's prosocial behaviors were mediated through both mothers' and fathers' responsive parenting. Overall, these results suggest that when mothers and fathers have a strong coparenting alliance, they are likely to withstand the negative effects of material hardship and thus engage in positive parenting behaviors that benefit their children's prosocial development. Family strengthening interventions, including responsible fatherhood programs, would do well to integrate a strong focus on enhancing a positive coparenting alliance between mothers and fathers. [ABSTRACT FROM AUTHOR]

We assess how a variety of disruptive life-course events impact the economic wellbeing of US households and trace the importance of household wealth in helping families who experience these events avoid entering a spell of material hardship. Using longitudinal data from two panels of the Survey of Income and Program Participation (SIPP), we draw on direct measures of material hardship, disruptive events and household assets. Our analyses reveal that the relationship between disruptive events and the likelihood of experiencing a new spell of material hardship strongly varies across the wealth distribution, suggesting that high household wealth provides an effective private safety net. By distinguishing different types of disruptive events, we demonstrate that divorce, disability and income loss entail a risk of material hardship but also that this risk is effectively buffered by substantial wealth. Different types of hardship – namely, financial, food and medical hardship – respond in similar ways. Like public insurance schemes, wealth insurance helps buffer the effects of disruptive events on material hardship, but unlike public insurance schemes, reliance on private wealth further stratifies the economic wellbeing of households. Policy options for addressing this highly stratified private insurance scheme include disposing of the need for it by funding more robust public insurance, for instance through wealth taxation. [ABSTRACT FROM AUTHOR]

It is well known that financial disadvantage is associated with alterations in brain development in regions critical to socioemotional well‐being such as the hippocampus and the amygdala. Yet little is known about whether family income at different points in development is differentially associated with these structures. Furthermore, little is known about which environmental factors statistically mediate associations between income and subcortical structure. Using a longitudinal birth cohort and linear mixed‐effects models, we identified associations between income‐to‐needs ratio (INR) at 6 timepoints throughout childhood and hippocampal and amygdala volumes at age 7–9 years (n = 41; 236 INR measurements; 41 brain measurements). Mediation analysis identified environmental sequelae of income that statistically accounted for INR–brain associations. Lower INR prior to age 4 was associated with smaller hippocampal volumes, whereas lower INR prior to age 2 was associated with smaller right amygdala volume. These associations were mediated by unmet basic needs (e.g., food, housing). These findings delineate the temporal specificity of associations between income and hippocampal and amygdala structures. [ABSTRACT FROM AUTHOR]

Adolescent mental health has implications for current and future wellbeing. While a link exists between poverty and mental health, little is known about how experiencing material hardship, such as insecurity of food, housing, utilities, and medical care, throughout early childhood affects adolescent mental health. We examine the relationship between material hardship in childhood and adolescent mental health. We use Poisson regression to examine the effect of material hardship experienced at different stages of childhood on adolescent depression and anxiety outcomes at age 15. We use longitudinal data from the Fragile Families and Child Wellbeing Study (N = 3,222). We find that recently experiencing material hardship during childhood is positively and significantly associated with anxiety and depression symptoms at age 15, even when controlling for material hardship at age 15. Additionally, we find that insecurity during mid-childhood and the stress of lacking basic needs during a critical age may influence mental health in adolescence. [ABSTRACT FROM AUTHOR]

• Material hardship, subjective financial stress, and household income impact the role of cost in parents' childcare decisions. • Economic hardships are household constraints that shape parents' childcare decisions. • Household income, subjective financial stress, and material hardship are independent dimensions of economic hardship. • The role of cost in childcare decisions varies by demographic group, suggesting unique barriers and constraints. The high cost of US childcare has become burdensome to most families with young children, yet little is known about how childcare costs shapes parental childcare decisions. This study addresses a critical gap in knowledge by examining how economic hardships shape parental childcare decisions, along with the individual and community characteristics associated with the influence of cost on childcare decisions. Guided by the accommodation model and family stress model, we used data from a statewide consumer survey in Iowa to conduct the first known study to examine associations between household constraints (i.e., economic hardships) and respondent reports that cost influenced their childcare decisions at least once in the previous year (i.e., systemic barriers to childcare). As hypothesized, each form of economic hardship was associated with increased odds of cost influencing childcare decisions. Our logistic regression demonstrated that every standard deviation increase in our financial stress scale resulted in a 110% increase in the odds of cost influence, while each additional experience of material hardship (out of 16) increased the odds of cost influence by 10%. Additionally, we identified demographic variations, with cost playing a more prominent role for people who were Hispanic/any race, unemployed, and were between the ages of 18- to 34-years old. Overall, findings demonstrate that economic hardships are constraints that, coupled with systemic barriers like cost, shape childcare decisions across demographic groups, communities, and income brackets. Findings also suggest the need for more public support to alleviate the costs of childcare among all families, such as expanding childcare subsidies or funding the provision of care, which may mitigate the risk of negative outcomes associated with economic hardship. [ABSTRACT FROM AUTHOR]

Background: Low socioeconomic status deemed by income-based measures is a risk factor for depression. Material hardship is commonly used as a multidimensional socioeconomic indicator to identify the struggles that low-income households encounter that are not captured by conventional income-based measures. The aim of this study was to examine the effect of material hardship on depression. Methods: We used wave 3 (2008) to wave 12 (2017) panel data collected by the Korea Welfare Panel Study. The material hardship measure included six dimensions: food, housing, medical care, paying utility bills, education, and financial hardship. Depression was measured using the Center for Epidemiologic Studies Depression Scale (CESD-11). A generalised estimating equation model was applied to test the causal association between material hardship and log transferred CESD-11. Results: The first time point comprised 3,866 participants. Those who continually experienced material hardship had higher depression scores (male: β = 2.82, female: β = 3.98, p-value: <.0001). Food hardship was the most critical risk factor (male: β = 3.29, female: β = 4.05, p-value: <.0001). Conclusions: Material hardship is associated with increased risk of depression, especially food hardship. We should consider guaranteeing food security, and community and policy makers should consider material hardship in their approach when identifying low-income populations at high risk for depression. [ABSTRACT FROM AUTHOR]

When faced with material hardships like missing a rent payment or having telephone service disconnected, where do people find help? Using data from the Survey of Income and Program Participation, I examine the receipt of assistance following material hardships. I find that most people do not receive assistance following a hardship, but when people do receive assistance, social ties are a more common source of support than public and private safety net institutions. I find that the likelihood of receiving assistance varies by type of hardship experienced, and there has been a notable increase over time in the likelihood of receiving assistance following telephone service disconnection or utilities payment hardship. The findings also reveal differences across social and demographic groups. Overall, the findings contribute to understandings of how families make ends meet during hard times and draw attention to high levels of unmet need for assistance among households experiencing hardship. [ABSTRACT FROM AUTHOR]

The federal Earned Income Tax Credit (EITC) provides substantial financial assistance to low‐ and moderate‐income workers and has been shown to reduce poverty and encourage employment. Many US states have also implemented their own EITCs to supplement the federal tax credits. Leveraging unique administrative and survey data and employing a difference‐in‐differences approach, this study investigates how changes in state EITC benefits between 2012 and 2016 impacted the levels of material and medical hardships in states that expanded or enacted state credits. We find that small changes in state EITC levels can alleviate medical hardship, but not most other types of hardship, especially when states experience a greater benefit increase or implement new state EITCs. Our research points to the limitations of using relatively modest tax credits to offset many of the economic challenges faced by low‐ and moderate‐income households. [ABSTRACT FROM AUTHOR]

This study examines how material hardship and perceived discrimination are associated with health care access and self-rated health among lower Rio Grande Valley residents. Of respondents to surveys administered at 2 clinic systems (N = 546), approximately 67% reported forgoing medical care in the past 12 months. Regression results suggested that perceived discrimination (odds ratio [OR] = 1.05, P < .05) and material hardship (OR = 1.63, P < .001) increased the odds of forgoing care. Also, discrimination (OR = 1.04, P < .01) and material hardship (OR = 1.24, P < .001) were independently associated with worse self-rated health. Service providers should consider screening for hardship experiences to target resources to address these stressors on patient health. [ABSTRACT FROM AUTHOR]

Previous literature has explored different dimensions of immigrant incorporation; however, no extant literature describes the extent to which migration status is associated with a comprehensive set of material hardship dimensions. Using data from the Survey of Income and Program Participation (SIPP) spanning more than a decade (1996–2008), we assess material hardship among the foreign-born by migration status, a unique contribution of this data. Trends over the study period reflect the persistent migration status gradient in material hardship. Multivariate models point to three important findings. First, unauthorized and legally resident non-citizens had significantly increased odds of hardship compared to the naturalized. Second, the magnitude of the migration status-hardship association varied depending on hardship with naturalized citizens generally having lower odds of each form of hardship than unauthorized and legally resident non-citizens. Finally, patterns of material hardship by US duration were not uniform. For example, for utility hardships, the unauthorized with 10 or more years of US duration have higher predicted probabilities than unauthorized of shorter durations. The results highlight the challenges of the immigrant experience in America for recent arrivals, the unauthorized, for legal immigrants, and immigrants who have resided in the US for more than 10 years. [ABSTRACT FROM AUTHOR]

The role of socioeconomic status (SES) in the etiology of childhood externalizing behavior remains unclear, especially within developmental models. Many scholars argue that material hardship (i.e. inability to meet basic needs such as food and shelter) is a better indicator of economic pressure than economic hardship (i.e. income), yet material hardship is seldom considered. We draw on a longitudinal sample of young males in the Fragile Families and Child Well-Being Study (n = 1,135) and contrast the influence of persistent material hardship with that of economic hardship. Results indicate that the experience of heightened material hardship, irrespective of economic hardship, matters. High-material hardship triples the odds of externalizing behavior by age 9 compared to those in a low-material hardship group. Effects are partially mediated by parental supervision, child diligence, and children's bonds to school. Findings warrant further investigation of material hardship and its impact on children's externalizing behavior. [ABSTRACT FROM AUTHOR]

There are four distinct, related types of material hardship—basic expense hardship, food insecurity, housing hardship, and medical hardship. Extant research has not sufficiently accounted for the complex relationships between these different types of material hardship. Using 1997 and 2002 data from the Panel Study of Income Dynamics Child Development Study on a national sample of 3- to 17-year-old children (N = 3563), this study describes the prevalence of each type of material hardship, their relative correlations, and their associations with children’s behavior problems, and reading and math scores. Material hardship is more prevalent than income poverty and the four types of material hardship were only moderately correlated with each other. Only basic expense hardship, food security, and one type of medical hardship were associated with increased behavior problems. Only housing hardship was associated with lower math and reading scores. These findings highlight the need to more carefully investigate the distinctions between material hardship types in childhood and the importance of a diversified set of policy responses to protect children from the possible effects of distinct, but interrelated experiences of material hardship.

Material hardship, or difficulty affording basic resources such as food, housing, utilities, and health care, increases children's risk for internalizing problems. The uncinate fasciculus (UNC) and two of the gray matter regions it connects—the orbitofrontal cortex (OFC) and amygdala—may play important roles in the neural mechanisms underlying these associations. We investigated associations among material hardship, UNC microstructure, OFC and amygdala structure, and internalizing symptoms in children. Participants were 5–9‐year‐old children (N = 94, 61% female) from socioeconomically diverse families. Parents completed questionnaires assessing material hardship and children's internalizing symptoms. High‐resolution, T1‐weighted magnetic resonance imaging (n = 51), and diffusion tensor imaging (n = 58) data were acquired. UNC fractional anisotropy (FA), medial OFC surface area, and amygdala gray matter volume were extracted. Greater material hardship was significantly associated with lower UNC FA, smaller amygdala volume, and higher internalizing symptoms in children, after controlling for age, sex, and family income‐to‐needs ratio. Lower UNC FA significantly mediated the association between material hardship and internalizing symptoms in girls but not boys. These findings are consistent with the notion that material hardship may lead to altered white matter microstructure and gray matter structure in neural networks critical to emotion processing and regulation. [ABSTRACT FROM AUTHOR]

Decades of research have attempted to understand the paradox of stubbornly high unintended pregnancy rates despite widespread use of contraception. Much of this research has focused on socioeconomic disparities in rates of unintended pregnancy, finding that economically disadvantaged women tend to use less effective contraceptive methods and use them less consistently. Building on this research, this study examines how material hardship is associated with less consistent contraceptive use among women who do not desire to become pregnant. Using the Relationship Dynamics and Social Life (RDSL) Study, a weekly longitudinal survey, I find lower levels of contraceptive use and less consistent use of contraception among women experiencing material hardship, relative to those without hardship experiences. I also investigate the extent to which this association is explained by access barriers and lower contraceptive efficacy among women experiencing hardship. Using structural equation modeling, I find that these mediators significantly explain the relationship between hardship and risky contraceptive behaviors, suggesting that hardship creates mental and resource constraints that impede successful implementation of contraception. However, net of these mediators, material hardship remains associated with riskier contraceptive behaviors among young women, calling for further research on how hardship exposes women to greater risk of unintended pregnancies. [ABSTRACT FROM AUTHOR]

Traditional measures of socioeconomic status (SES) are associated with asthma morbidity, but their specific contributions are unclear. Increased exposure to indoor allergens among low SES children is an important consideration. Material hardship, a concept describing poor access to basic goods and services, may explain the relationship between low SES and indoor allergen exposure, and thereby, the increased risk of asthma morbidity. We sought to (i) describe the specific hardships experienced by low-Income, urban, minority children with asthma and indoor allergen sensitization and (ii) determine if material hardship is associated with indoor allergen exposure in this population. We conducted a cross-sectional analysis of children undergoing the baseline assessment for a clinical trial of home environmental modification. Participants were scored in five domains of material hardship. Domain scores were assigned based on caregiver responses to a questionnaire and were summed to generate a total material hardship score. Linear regression was used to examine the relationship between material hardship scores and bedroom floor concentrations of five common indoor allergens. Participants experienced high levels of material hardship in each of the five domains, with 33% not having access to a car, 35% not being able to pay utility bills, and 28% not being able to pay rent in the past year. Each one-point increase in material hardship was associated with an increase in cockroach allergen of 16.2% (95% CI 9.4%, 24.6%) and an increase in mouse allergen of 9.4% (95% CI 1.0%, 18.5%). After adjusting for traditional measures of SES, including household income, health insurance type, caregiver education, and caregiver employment status, the association between material hardship and cockroach allergen, but not mouse allergen, remained. These data suggest that a significant proportion of families of low-income, minority children with asthma may experience material hardship, and that they may be at greater risk of cockroach allergen exposure than their peers with similar income, but without material hardship. [ABSTRACT FROM AUTHOR]

Church-based interventions have the potential to extend services to economically disadvantaged individuals with depression in rural communities. This study examined depressive symptoms, material hardship, barriers to mental health treatment, and perceptions of a church-based group depression intervention among a sample of 57 rural residents seeking food-bank services. Forty-nine percent of respondents screened positive for depression on the Patient Health Questionnaire-2. Respondents with positive depression screens (M = 2.22; SD = 1.74) experienced greater material hardship compared to non-depressed respondents (M = 1.21; SD = 1.00; U = 262.0; p=.04). The most commonly endorsed barriers to mental health treatment were: cost (47.4%), lack of transportation (31.6%), no insurance/lack of insurance coverage (26.3%), and wanting to handle these problems on my own (26.3%). The majority of respondents indicated that church-based depression treatment would benefit their community (62.5%), would consider attending church-based depression treatment (55.4%), and would recommend this intervention to others experiencing depressive symptoms (66.1%). Clinical and policy implications of these findings are discussed. [ABSTRACT FROM AUTHOR]

Using a longitudinal population-based sample (n = 4,234), this study explored the association of intimate partner violence (IPV) with material hardship. We found that women who experienced IPV are substantially more likely to experience material hardship, even after controlling for a comprehensive set of static and time-varying characteristics, including material hardship at the prior wave and individual fixed effects. Associations were strongest for experiences of physical abuse (the least prevalent type of IPV) and controlling abuse (the most prevalent type of IPV) but were weaker for emotional abuse. Results suggest that IPV increases the probability of material hardship by 10-25%. [ABSTRACT FROM AUTHOR]

Low-wage workers have borne the brunt of the changing labor market, including wage stagnation, growing income inequality, and increasingly unstable work environments. Most research on low-wage workers focuses on precarious minimum wage employment; however, some low-wage workers hold jobs earning more than minimum wage with consistent, full-time hours. This study explores strategies parents in these "good" low-wage jobs use to provide for their children, using data from in-depth interviews with hospital workers. We find workers use multiple strategies, which we categorized as scarcity, maintenance, and investment strategies to highlight the distinct types of resources and varying amount of stress associated with them. Finally, we compare the types and number of strategies parents use by hourly wage versus net household income. [ABSTRACT FROM AUTHOR]

Several states and local areas have increased the minimum wage in recent years, and we anticipate that many policymakers and advocates will be interested in evaluating the impacts that these increases have had on material hardships such as not having enough money for rent, food, and utilities. The relationship between wages and material hardship absent policy changes has not been thoroughly documented in the literature, however. An understanding of how material hardships relate to wages is critical when trying to determine whether minimum wage policy changes have impacted material hardship. This article asks, is there a linear relationship between wages and material hardship at the bottom of the wage distribution, or do wages have to hit a certain point before we observe significant declines in material hardship? Results come from the New York City Longitudinal Study of Wellbeing (NYC-LSW), also referred to as the "Poverty Tracker," and are specific to New York City in 2016. The results show that among workers in New York City in 2016, rates of material hardship are relatively constant at the bottom of the wage distribution, if not increasing. However, rates of hardship begin to decline more rapidly in the wage distribution around US$15 per hour. [ABSTRACT FROM AUTHOR]

Food insecurity, defined as a condition of limited or uncertain access to adequate food, is a widely used measure of well-being in the U.S. The survey module in the Current Population Survey (CPS) that is used to generate the official U.S. food insecurity measure is also included on multiple waves of the Panel Study of Income Dynamics (PSID), offering the first opportunity to answer key research questions on the persistence of food insecurity within and across generations. We assess the validity of the food insecurity measure in the PSID by comparing it to the CPS. We find that, although estimated food insecurity rates in the PSID are lower than those in the CPS, the trends over time in the two datasets are similar, and the rates converge from the 1999–2003 period to the 2015–17 period. Our findings lend credence to the use of the PSID for food insecurity research. [ABSTRACT FROM AUTHOR]

Objectives: Material hardship represents a potential mechanism by which poverty influences the mental health of mothers. This study examined the association between two forms of material hardship, diaper need and food insufficiency, and maternal depressive symptoms. Methods: Data were from a cross-sectional study of 296 urban, pregnant or parenting, low-income women. A linear regression model was used to examine the association of maternal depressive symptoms, measured by the Center for Epidemiologic Studies Depression (CES-D) score, with diaper need and food insufficiency, after adjustment for demographic factors. Results: More than half of women reported diaper need (50.3%) and food insufficiency (54.7%). Nearly one-third of women who reported diaper need did not report food insufficiency (32.2%). In bivariate analyses, diaper need and food insufficiency were associated with maternal CES-D score. In multivariate analyses, women who reported diaper need had a significantly higher CES-D score than women who did not report diaper need (?=3.5, p=0.03). Women who reported food insufficiency did not have a significantly higher CES-D score than women who did not report food insufficiency (?=2.4, p=0.15). Conclusions: Diaper need is a form of material hardship that has received little attention in the research literature. Diapers, unlike food, are currently not an allowable expense in U.S. antipoverty programs. Diaper need may contribute to maternal depressive symptoms, beyond the contribution of other forms of material hardship, because there are no supports in place to provide assistance meeting this basic need. Importantly, diaper need is a malleable factor amenable to public health and policy interventions.

Background: Families experience financial burden and household material hardship (HMH) after a pediatric cancer diagnosis. This study investigates types of financial assistance and other financial coping strategies (FCS) adopted by families during the first year after diagnosis., Methods: Retrospective survey of caregivers of pediatric patients diagnosed with cancer from 2015 to 2019. The survey collected data on demographics, diagnosis, income, HMH, and private, hospital, and government assistance received and other FCS adopted after diagnosis. Bivariate and multivariable logistic regressions were used to analyze FCS by income. Subgroup analysis of families experiencing HMH was used to identify predictors of receiving government assistance., Results: Of 156 respondents, 52% were low-to-middle income, 29% had public insurance, and 22% had non-English language preference. Low-to-middle-income families were more likely to incur debt (odds ratio [OR] 6.24, p < .001) and reduce consumption (OR 2.16, p = .03) than high-income families, and this association persisted in multivariable analysis. Among families with housing, food, and energy insecurity, 40%, 70%, and 39%, respectively, received hospital or government assistance specific to the experienced hardship. In subgroup analysis of families with HMH, after adjusting for income and other confounders, non-English language preference was associated with lower odds of receiving government assistance., Conclusions: After a pediatric cancer diagnosis, low-to-middle-income families are more likely to incur debt than high-income families. Most families experiencing food insecurity received some food assistance, while housing and energy assistance were less common. Future studies should investigate methods to equitably improve access to financial assistance and minimize long-term financial consequences., (© 2024 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.)

Background: Almost one billion people live in slum environments across low- and middle-income countries. Little is known about the mental health status of slum residents or its associations with living conditions.Methods: A cross-sectional, population-representative survey was conducted among 892 adults in four slum communities in Port-au-Prince. Psychological distress was assessed with the Kessler Psychological Distress Scale (K-6). Log-binomial regression modeled the association of sociodemographic variables, living conditions, and material hardship and severe psychological distress [SPD].Results: Eighty-six percent of adults reported psychological distress (24% severe and 62% moderate). Reliance on an outdoor drinking water source (versus bottled water) and a pit toilet (versus a flush toilet) were marginally positively associated with SPD (adjusted prevalence ratio [aPR]=1.42, 95% confidence interval [CI]: 1.00-2.02 and aPR=1.74, 95% CI: 0.96-3.15, respectively). The prevalence of SPD was higher among women (versus men, aPR=1.66, 95% CI: 1.26-2.19), residents who had foregone healthcare to afford food (versus those who had never done so, aPR=1.60, 95% CI: 1.16-2.45), and persons who drank alcohol at least twice a week (versus monthly or less, aPR=1.73, 95% CI: 1.22-2.45).Limitations: Data were cross-sectional and lacked information on potential risk factors such as exposure to trauma.Conclusions: Psychological distress was highly prevalent and associated with poor living conditions. Prospective studies on the mechanisms through which slum living conditions are associated with psychological distress are needed. Research should also assess the feasibility and acceptability of implementation strategies to increase access to mental health screening and treatment for slum residents. [ABSTRACT FROM AUTHOR]

The construct of material hardship has been introduced to broaden the understanding of living conditions beyond household income. However, much remains unclear about how much variation in material hardship can be explained by income and other economic indicators such as asset holdings. To get advance knowledge on these related but distinct relationships, using the Korean Welfare Panel Study we tested the association between material hardship and three poverty indicators (joint income‐asset, asset‐only, and income‐only). For income poverty and asset poverty, we found a statistically significant association between a household's poverty condition and material hardship. The joint income‐asset poor were most likely to experience hardship (with respect to food, utility, and health). In addition, householders who rented rather than owned their own home, and householders whose heads were younger, single, less‐educated, and only temporarily employed suffered more hardship than their counterparts. Future longitudinal research that identifies the casual relationships between poverty and hardship is needed. Key Practitioner Message: •Considering only overall hardship may mask within‐group differences in living conditions; thus, practitioners may gain greater insight into client populations by assessing various types of hardships such as food, utility, and health; •Because the asset‐only poor suffer from hardship despite their above‐poverty‐level income, the asset poverty‐related programs should be more responsive to the problems of the asset poor; •Based on our findings showing that the income‐only poor, especially the relatively older age group, suffers from difficulties in cash flow despite their high homeownership rate, policies are needed to help older homeowners leverage their home equity or other real estate to alleviate their financial difficulties. [ABSTRACT FROM AUTHOR]

More data is needed about the pathways through which intimate partner violence (IPV) impacts the economic well-being of survivors. The current study assesses the moderating influence of social support on the association between economic abuse (EA) and economic hardship. Female participants (n = 435) were recruited to participate in a web-based survey which included standardized measures of EA, other forms of IPV, domains of social support, and economic hardship. Analysis included bivariate and multivariate regression with an investigation into interaction effects.Experiencing EA was significantly correlated with economic hardship, even with extent of physical and emotional IPV controlled. Both tangible and appraisal support had significant negative association with extent of material hardship. Significant interactions between forms of social support and economic abuse were observed. For those at high levels of economic abuse, support had less influence on economic hardship. A mix of direct economic aid, advocacy, education and support could provide a blueprint for addressing the economic hardship experiences of community-dwelling survivors of economic abuse. A comprehensive response to EA requires interventions aimed directly at economically controlling and exploitative tactics, including credit building, individual economic advocacy, and education. Interventions that seek to enhance survivors' access to social support may be necessary but not sufficient to buffer the impacts of violence on survivors' economic outcomes. [ABSTRACT FROM AUTHOR]

Income poverty, material deprivation, and subjective financial stress are three distinct dimensions of economic hardship. The majority of the theoretical and empirical literature on the effects of economic hardship on children has treated material deprivation and subjective financial stress as only mediators of the effects of income poverty, not considering the independent effects of each dimension or the effects of their combinations. Using nationally representative, longitudinal data from the Millennium Cohort Study on more than 18,000 families in the United Kingdom, we propose seven distinct experiences of economic hardship, based on the possible combinations of income poverty, material deprivation, and subjective financial stress. We use mixed- and fixed-effects linear regression models to identify whether these different economic hardship combinations are differentially associated with children's behavior problems between ages 3 and 7. We find that all economic hardship combinations, including those without income poverty, are associated with higher levels of children's behavior problems. The combination of material deprivation and subjective financial stress and the combination of all three dimensions of economic hardship are associated with the highest levels of behavior problems. Based on these findings, we argue that income poverty is an important but insufficient measure of economic hardship for children and that theory and research on the effects of economic hardship on children should consider the multidimensional nature of economic stressors for families. [ABSTRACT FROM AUTHOR]

The financial behaviors of adolescents, especially those from economically disadvantaged families, is critical and has long-term effects. This study tested and compared two conceptual models that connect a family's material hardship to adolescents' financial behaviors by using a convenience sample of adolescents in Hong Kong. The main purpose of this study was to offer effective entry points for parents and family practitioners to implement interventions for improving the financial behaviors of adolescents, particularly those from economically disadvantaged families. The model of financial socialization demonstrates that material hardship was associated with financial behaviors through financial self-beliefs, direct parental instruction, and the adoption of parental financial role models. The model of general poverty links material hardship to financial behaviors through parental investment, parental stress, financial literacy, and financial self-beliefs. Of the two models, the model of parental financial socialization offers more effective entry points for family practitioners to implement interventions. [ABSTRACT FROM AUTHOR]

The housing market crash in the mid-2000s was characterized by unusually high rates of mortgage delinquencies and foreclosures. Thus, many householders and their families faced the prospect of losing their homes. This paper employs a unique data-set linking the 2008 Survey of Income and Program Participation with individual foreclosure event records from Realty Trac to examine the effects of foreclosure on changes in household well-being. Results from random effects models suggest that foreclosure was positively associated with hardship and food insecurity. Further, households at risk of foreclosure had greater odds of accessing government assistance programs but lower odds of receiving support from private safety nets. Results from lagged dependent variable models suggest that changes in foreclosure status are associated with increased hardship and reduced economic well-being. The lack of access to private safety nets suggests the need for comprehensive public programs to identify and assist homeowners at risk. [ABSTRACT FROM AUTHOR]

Harsh parenting is more likely among economically insecure families, yet it is unclear how persistent economic insecurity, including material hardship and income transfers from friends, family, and social assistance programs like Medicaid, are related to harsh parenting. Using a sample of mothers from the Fragile Families and Child Well-being Study (Age 3 & 5 N = 4, 523), we investigated these hypotheses: 1) Unique combinations, or classes, of economic insecurity are differentially associated with harsh parenting at ages three and five, 2) classes of economic insecurity persist over time, and 3) persistent economic insecurity heightens the likelihood for harsh parenting. We found support for the first two hypotheses and mixed support for the third hypothesis. The four latent classes of economic insecurity were differentially associated with harsh parenting, with economically insecure mothers perpetrating more harsh parenting. Most mothers retained their class of economic insecurity over time. Finally, the relationship between persistent economic insecurity and harsh parenting is not straightforward: Persistent economic insecurity was related to moderate amounts of harsh parenting at age five, yet also buffered mothers from classes 1, 2, and 4 from even harsher parenting practices. • 60% of mothers perpetrated harsh parenting, including kicking & spanking. • Classes of economic insecurity ranged from high to low hardship/income transfers. • More economic insecurity associated with more risk for harsh parenting. • 70% of mothers maintained their level of economic insecurity from age 3 to 5. • Economic gains & losses from age 3 to 5 associated with more harsh parenting. [ABSTRACT FROM AUTHOR]

This paper investigates the relationship between self-reported health and material hardship among older Americans. Differently from income-based measures, material hardship provides a more specific description of the concrete adversities faced by the elderly. We have used the last six waves of the Health and Retirement Study to explore the relative contributions of state dependence, unobserved heterogeneity and time-specific shocks on reporting poor health, experiencing food insecurity and medication cutbacks. We have used a Latent Markov model to estimate a multivariate non-linear system of equations for panel data allowing time-varying unobserved heterogeneity. Our results reveal a high state dependence of both health and material hardship conditions. Estimated trajectories reveal that pathways of material hardship are associated differently with health. Material hardship is also spread across its dimensions. [ABSTRACT FROM AUTHOR]