Economic Stress Among Older Latinos with Chronic Illness: Effects on Quality of Life

Background

Attention to the economic impact of chronic illness is increasing, especially among vulnerable populations.  Economic disparities intensifies emotional suffering and limits individuals and their caregivers in managing healthcare (Ell et al., 2008). Individuals with multiple chronic conditions can also experience increased out-of-pocket expenses (Hwang, Weller, Ireys, & Anderson, 2001) and other economic changes which negatively impacts access to treatment. This economic burden is especially significant for those dealing with advanced illness and end-of-life care (Nedjat-Haiem, Lorenz, Ell, Hamilton, & Palinkas, 2012). Some data suggest economic stress negatively impacts emotional symptoms of anxiety and depression and overall quality-of-life (QOL) (Delgado-Guay et al., 2015). Limited data is available to help us understand the effects of economic/financial stress associated with suffering during an illness. This study examines economic concerns associated with QOL among older Latinos living with chronic illness in New Mexico.

Methods

This cross-sectional study investigates economic stress on QOL among participants (N=68) who had enrolled in a randomized controlled pilot study.  These data were collected in Southern New Mexico, near the United States/Mexico border region using convenience and snowball sampling methods.  Baseline data were used to examine relationships among the variables in this study. Using survey methods, we collected demographic and descriptive health information, economic concerns, and QOL indicated by the Functional-Assessment-of-Chronic-Illness-Therapy scale (FACT G/FACIT) (Cella et al., 1993). We conducted hierarchical regression analyses examining the variance explained between economic stress and QOL, controlling for age, gender, language preference (English/Spanish), hospitalizations in six months, and chronic illness.

Results

Economic concerns ranged 0 to 7, average scores indicated (2.46, SD=2.06) financial concerns about current financial situation, difficulty paying bills, concerns about hospitalization and medication costs; financial burden indicated inability to fill or pay for medications prescribed or secure needed treatment. QOL scale ranged 25 to 115, average sum score (78.03, SD=19.35).  Higher scores indicated better QOL. Lowest subscale scores were social/family (16.63, SD=6.45) and emotional well-being (17.50, SD=5.06).  Final regression model accounted for 19.3% of the variance, controlling for other variables showing 10.2% increase of predictive capacity, R²_change=from 9.1% to 19.3%, F(1,61)=7.70,P<.01. 

Conclusion

Economic concerns/stress negatively impact QOL, highlighting the importance of addressing economic issues in Latinos with chronic illnesses. Social workers, especially those working in healthcare, can use these findings to support interventions targeting Latinos.  Future research is needed to explore these effects of economic stress on QOL.