Abstract: Are Credit Scores and Financial Well-Being Associated with Physical Health? (Society for Social Work and Research 27th Annual Conference - Social Work Science and Complex Problems: Battling Inequities + Building Solutions)

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Are Credit Scores and Financial Well-Being Associated with Physical Health?

Friday, January 13, 2023
Paradise Valley, 2nd Level (Sheraton Phoenix Downtown)
* noted as presenting author
Julie Birkenmaier, PhD, Professor, Saint Louis University, St. Louis, MO
Euijin Jung, Ph.D., Postdoctoral Research Fellow, Boston College, Chestnut Hill, MA
Stephen Edward McMillin, PhD, AM (MSW), Associate Professor, Saint Louis University, St Louis, MO
Zhengmin Qian, MD, PhD, Professor and Chair, Saint Louis University, MO
Background and Purpose

The examination of social determinates of health have expanded in recent years to include the relationship between health and personal finances (Landord et al., 2022). Previous research findings have established associations between consumer credit and financial well-being, and between financial well-being and physical health. To date, little research has explored the direct association between consumer credit scores and health (Knapp & Dean, 2018), or the potential mediating effect of financial well-being.

Using nationally representative data, this study seeks to examine the potential association between consumer credit score and physical health, as well as financial well-being as a mediator. Therefore, this study examines the following research questions: (1) Does self-rated consumer credit score associate with self-rated general physical health?; and (2) Does financial well-being mediate the association between credit score and physical health? This study fills a gap in the literature about the importance of consumer credit on physical health.


A cohort of 5,391 participants was derived from the U.S. Financial Health Pulse, which is a nationally representative probability-based internet survey conducted annually by the Financial Health Network working with the University of Southern California. This study used public data derived from the survey conducted from April to June 2019. The sample was weighted to be nationally representative using the 2018 Current Population Survey Annual Social and Economic Supplement as the reference. The dependent variable was self-rated physical health, self-reported credit score was the independent variable, and the mediator variable was financial well-being measured by five items derived from Consumer Financial Protection Bureau’s Financial Well-being Scale (alpha=0.8). Sociodemographic variables were included as control variables. Structural Equation Modeling was used to test the mediation model.


All the model fit indices, RMSEA (0.04), SRMR (0.02), CFI (0.97) and TLI (0.99) showed very good fit with the data, indicating that the study model is well explaining the specified association set by the researchers. The direct effects of credit to health, credit to financial well-being, and financial well-being to health are all positive and statistically significant. Financial well-being positively mediates the relationship between credit and health.

Conclusions and Implications:

Changes in credit score are associated with changes in physical health status, mediated by financial well-being. In health practice setting, further attention is needed to the credit score and financial well-being status of individuals as important for overall physical health assessment. Health workers should be empowered to inquire about the financial situation of patients, and to educate patients about the influence of credit on their health. Programs that situate financial interventions within physical health settings should be expanded (Bartholomae et al, 2021). The influence of financial situations on physical health, and potential mediators, needs additional research.