A new study from Yale University found among older people who have been hospitalized for a heart attack, severe financial strain—having too little money each month to make ends meet—is associated with a 60% higher risk of dying within six months.
The study is published in JAMA Internal Medicine and was conducted by Alexandra Hajduk et al.
There is extensive evidence that many older people are at-risk for financial strain due to reduced income opportunities and financial losses following recent economic downturns.
In the study, the team examined whether financial strain might also be associated with a higher risk of dying following a heart attack among older adults.
They tested participants who were hospitalized with a heart attack and asked whether they had more than enough money to make ends meet (defined as no financial strain), just enough (moderate financial strain), or not enough (severe financial strain).
The team found in the patients who reported having more than enough money to pay the bills, 7.2% died within six months of leaving the hospital.
Of those who reported having “just enough” money to make ends meet, 9% died within six months. Of those who reported having too little money, 16.8% died within six months.
After adjustments, the researchers found that patients who reported severe financial strain were 61% more likely than patients reporting no financial strain to die within the six months following a heart attack.
The team says financial strain could make it harder for patients to access transportation to their follow-up appointments and to afford co-pays for their medications, which could result in missed appointments and skipped medication doses.
It could run the gamut: from not being able to fill a prescription at all, to skipping doses, which could be very dangerous for some of these drugs, to splitting doses in half to make them last longer.
Increased stress from money problems could also worsen health outcomes due to the effects of chronic stress on the body.
The results suggest that asking older adults who are admitted to the hospital with heart attacks about their financial strain could identify patients who will be at higher risk of death following discharge.
Social workers could then refer patients with severe financial strain to social services to help them pay for transportation to and from follow-up appointments, prescription drug co-pays, and other medical needs.
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