A sudden loss of wealth in middle or older age can increase mortality 50 percent. Take a look at the stock market. Valuations and therefore wealth can shift greatly from day to day. And with valuation, I would imagine that heart rate variation will do the same thing. These are stressful times. But what toll does this financial stress really take on an individual? Data suggest that the toll is significant and alarming. A paper in JAMA examined 8714 adults aged 51 to 61 years who experienced a negative wealth shock and followed this group for 20 years. Wealth shock was defined as a loss of 75% or more of total net worth over a 2-year period, or asset poverty, defined as zero or negative total net worth at study entry. Simply put, the group experiencing wealth shock had a 50% greater death rate over controls. Yes, 50% greater! That's a significant number and one often in the range of those numbers in clinical trials where conditions such as high cholesterol or elevated blood pressure therapies are evaluated. The mortality was from all causes and didn't reflect one particular condition such as a heart attack or cancer. Nevertheless, these data were highly significant (95% confidence interval). A look deeper deeper into the data raised even more questions. While the authors looked at financial considerations associated with all-cause mortality, they carefully examined those underlying causes. Associated with this type of financial crisis, depression, anxiety, suicide and substance abuse can also factor into the complex clinical and social dynamic. Further, a significant loss of income may decrease the utilization of healthcare and lead to poorer outcomes. In a related finding from a few years ago, research demonstrated that stress and depressive symptoms lead to the occurrence of heart attack. In this study, participants with concurrent high stress and high depressive symptoms had increased risk for myocardial infarction or death by about 50% relative to those with low stress and low depressive symptoms. There was no analysis of financial status in this study. Interestingly, In these two studies, the authors chose language that captured this concern. In the first, we have "wealth shock" and in the second the authors define this high stress condition as the "perfect storm." Both leverage interesting non-clinical terms to define what may be dire circumstances that are life-threatening. In today's world, stress—from money to social issues—can be a powerful factor in health and wellness. And it's been said that health is wealth, and it might be just as true that wealth could be health too.
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