Samuel Laura J, Abshire Saylor Martha, Lutz Melissa, Choe Monica Y, Smith Wright Rhonda, Kim Boeun, Szanton Sarah L, Nkimbeng Manka, Mena-Carrasco Fernando, Austin Rachel, Perrin Eliana M
Johns Hopkins University School of Nursing, Baltimore, Maryland.
Johns Hopkins University School of Medicine, Baltimore, Maryland.
AJPM Focus. 2025 Mar 24;4(4):100337. doi: 10.1016/j.focus.2025.100337. eCollection 2025 Aug.
Despite the focus on pediatric social needs, there is a dearth of research on financial strain, which is characterized by challenges in meeting basic needs. This study systematically reviewed the literature on different measures of self-reported financial strain and health outcomes.
A systematic literature search in PubMed, PsychINFO, and Web of Science identified papers that examined relationships between self-reported financial strain and health outcomes among U.S. children or adolescents. Two blinded reviewers screened each paper (65 papers, 39 studies) and extracted data. Financial strain measures were coded for content. Findings were synthesized based on age and type of measure.
Financial strain measures asked about the lack of money for basic needs (32 studies), difficulty making ends meet (23 studies), relying on coping strategies (13 studies), experiencing stress or worry about finances (4 studies) anticipating future strain (4 studies), and the lack of money for leisure (4 studies). Financial strain was associated with poorer health and well-being and more behavior challenges among children of all ages, poorer academic performance among school-age children, and more depressive symptoms among adolescents. Associations were consistent across diverse samples when accounting for other socioeconomic factors and across financial strain measures, including a single item about difficulty making ends meet. Fourteen studies tested hypothesized mechanistic factors that explain associations, including material, psychosocial, and behavioral pathways.
The consistency of associations between financial strain and pediatric health and well-being highlights an urgent need to address financial strain to advance health equity. Results show predictive validity for a simple financial strain question, similar to one recommended by the National Academy of Medicine.
尽管人们关注儿童的社会需求，但对于以满足基本需求面临挑战为特征的经济压力的研究却很匮乏。本研究系统回顾了关于自我报告的经济压力的不同衡量指标与健康结果的文献。
在PubMed、PsychINFO和Web of Science中进行系统的文献检索，以确定研究美国儿童或青少年自我报告的经济压力与健康结果之间关系的论文。两名盲审员筛选每篇论文（65篇论文，39项研究）并提取数据。对经济压力衡量指标进行内容编码。根据年龄和衡量指标类型对研究结果进行综合分析。
经济压力衡量指标涉及缺乏满足基本需求的资金（32项研究）、难以维持收支平衡（23项研究）、依赖应对策略（13项研究）、经历财务压力或担忧（4项研究）、预期未来压力（4项研究）以及缺乏休闲资金（4项研究）。经济压力与各年龄段儿童的较差健康和幸福感以及更多行为挑战相关，与学龄儿童较差的学业成绩相关，与青少年更多的抑郁症状相关。在考虑其他社会经济因素时，不同样本之间以及包括关于难以维持收支平衡的单个项目在内的各种经济压力衡量指标之间的关联是一致的。十四项研究测试了解释关联的假设机制因素，包括物质、心理社会和行为途径。
经济压力与儿童健康和幸福感之间关联的一致性凸显了迫切需要解决经济压力以促进健康公平。结果显示了一个简单的经济压力问题的预测效度，类似于美国国家医学院推荐的问题。
