Chronic Disease and Future Perceptions of Financial Control: Results From the Midlife in the United States Cohort Study.

Abstract

Objective: Rising health care costs and chronic disease prevalence have increased concerns about health-related financial burden. This study examined how baseline chronic disease burden was associated with subsequent perceptions of financial control ∼9 years later.

Methods: Data came from the Midlife in the United States (MIDUS) cohort, with MIDUS 1 and 2 used as baseline predictors for future perceived financial control outcomes at MIDUS 3. Adjusted mixed effect models examined the relationship between baseline chronic disease burden on 4 variables representing future perceptions of financial control.

Results: A total of 3297 participants [mean (SD) age: 54 (11.36) y] were included. Greater chronic disease burden and medication use at baseline were associated with a higher likelihood of inadequate resources [adjusted odds ratio (AOR) = 1.22; 95% CI: 1.07-1.38; P = 0.001 and AOR = 1.29; 95% CI: 1.13-1.46; P = 0.001, respectively]. Having more chronic conditions predicted reduced feelings of financial control (AOR=0.85; 95% CI, 0.78-0.93; P <0.001) and a more pessimistic financial outlook (AOR = 0.87; 95% CI: 0.79-0.97; P < 0.01). Higher baseline cholesterol levels showed mixed associations: better perception of current finances (AOR = 1.36; 95% CI: 1.22-1.51; P =0.001) but reduced sense of financial control (AOR = 0.86; 95% CI: 0.78-0.95; P < 0.001) and more negative financial outlook (AOR = 0.69; 95% CI: 0.62-0.77; P < 0.001). No baseline factors predicted bill payment capability.

Conclusion: The findings suggest a need for additional strategies to reduce the financial burden of chronic diseases.