Financial Hardship and Health Related Quality of Life Among Older Latinos With Chronic Diseases

Am J Hosp Palliat Care. 2021 Aug;38(8):938-946. doi: 10.1177/1049909120971829. Epub 2020 Nov 6.

Abstract

Background: Financial hardship influences health-related quality of life (HRQoL) of older adults. However, little is known about the relationship between financial hardship and HRQoL among vulnerable populations.

Objective: We examined the associations between financial hardship and HRQoL among older Latinos living with chronic disease, including cancer.

Methods: This cross-sectional study included 68 Latinos (age range 50-87) with one or more chronic health conditions who participated in a pilot randomized clinical trial. Participants responded to 11 financial hardship questions. We used factor analysis to explore constructs of financial hardship. HRQoL was assessed using the 27-item Functional Assessment of Cancer Therapy-General (FACT-G). Multiple linear regression examined the associations between financial hardship and HRQoL subscales (physical, social/family, emotional, functional well-being).

Results: The factor analysis revealed 3 constructs of financial hardship: medical cost concerns, financial hardship treatment adherence, and financial worry. A 1-point increase in the factor score for financial hardship treatment adherence was associated with a 2.1-point (SE = 0.771) decrease in physical well-being and with a 1.71-point (SE = 0.761) decrease in functional well-being. A 1-point increase in the financial stress factor score was associated with a 2.0-point (SE = 0.833) decrease in social/family well-being, and with a 2.1-point (SE = 0.822) decrease in functional well-being.

Conclusion: In this study of older Latinos with chronic diseases, financial hardship was associated with worse HRQoL across several domains. Healthcare providers should refer older Latinos living with chronic disease to appropriate support providers, such as care coordinators, social workers, or patient navigators, who can assist them with obtaining financial assistance and other resources.

Keywords: chronic disease; cost of illness; financial hardship; health disparities; health-related quality of life; healthcare costs; latinos.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cost of Illness
  • Cross-Sectional Studies
  • Financial Stress*
  • Hispanic or Latino
  • Humans
  • Middle Aged
  • Quality of Life*