Sudden wealth loss after 50 linked to higher death risk
=======================================================

* Julia Haskins

A sudden loss of wealth in middle or older age may be linked to an increased risk of death, according to a study published in April in the *Journal of the American Medical Association*.

The study pointed to an association between negative wealth shock — the loss of at least three-quarters of a person’s net worth over a two-year period — and an increased risk of death for people over age 50.

Researchers followed adults through the Health and Retirement Study and collected mortality data from the National Death Index and postmortem interviews with families. Among the study sample of more than 8,700 adults, or about 26 percent, had experienced a negative wealth shock, and about 750 people, or almost 7 percent, had no or negative assets at the study baseline. The increased risk of death doubled for people who had negative wealth shocks compared with people who had continuous positive wealth, and increased by 67 percent for people with no assets compared with people who had continuous positive wealth.

People experiencing negative wealth shock were more likely to be women, minorities, have lower household incomes and net worth and have worse health. The disparities in negative wealth shocks affecting women could be attributed to factors such as marital disruption, including divorce and widowhood, said lead study author Lindsay Pool, PhD, MPH, research assistant professor of preventive medicine at the Northwestern University Feinberg School of Medicine. She noted that institutional racism could also play a role in the wealth shock disparities affecting minorities, pointing to racist banking practices as one example.

While the study period took place during the Great Recession that began in late 2007, macroeconomic forces were not necessarily linked to the poor health outcomes resulting from negative wealth shock, Pool said. She noted that there are other individual experiences to consider, such as paying high medical bills.

Even though the mechanisms for the association between negative wealth shock and increased risk for mortality are unclear, there could be opportunities for public health practitioners and clinicians to develop interventions in response to a crisis that could affect many people, according to Pool.

“This is a study about people who, for the most part, were trying to do everything right,” Pool told *The Nation’s Health*. “In the role of public health, it’s very important for us to be aware that this could occur.”

A major loss of wealth can happen to people in any income bracket. For example, Pool noted that during the recession, more people became food-insecure for the first time in their lives. Public health can increase awareness of the commonplace experience of losing a significant portion of wealth in a short period. Creating awareness also presents an opportunity to reduce stigma and ensure that people have access to necessary resources, as someone who has not had to deal with a huge blow to their finances may not know where to get help. Public health can boost the sentiment that “there’s no shame in going through something that so many people go through,” Pool said.

Clinicians may also be able to offer assistance to people who have suddenly lost a huge share of their wealth. Pool said that health care providers must let go of their unconscious biases about who is struggling financially to ensure that people are connected to resources. Clinicians should be made aware of the prevalence of negative wealth shock so that they know to check with their patients about paying for medication and other forms of health care, she said.

For more information, visit [https://jamanetwork.com/journals/jama/fullarticle/2677445](https://jamanetwork.com/journals/jama/fullarticle/2677445).

*   Copyright The Nation’s Health, American Public Health Association