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In Sickness and Wealth: Financial Stress Can Make Us Sick

Is financial toxicity to health a matter of what you have or where you live?

Key points

  • Financial burdens are related to harmful biological outcomes.
  • Changes to the immune, neural, and endocrine systems depend on individual wealth.
  • Lifestyle buffered the effects of financial stress on the immune system.
5second/Adobe Stock
Source: 5second/Adobe Stock

Financial scarcity is a major psychological stressor that contributes to changes in biological processes. It is a stressor that quite literally gets beneath the skin. With the financial crisis that has hit the globe, money woes that were once relegated to working-class populations have now drifted to the middle class like a cloud of fog, as it progressively makes its way toward elites.

Putting food on the table

It is hard to put a hierarchy on stress. The body does not care whether you feel stressed because of work, relationships, caregiving, discrimination, bereavement, disability, or finances. The body responds the same. But financial stress is a particularly insidious stressor that has the ability to permeate every aspect of our lives. Because, ultimately, we need money to live. Irrespective of class, the ability to pay bills, put food on the table, and enjoy life without the pressure of debt collectors knocking at the door can all impact whether we remain healthy.

The area that you live in

We know that there is greater exposure to stress and communicable disease in deprived areas. Individuals within those areas are, on average, more likely to engage in harmful health behaviours and are more exposed to crime. They tend to have fewer educational, social, and psychological resources with which to cope, and they often have less access to medical services. Therefore, it is important to determine whether it is the area that we live in, or our personal financial circumstances (irrespective of where we live), that most impact our health. It could bring some clarity to the structure of financial strain and disadvantage.

Biology is the foundation of health

Advances in medicine have shown that immune and neuroendocrine processes are crucial to health and disease. They determine whether we have physical health and whether we have mental health. From organ disease, developmental growth, muscle mass, tissue loss, and blood disorders, to depression, anxiety, psychosis, and cognitive decline, these biological pathways underly an array of health conditions.


Interestingly, financial stress is a psychological stressor that has been found to trigger a systemic level response in the body. It does this through biological pathways that connect psychological responses to the immune, neural, and endocrine systems—a field of study called psychoneuroimmunology ([PNI] or psychoendoneuroimmunology [PNEI]—yes, quite the mouthful, but they are real words).

A population-based study

Substantial evidence points to where you live being more important to health than what you have—such that neighbourhoods shape individual health and health inequalities among populations, rather than individual financial circumstances. But a recent population study by Hamilton and Steptoe (2022) found that it is more nuanced than this. They found that both where you live, and your individual financial circumstances, influenced immune and neuroendocrine processes. But where you live actually mattered much less. Strikingly, the effects they found were immediate, but they also lasted over a four-year period. They demonstrate that financial stress has long-term influences on biological processes and therefore overall health.

Wealth, education, and occupation

Still, the strongest factor was individual wealth—not income, but how much capital you have available to you and the overall comfort level of your financial circumstance. An individual's level of education and occupation were much less important to these biological processes. However, this could be because these factors are less important as we age, whereas the accumulation of wealth becomes much more important as we age.

Lifestyle matters

Also as we age, financial stress can become increasingly more impactful on our health. This was certainly the case for neuroendocrine processes. But lifestyle made the greatest difference in whether financial stress altered the immune processes responsible for maintaining health. Smoking, drinking alcohol, physical activity, and BMI all matter. They all have the potential to offset some of the biological damage that financial stress causes.

Policies and prescriptions

This is an important study for people and policy. Examining disparities in health through the lens of financial stressors can improve the surveillance of important health equity issues. It will help to steer interventions toward individual-level prescriptions and financial supports, rather than a broader societal approach that would likely be less impactful for individual health.

This post is adapted from Hamilton and Steptoe’s (2022) medical paper titled “Socioeconomic determinants of inflammation and neuroendocrine activity: A longitudinal analysis of compositional and contextual effects."


Hamilton, O. S., & Steptoe, A. (2022). Socioeconomic determinants of inflammation and neuroendocrine activity: A longitudinal analysis of compositional and contextual effects. Brain, Behavior, and Immunity, 107, 276–285.

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