The Great Recession led to a dramatic increase in the number of Americans living with day-to-day economic insecurity. According to the Survey of Economic Risk Perception and Insecurity, 93 percent of U.S. households experienced a decline in their wealth between 2008 and 2009. A more recent study by the Federal Reserve suggests that financial insecurity is fairly common. For example, 47 percent of survey respondents said they would have difficulty covering an emergency expense of $400.
Growing financial insecurity has been accompanied by another trend: an increased number of Americans who report living with physical pain. The National Survey on Drug Use and Health reported that dependence on painkillers increased by 50% between 2006 and 2012. In 2008, the estimated economic cost of pain exceeded the combined cost of cancer, heart disease, and diabetes.
A research team led by public policy Professor Eileen Chou at the University of Virginia hypothesized that the confluence of these two trends – greater economic uncertainty and more physical pain – may not be entirely coincidental. Chou and her colleagues recently published a paper in Psychological Science summarizing six studies that demonstrate a direct link between financial insecurity and the experience of physical pain.
The first study looked at a diverse sample of 33,720 American households and found that households in which one or more of the primary adults are unemployed spend more money on painkillers. This finding held steady even after the researchers statistically controlled for other factors that could be linked to the purchase of pain medication, such as the number of people living in the household, total household income, and consumption of cold and flu medications. While suggestive, these findings don’t prove that economic insecurity causes more pain. To test this hypothesis, the researchers designed experiments where they manipulated people’s feelings of economic insecurity.
In one study, they recruited online participants and randomly assigned half of them to write about a time in their lives when they felt uncertain about their economic future, for example, due to job instability. The rest of the participants were asked to write about a time when they felt secure about their economic future. Afterwards, all participants completed a short survey asking the amount of pain they were currently experiencing in their head, chest, or stomach. Chou and her colleagues found that participants who had written about a time when they felt insecure about their finances reported almost twice as much pain as those who wrote about a time when they felt financially secure. It’s important to point out that the researchers manipulated people’s subjective feelings of financial insecurity rather than their actual financial situations. Therefore, how people feel about their financial situations, regardless of their actual economic well-being, may have important consequences for physical health.
Why would feelings of financial insecurity lead people to report higher levels of physical pain? Several previous studies have shown that psychological pain and physical pain share similar brain pathways. This may explain why taking painkillers has been shown to reduce both physical and emotional pain. In addition, Chou and her colleagues hypothesized that financial insecurity may cause people to feel less control over their lives, which in turn, leads to heightened feelings of pain. Their assumption is based on past research showing that people who feel less control over their lives are at higher risk for physical health problems.
To test their hypothesis, the researchers conducted a study where they manipulated people’s feelings of control. Using online participants, they randomly assigned half of the people in their study to write about a time in their lives when felt a lack of control. The remaining participants were assigned to write about an incident in their life when they felt like they were in complete control of what has happening to them. After the writing exercise, participants indicated how much pain they were experiencing at that very moment. Those who had written about a time when they felt a lack of control reported more than twice the amount of physical pain than those who wrote about a time when they felt complete control. Feelings of control may at least partly explain how economic insecurity leads to more physical pain.
Although suggestive, the research presented by Chou and her colleagues is only a very early step. Most likely the factors at play are complex. For example, anxiety and depression are also associated with greater reports of physical pain. While both of these conditions stem from a lack of perceived control, they are also frequently accompanied by low self-esteem.
Nevertheless, Chou’s research provides an important perspective on how economic insecurity directly impacts people’s physical well-being. Understanding this connection may point towards solutions that could help people get back on their feet – both financially and physically. After all, physical pain can severely limit or even preclude someone’s ability to hold down a steady job, thereby leading to more financial insecurity. Figuring out how to intervene, perhaps by finding ways to restore people’s feelings of control over their lives, might lessen physical pain as well as provide the best chance of helping people regain their financial footing.