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Medical Debt Affects Mental Health

Trouble paying bills can take a toll on fathers’ mental health

Joyce Y. Lee by Joyce Y. Lee
October 19, 2022
in Financial Markets
0
Medical Debt Affects Mental Health

For families on low incomes, difficulty paying utility bills, rent, mortgage or health care costs set the stage for parental mental health problems, especially for fathers, that then lead to potentially violent family conflict. These are the key findings of a study I led that was recently published in the journal Family Relations.

Prior poverty research has been primarily conducted with mothers, with a predominant focus on low incomes, without considering the role of so-called “material hardship” and its impact on fathers. Family income refers to a specific dollar amount that parents bring in through paid work, such as an annual household income of US$27,750 for a family of four, whereas material hardship – or the “everyday hardships of making ends meet” – refers to whether a family has faced any challenges meeting basic needs such as food, utilities and health insurance.

My research team found that it was not low family income per se but rather the everyday hardships of making ends meet that was linked with fathers’ poorer mental health that then led to more negative conflict behaviors with the mothers. Such conflict behaviors included blaming the partner for things that go wrong; putting down a partner’s feelings, opinions or desires; or little arguments turning into ugly fights with accusations and name-calling. Such verbal aggression can be damaging to the partner relationship and is shown to be harmful for young children who witness their parents engaging in such behaviors.

To carry out this study, my team used data from the Building Strong Families project, a large and racially diverse sample of 2,794 mostly unmarried heterosexual couples caring for young children and living with low income. Our goal was to examine how economic insecurity – defined as low family income and material hardship – was associated with mothers’ and fathers’ mental health conditions and relationship functioning.

One of the key findings was that the association between material hardships such as difficulty paying for bills, rent and health insurance and destructive conflict behaviors worked primarily through fathers’ depressive symptoms and not those of the mother. Examples of depressive symptoms included feelings of sadness, sleep problems, difficulty concentrating, disinterest in eating, and loneliness.

Why it matters

These findings suggest that the negative effects of material hardship on relationship dynamics within couples operate by hurting fathers’ mental health more so than that of mothers. In light of traditional gender norms, fathers may feel more stressed than mothers when they are not able to fulfill the primary breadwinner role. That is, when fathers feel they are not economically providing to alleviate everyday economic stressors in their families, that can lead to more mental health problems and more conflict between fathers and mothers. Our study suggests the importance of focusing equal attention on fathers and how family interventions might help alleviate the issues that lead to fathers’ depressive symptoms and negative conflict between parents.

Relatedly, during the COVID-19 pandemic, parents – including fathers of low-income status – have experienced high levels of pandemic-related unemployment, economic insecurity and mental health problems. As such, addressing fathers’ and mothers’ mental health seems exceptionally critical and has the potential to support healthy family functioning during the ongoing pandemic.

What other research is being done

I am beginning to explore how families might be resilient against the negative effects of poverty by looking at positive relationships between parents as sources of strength. For example, in another study I led, I showed that when mothers and fathers focused on positive behaviors such as being a good co-parenting team on behalf of their children, they were more likely to withstand economic stressors linked with poverty and to engage in warm and sensitive parenting that benefited their young children’s social development.

Joyce Y. Lee, Assistant Professor of Social Work, The Ohio State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Source: The Conversation
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Joyce Y. Lee

Joyce Y. Lee

Joyce Y. Lee identifies as a child welfare and family strengthening scholar. Her research seeks to promote child welfare and family strengthening through preventing child maltreatment, promoting the health and wellbeing of foster children, and supporting positive parenting practices. Her current research focuses on the following four areas: (1) preventing child abuse and neglect in families with low income or other adverse family contexts; (2) promoting foster children’s physical, mental, and behavioral health and reducing disparities in such health outcomes; (3) examining the role and impact of legal tools and mechanisms in reforming child welfare systems; and (4) informing the development of culturally responsive approaches to serving child welfare systems involved children and families. Research in these areas is intended to inform child welfare policies and practices that improve children’s health outcomes and strengthen children’s relationships with their family members.

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In this episode of the Daily Remedy Podcast, Tiffany Ryder discusses her insights on healthcare messaging, the impact of COVID-19 on patient trust, and the importance of transparency in health policy. She emphasizes the need for clear communication in the face of divisiveness and explores the complexities surrounding the estrogen debate. Additionally, Tiffany highlights positive developments in health policy and the necessity of effectively conveying these changes to the public.

Tiffany Ryder is a political commentator and public health policy thought leader who publishes the Substack newsletter Signal and Noise: https://signalandnoise.online/


Chapters

00:00 Introduction to Healthcare Conversations
02:58 Signal and Noise: Understanding Healthcare Communication
05:56 The Storytelling Problem in Healthcare
08:58 Navigating Political Divisiveness in Health Policy
11:55 The Role of Media in Health Policy
15:03 Bias in Health Reporting
17:56 Estrogen and Health Policy: A Case Study
24:00 Positive Developments in Health Policy
27:03 Looking Ahead: Future of Health Policy
31:49 Communicating Health Policy Effectively
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Policy Shift in Peptide Regulation

Clinical Reads

GLP-1 Drugs Have Moved Past Weight Loss. Medicine Has Not Fully Caught Up.

Glucagon-Like Peptide–Based Therapies and Longevity: Clinical Implications from Emerging Evidence

by Daily Remedy
March 1, 2026
0

Glucagon-like peptide–based therapies are increasingly used for weight management and glycemic control, but their potential impact on long-term survival remains uncertain. The clinical question addressed in this report is whether treatment with glucagon-like peptide receptor agonists is associated with reductions in all-cause mortality and age-related morbidity beyond their established metabolic effects. This question matters because these agents are now prescribed across broad patient populations, including individuals without diabetes, and long-term exposure may influence cardiovascular, oncologic, and neurodegenerative outcomes. Understanding whether...

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