Chronic disease burden and future perceptions of financial control

Living with a chronic disease affects more than just physical health—it can cast a shadow over people’s perceived financial control and wellbeing, says a new study published in the journal Medical Care by University of Michigan School of Public Health researchers.

The research details
Researchers analyzed data from over 3,200 participants in the Midlife in the United States (MIDUS) study, examining how chronic health conditions affected participants’ financial outlook approximately nine years later. The study looked at several key factors:

• Number of chronic conditions
• Medication use
• Biological markers like glucose levels, cholesterol and blood pressure
• Various measures of financial wellbeing, from current situation to future outlook

Key findings
The research revealed several important patterns of financial outlook after nine years. People with more chronic conditions were:

• 22% more likely to report having inadequate financial resources
• Less confident about controlling their financial situation
• More pessimistic about their financial future

Those taking more medications showed similar patterns and were 29% more likely to report inadequate resources.

“The results suggest a long-term relationship between managing multiple chronic conditions and having negative views about one's financial situation. This speaks to the rising costs of healthcare and medicines alongside inflation,” says Victoria Davis, the study’s first author and a doctoral student in the Department of Health Behavior & Health Equity at the U-M School of Public Health.

Interestingly, people with higher cholesterol levels showed mixed results—while they felt better about their current finances, they were less confident about their financial future and felt less control over their money situation.

Why it matters
The relationship between chronic disease burden and financial perceptions operates through multiple pathways:

• Accumulating financial pressure from out-of-pocket costs for medications, medical visits, and lifestyle changes, since managing many chronic diseases is a long-term commitment
• Impact on work capacity and earning potential, creating longer-term financial strain
• Need to plan for future healthcare needs and potential complications
• Psychological burden of ongoing healthcare management
• Structural influences like the rising costs of healthcare and inflation

This complex relationship between health and financial wellbeing can create a cycle: Chronic disease increases financial strain, which may lead to people making tradeoffs with treatments to save money, potentially worsening their health outcomes.

“The burden of chronic disease extends far beyond physical symptoms—it casts a long shadow over people's financial future and sense of control, especially in the US,” says Minal Patel, professor of Health Behavior & Health Equity and senior author of the paper. “When managing multiple health conditions becomes a daily reality, it's not just about counting pills, but counting dollars, creating a concerning cycle where health and financial stability become increasingly intertwined. Our findings show that this plays out over a long period of time.”

Proposed solutions 
The study suggests several strategies for reducing financial burden among people living with chronic diseases:

• Healthcare institutions should better screen for and support addressing financial concerns stemming from healthcare
• Healthcare institutions need better tools to support patient requests around cost-informed treatment recommendations
• Policy efforts should continue to address high healthcare and medication costs, especially for people managing multiple chronic conditions

These efforts could improve treatment adherence, quality of life, and health and financial outcomes for people with chronic conditions, the researchers say.

The research team acknowledges that while financial circumstances can change over time, the ongoing healthcare costs, impact on work capacity, and anticipated future medical expenses caused by chronic disease burden and managing disease may have lasting effects on individuals' financial outlook.

Study: “Chronic disease burden and future perceptions of financial control: Results from the Midlife in the United States cohort study,” Medical Care. https://doi.org/10.1097/mlr.0000000000002126

Additional author: Guanghao Zhang, PhD student in the Department of Biostatistics.