Why Financial Strain Is So Harmful to Your Health

Why Financial Strain Is So Harmful to Your Health

A conversation with Dr. Michael Stein on the toll simply not having enough money takes on your body.

BY DREW MILLARD   March 29, 2021

A 100 bill's face is covered with a mask as a doctor would wear.  Anton Petrus

In an address to the nation earlier this month, President Joe Biden marked the one-year anniversary of the coronavirus pandemic by announcing that all American adults would be eligible for the COVID vaccine by May 1. If we all get vaccinated, he said, “there’s a good chance you, your families, and friends will be able to get together” on the Fourth of July “and have a cookout.” The implication was that we will finally have passed the apex of the virus, and that, slowly but surely, things will once again begin to feel normal again.

Except that’s not how things work, really. We have spent the past year in the throes of a public health crisis which quickly brought with it an economic one to match. Nearly a year after the initial shock of 22 million Americans losing their jobs at the onset of the pandemic, 18.7 million people are still filing for unemployment. This is to say nothing of those who have been without a job for so long that they are no longer technically counted as members of the workforce. While plenty of people are going to emerge from the pandemic in better financial shape than ever, many others have felt the sting of financial precarity in ways that affect their ability to pay for their housing or food. We will be dealing with the economic consequences of the pandemic for years.

To Dr. Michael Stein, a Boston University professor and chair of the school’s Health Law, Policy, and Management department—and who also works as a primary care doctor to low-income patients—America’s issues with physical and financial health are inextricable. “Perhaps poverty should be approached from a public health perspective, as the moral perspective alone has failed us,” he writes in the introduction of his recent book Broke:

Patients Talk about Money with Their Doctor. On the surface, Broke is exactly what it sounds like it would be—a book full of anecdotes, narrated by Stein but told mostly without commentary, about how his patients deal with money. But the format is just a narrative device, really, meant to illustrate Stein’s larger point, which is that when people are poor, their lives are hard in ways that are always unique and frequently unmanageable—to the point where day-to-day survival must take precedent over their long-term goals. It’s his professional obligation, he believes, to talk to his patients about money, help them deal with their financial problems as best he can. “Feeling a bit more in control of their finances, or less out of control," he writes, "allows patients the mental space to make clearer decisions, health decisions included."

Stein says he decided to start the book when a patient told him, “I’m so broke I have to rinse off paper plates.” The image is indelible, and in Broke it is the first thing we hear from his patients, who throughout the pages tell stories of hustling black-market watches to make ends meet, altercations with rapacious landlords, being swindled out of money by their loved ones, and falling through bureaucratic holes in America’s ragged, underfunded, and uncaring social safety net. Together, the vignettes of Broke describe a dizzying array of symptoms to the same sickness whose cure, however simple, is nevertheless out of reach. With more Americans hanging on by a thread than ever before, this is a book worth reading.

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https://www.gq.com/story/financial-strain-is-so-harmful-to-your-health-michael-stein