Mathieu R. Despard

Informal financial support networks can potentially mitigate hardships associated with income loss. This study examines patterns of informal financial support receipt during the COVID-19 pandemic and explores how such support may have mitigated hardships due to pandemic-related job or income loss. Using a national sample of U.S. adults (n = 3874) who completed a survey during the first year of the pandemic, we descriptively examine patterns in informal financial support receipt, including the predictors of receiving support, the sources of support, and what the funds were used for. We also examine the extent to which receipt of informal financial support moderates the relationship between COVID-19-related job or income loss and an array of financial hardships. 16% of our sample reported receiving some form of informal financial support because of the pandemic. Informal financial support was primarily used for food and essential expenses, and the most common source of support was parents. Those who experienced hardships and job/income loss were more likely to receive informal financial support, and receiving support did not moderate the relationship between job/income loss and most measures of hardship. Informal support may provide a buffer against some hardships but formal interventions may be necessary to more substantively protect households against hardship risks.

Introduction: Medical debt is widely regarded as a social problem that reflects growing out-of-pocket costs. Yet whether medical debt acts a social determinant of health by discouraging people to seek additional care may depend on one's ability to repay this debt. Methods: We use data from the first wave of a survey of a nationally representative sample of 2090 low-wage workers in the U.S. We ran linear probability models to predict putting off filling prescriptions, receiving primary medical care, and receiving specialty medical care based on medical debt disposition. Results: We find that workers with medical debt they cannot afford to repay are more likely to defer three types of health care and are confronted with several other financial risk factors compared with workers with medical debt they are repaying. Also, concerning putting off needed health care, there is no difference between workers who are repaying their medical debt and those with no medical debt. Discussion: These findings suggest the need to strengthen financial assistance policies and programs and ensure access to low-cost health coverage for low-wage workers.

Many U.S. workers struggle with financial challenges. Human service organizations (HSOs) can consider ways to better promote financial well-being among staff, especially lower-wage, frontline workers. In addition to raising pay, HSOs can improve benefits and working conditions in ways that will meaningfully affect staff's financial well-being, such as offering wage-tiered health insurance premiums, financial counseling, access to public benefits, and giving staff more control over their schedules. Doing so will help HSOs strengthen their commitments to social and economic justice, yet financial challenges among nonprofit HSOs – especially those that are minority-led and/or -serving – require changes in public policies.

In this study, we partnered with a large credit union to conduct a 10‐arm field experiment aimed at reducing delinquent payments on installment debts. This experiment tested common behavioral interventions such as payment reminders against more novel approaches such as magnet reminders and savings accounts that automated emergency savings. It also tested the impact of offering financial counseling services. Our findings indicate that the email reminders—which emphasized resolving current delinquencies in some treatments and preventing future delinquencies in others—were effective at reducing moderate and severe payment delinquency rates. Other, more intensive treatments, which required participants to enroll in a new account or financial counseling, likely did not have an impact due to low takeup rates. We also find limited evidence that certain interventions were more effective for individuals with higher credit risk.

Nearly a quarter of U.S. households experienced job or income losses related to the COVID-19 pandemic. Liquid assets mitigate financial distress amidst financial shocks such as job loss, yet this relationship concerning the COVID-19 pandemic is unknown. Using a nationally representative sample of U.S. respondents (N = 4,765) who completed a survey in the early days of the pandemic, we examined pre-pandemic liquid assets as a moderator of the relationship between COVID-19-related job and income loss and financial distress such as difficulty meeting financial obligations and the use of high-cost financial resources. Estimates from propensity score-weighted linear probability models indicated that greater liquid assets lessened the probability of experiencing all eight measures of financial distress and moderated the effect of COVID-19-related job/income loss on five out of eight measures. These results hold when examining financial distress specifically attributed to COVID-19 and controlling for public program participation and Coronavirus Aid, Relief, and Economic Security Act supports.

Concern is growing about financial stress among U.S. workers, many of whom experience financial insecurity (FIS) as they struggle to make ends meet, manage debt, and save. Benefits comprise almost a third of total compensation and affects hiring and retention, which is important with respect to the shortage of frontline healthcare workers (FHWs). We present results from a survey of 2321 FHWs, finding that FHWs without college degrees and working in home health and private duty settings have lower access to benefits and greater FIS compared to those with college degrees and who work in facility-based settings. Among all FHWs, access to benefits has a strong association with FIS, even while controlling for income. Our findings suggest that employers consider improving benefits to help address FIS and within healthcare, address issues of compensation equity based on educational attainment. Still, addressing worker FIS may take strengthening the public social safety net.

This chapter reviews research to date concerning the association between financial technology (“FinTech”) and consumer financial behavior. A total of 63 studies were reviewed concerning various forms of FinTech, such as Personal Financial Management (PFM) apps and digital loans, and consumers’ budgeting and spending, use of credit, debt management, saving, and investing. Early evidence suggests that use of FinTech is associated with improved budgeting, repayment, and saving behavior and increased access to credit. However, it is unclear whether FinTech is having a net positive impact among lower-income consumers and/or consumers with lower levels of financial literacy, while some evidence points to the role of FinTech in promoting overspending and overborrowing and exposing consumers to predatory practices. New research is needed concerning the use of artificial intelligence and bias in financial services, to correct for endogeneity via self-selection, and to further illuminate whether FinTech is mitigating or exacerbating economic marginalization.

Individuals who cannot afford out of pocket medical expenses may reduce health care use, resulting in poorer health outcomes. To ease the situation, employers turn to financial technology (“fintech”) health care credit applications. We examine whether an employer-sponsored credit fintech application (MedPut) helps employees manage medical expenses. Results of the analysis of variance (ANOVA) and probit regression models reveal MedPut users did worse financially and delayed health care due to cost more often than employees who did not use MedPut. Results may inform social work policy and direct practice perspectives on fin-tech and medical expenses.