LAUSR

Objective We examined the associations between material hardship and health outcomes in early adulthood, and the extent to which these associations are mediated by perceived stress. Methods We used Wave I & IV of the National Longitudinal Study of Adolescent Health (Add Health), a nationally representative survey of young adults aged 18 to 34 years old (N=13,313). Multivariate logistic regression and decomposition methods were used to evaluate the associations between types and depth of material hardship (food, bill-paying and health resource hardship) and health outcomes (self-rated health, depression, sleep problems, and suicidal thoughts) in early adulthood, and the extent to which these associations were mediated by perceived stress. Results The adjusted odds of fair or poor health status, depression, sleep problems, and suicidal thoughts were higher among individuals with material hardship than counterparts without. A considerable proportion of the association between material hardship and health outcomes was attributable to perceived stress. Conclusions Material hardship is associated with adverse health outcomes in early adulthood, and these relationships are robust after accounting for various sociodemographic characteristics and family background. Perceived stress accounted for a sizable portion of the effects of material hardship on health. Public Health Implications Efforts to promote health equity in young adults should focus on material hardship and associated stressful conditions.