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Abstract
The mechanisms by which financial strain affects health are not well understood. In
this paper, we conduct a longitudinal mediation analysis of the Dutch National Bank
Household Survey. To quantify the relative importance of biological and nonbiological
pathways from financial strain to health, we consider smoking, heavy drinking and
being overweight as plausible behavioural responses to financial strain but find that
only 4.9% of the response of self-reported health to financial strain is mediated
by these behaviours. Further analysis indicates that although financial strain increases
impulsivity this has little effect on unhealthy behaviours. Economic stresses therefore
appear to be distinct from other forms of stress in the relatively minor influence
of nonbiological pathways to ill-health.