{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T02:05:44Z","timestamp":1790820344048,"version":"4.1.0"},"reference-count":26,"publisher":"Cambridge University Press (CUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S1047951126112943_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Understanding the long-term implications of CHD has become a priority as survival rates have improved. Little is understood about the economic implications of living with CHD into adulthood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126112943_as2\">\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We aimed to determine the prevalence and risk factors of financial fragility (i.e., ability to pay $2,000 for an emergency expense) among adults with CHD in the United States and compare outcomes to their healthy siblings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126112943_as3\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study using data from the CHD Project to Understand Lifelong Survivor Experience survey (2021\u20132023). The survey assessed demographics, medical history, and economic outcomes, including financial fragility. Analyses included chi-square and Wilcoxon rank-sum tests with multivariable logistic regression models adjusted for demographic and socioeconomic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126112943_as4\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There were 3074 adults with CHD and 324 siblings who answered the financial fragility question. The prevalence of financial fragility was 20.6% for individuals with CHD versus 12.7% in siblings (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.02); individuals with CHD had higher odds (OR 1.50, 95% CI 1.04\u20132.17,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.029) of financial fragility compared to siblings. Single ventricle anatomy was the only CHD group significantly associated with financial fragility (aOR 1.59, 95% CI 1.12\u20132.26). Financially fragile individuals were more likely to report blindness, be female or a race other than non-Hispanic white, and have single ventricle CHD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S1047951126112943_as5\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Adults with CHD experience greater financial fragility than their siblings and disease severity is associated with increased risk. Addressing financial fragility is essential to mitigate the long-term economic burden of CHD on patients and families.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/s1047951126112943","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T08:11:37Z","timestamp":1782720697000},"page":"1460-1468","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Financial fragility in adults with CHD: a report from the CHD Project to Understand Lifelong Survivor Experience"],"prefix":"10.1017","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1329-9440","authenticated-orcid":false,"given":"Cassidy","family":"Golden","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/024mw5h28","id-type":"ROR","asserted-by":"publisher"}],"name":"The University of Chicago Pritzker School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Shi","sequence":"additional","affiliation":[{"name":"Emory University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2243-8367","authenticated-orcid":false,"given":"Matthew E.","family":"Oster","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University Department of Pediatric Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-634X","authenticated-orcid":false,"given":"Lazaros","family":"Kochilas","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University Department of Pediatric Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley","family":"Marino","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Children\u2019s Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mansi","family":"Gaitonde","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center, Children\u2019s Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Ilardi","sequence":"additional","affiliation":[{"name":"Pediatric Neurodevelopmental Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3204-1176","authenticated-orcid":false,"given":"Michael","family":"Fundora","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta, Emory University Department of Pediatric Cardiology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,6,29]]},"reference":[{"key":"S1047951126112943_ref17","unstructured":"17. Paul, J , Yakoboski, AL , Hasler, A. How financial literacy varies among U.S. adults. 2022, 24. https:\/\/www.tiaa.org\/content\/dam\/tiaa\/institute\/pdf\/research-report\/2022-04\/tiaa-institute-gflec-2022-personal-finance-p-fin-index-ti-yakoboski-april-2022.pdf"},{"key":"S1047951126112943_ref6","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0306620"},{"key":"S1047951126112943_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2024.09.003"},{"key":"S1047951126112943_ref19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2408259"},{"key":"S1047951126112943_ref12","doi-asserted-by":"publisher","DOI":"10.3386\/w17072"},{"key":"S1047951126112943_ref2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.122.060834"},{"key":"S1047951126112943_ref24","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.01.060"},{"key":"S1047951126112943_ref20","doi-asserted-by":"publisher","DOI":"10.1007\/s10834-021-09796-y"},{"key":"S1047951126112943_ref21","first-page":"252","article-title":"Quality of life among siblings of patients with chronic conditions","volume":"118","author":"Velasco","year":"2020","journal-title":"Arch Argent Pediatr"},{"key":"S1047951126112943_ref3","doi-asserted-by":"publisher","DOI":"10.1111\/pedi.13216"},{"key":"S1047951126112943_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.01.049"},{"key":"S1047951126112943_ref23","doi-asserted-by":"publisher","DOI":"10.1016\/j.ridd.2014.05.001"},{"key":"S1047951126112943_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.08.035"},{"key":"S1047951126112943_ref11","unstructured":"11. Susan, K , Urahn, TP. The Precarious State of Family Balance Sheets. 2015; https:\/\/www.pewtrusts.org\/en\/research-and-analysis\/reports\/2015\/01\/the-precarious-state-of-family-balance-sheets."},{"key":"S1047951126112943_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2021.04.008"},{"key":"S1047951126112943_ref16","unstructured":"16. The Role of Emergency Savings in Family Financial Security: What Resources Do Families Have for Financial Emergencies? 2015. 14 Nov 2015. https:\/\/www.pewtrusts.org\/~\/media\/assets\/2015\/11\/emergencysavingsreportnov2015.pdf."},{"key":"S1047951126112943_ref18","unstructured":"18. York FRBoN. Survey of Consumer Expectations: Credit Access. 2015, Federal Reserve Bank of New York. Accessed April 15, 2025. https:\/\/www.newyorkfed.org\/microeconomics\/sce\/credit-access#\/financial-fragility1."},{"key":"S1047951126112943_ref22","first-page":"1125","article-title":"Financial hardship among siblings of long-term survivors of childhood cancer: a childhood cancer survivor study report","volume":"130","author":"Ohlsen","year":"2024","journal-title":"Ann Ny Acad Sci"},{"key":"S1047951126112943_ref1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3435"},{"key":"S1047951126112943_ref4","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6963-9-182"},{"key":"S1047951126112943_ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-021-02763-2"},{"key":"S1047951126112943_ref14","first-page":"395","article-title":"Canadian consensus conference on adult congenital heart disease 1996","volume":"14","author":"Connelly","year":"1998","journal-title":"Can J Cardiol"},{"key":"S1047951126112943_ref10","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.010342"},{"key":"S1047951126112943_ref25","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002345"},{"key":"S1047951126112943_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.03.491"},{"key":"S1047951126112943_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00636-8"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951126112943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T01:46:16Z","timestamp":1790819176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951126112943\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,29]]},"references-count":26,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["S1047951126112943"],"URL":"https:\/\/doi.org\/10.1017\/s1047951126112943","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,29]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. 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