{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:33:37Z","timestamp":1793813617934,"version":"4.6.1"},"reference-count":32,"publisher":"Bristol University Press","issue":"4","funder":[{"name":"National Institute on Minority Health and Health Disparities","award":["U54MD000502"],"award-info":[{"award-number":["U54MD000502"]}],"id":[{"id":"https:\/\/ror.org\/0493hgw16","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec id=\"as1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Does the association between indebtedness and midlife health, that is, the debt gap in health, vary systematically by individuals\u2019 propensity for becoming indebted? To answer this question, we investigated potential heterogeneity in the debt\u2013health association and tested competing hypotheses derived from cumulative inequality and relative deprivation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"as2\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>With data from the National Longitudinal Survey of Youth 1979 (NLSY79), we measured indebtedness as self-reported negative net worth. Midlife health was assessed using SF-12 mental and physical health scores at age 50. The analysis estimated Average Treatment Effects (ATEs) to test the overall association between debt and midlife health. We then applied matching-smoothing (MS) and stratification-multilevel (SM) estimators to assess heterogeneity in the debt gap in midlife health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"as3\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Indebtedness was associated with significantly poorer midlife mental and physical health. Both MS and SM estimators found evidence that the debt\u2013health association varied systematically across the propensity for indebtedness, with the largest debt gap in health concentrated among those with the highest likelihood of experiencing indebtedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"as4\">\n                    <jats:title>Contribution<\/jats:title>\n                    <jats:p>These findings provide empirical support for cumulative inequality theory, suggesting that the debt gap in midlife health widens significantly as chronic adversity increases. Findings highlight the importance of policies assisting financially vulnerable adults across the life course.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1332\/17579597y2026d000000089","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T22:15:49Z","timestamp":1789769749000},"page":"617-627","source":"Crossref","is-referenced-by-count":0,"title":["Who\u2019s hurt most by debt? Life course adversity and the debt gap in midlife health"],"prefix":"10.1332","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7392-6937","authenticated-orcid":true,"given":"Joseph D.","family":"Wolfe","sequence":"first","affiliation":[{"name":"https:\/\/dx.doi.org\/https:\/\/ror.org\/008s83205University of Alabama at Birmingham, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6679-3125","authenticated-orcid":true,"given":"Shawn","family":"Bauldry","sequence":"additional","affiliation":[{"name":"https:\/\/dx.doi.org\/https:\/\/ror.org\/05p8z3f47Purdue University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"165","reference":[{"key":"CIT0001","series-title":"Social Science & Medicine","first-page":"94","article-title":"Conditional health-related benefits of higher education: an assessment of compensatory versus accumulative mechanisms","volume":"111","author":"Bauldry, S.","year":"2014","unstructured":"Bauldry, S. (2014) Conditional health-related benefits of higher education: an assessment of compensatory versus accumulative mechanisms, Social Science & Medicine, 111: 94\u2013100, doi: 10.1016\/j.socscimed.2014.04.005"},{"issue":"15","key":"CIT0002","series-title":"Proceedings of the National Academy of Sciences","first-page":"7266","article-title":"Parental divorce is not uniformly disruptive to children\u2019s educational attainment","volume":"116","author":"Brand, J.E.","year":"2019","unstructured":"Brand, J.E., Moore, R., Song, X. and Xie, Y. (2019) Parental divorce is not uniformly disruptive to children\u2019s educational attainment, Proceedings of the National Academy of Sciences, 116(15): 7266\u201371, doi: 10.1073\/pnas.1813049116"},{"key":"CIT0003","series-title":"Annual Review of Sociology","first-page":"487","article-title":"The intersection of gender and race in the labor market","volume":"29","author":"Browne, I.","year":"2003","unstructured":"Browne, I. and Misra, J. 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