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Financial, housing, food, and healthcare insecurities and their independent and joint associations with depressive symptoms and stress in a U.S. cohort of adults with and without HIV

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dc.contributor.coauthorBethancourt, H. J.
dc.contributor.coauthorRichards, A. L.
dc.contributor.coauthorNorcini-Pala, A.
dc.contributor.coauthorMaya, S.
dc.contributor.coauthorPalar, K.
dc.contributor.coauthorWhittle, H. J.
dc.contributor.coauthorKempf, M. C.
dc.contributor.coauthorWu, K. C.
dc.contributor.coauthorKizer, J. R.
dc.contributor.coauthorTien, P. C.
dc.contributor.coauthorHanna, D. B.
dc.contributor.coauthorAppleton, A. A.
dc.contributor.coauthorMerenstein, D.
dc.contributor.coauthorD'Souza, G.
dc.contributor.coauthorOfotokun, I.
dc.contributor.coauthorKonkle-Parker, D.
dc.contributor.coauthorMichos, E. D.
dc.contributor.coauthorKrier, S.
dc.contributor.coauthorStosor, V.
dc.contributor.coauthorWeiser, S. D.
dc.contributor.coauthorFrongillo, E. A.
dc.contributor.departmentDepartment of Psychology
dc.contributor.kuauthorTuran, Bülent
dc.contributor.schoolcollegeinstituteCollege of Social Sciences and Humanities
dc.date.accessioned2026-07-17T08:29:02Z
dc.date.issued2026
dc.description.abstractFinancial, housing, food, and healthcare insecurities are prevalent forms of material-need insecurity (MNI) in the U.S. that often co-occur, with significant consequences for health. We investigated how these MNIs overlap and relate jointly and independently to mental health among people with and without HIV enrolled in the MACS/WIHS Combined Cohort Study (MWCCS). Confirmatory bifactor analyses were used to examine how much unique variability remained in subfactors for financial, housing, food, and healthcare insecurities after accounting for common, underlying material hardship, described herein as overall MNI severity (n = 2433). Structural equation models tested how overall and specific MNI severity relate independently to depressive symptoms, as measured by the Center for Epidemiologic Studies Depression scale, and perceived stress, as measured by the Perceived Stress Scale, adjusting for income and other socioeconomic covariates. Most of the variance in financial (76.2%), housing (88.7%), food (55.7%), and healthcare insecurity (64.4%) was explained by overall MNI severity, which was strongly related to depressive symptoms (standardized β: 0.508, SE: 0.028, p
dc.description.harvestedfromManual
dc.description.indexedbyWOS
dc.description.indexedbyScopus
dc.description.indexedbyPubMed
dc.description.publisherscopeInternational
dc.description.readpublishN/A
dc.description.sponsoredbyTubitakEuN/A
dc.description.sponsorshipData in this manuscript were collected by the MACS/WIHS Combined Cohort Study (MWCCS). The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institutes of Health (NIH). MWCCS (Principal Investigators): Atlanta CRS (Cecile Lahiri, Anandi Sheth, and Gina Wingood), U01-HL146241; Baltimore CRS (Todd Brown and Joseph Margolick), U01-HL146201; Bronx CRS (Kathryn Anastos, David Hanna, and Anjali Sharma), U01-HL146204; Brooklyn CRS (Deborah Gustafson and Tracey Wilson), U01-HL146202; Data Analysis and Coordination Center (Gypsyamber D'Souza, Stephen Gange and Elizabeth Topper), U01-HL146245; Chicago-Northwestern CRS (Steven Wolinsky, Frank Palella, and Valentina Stosor), U01-HL146240; Northern California CRS (Bradley Aouizerat, Jennifer Price, and Phyllis Tien), U01-HL146333; Metropolitan Washington CRS (Seble Kassaye and Daniel Merenstein), U01-HL146203; Pittsburgh CRS (Jeremy Martinson and Charles Rinaldo), U01-HL146208; UAB-MS CRS (Mirjam-Colette Kempf, James B. Brock, Emily Levitan, and Deborah Konkle-Parker), U01-HL146192. The MWCCS is funded primarily by the National Heart, Lung, and Blood Institute (NHLBI), with additional co-funding from the Eunice Kennedy Shriver National Institute Of Child Health & Human Development (NICHD), National Institute On Aging (NIA), National Institute Of Dental & Craniofacial Research (NIDCR), National Institute Of Allergy And Infectious Diseases (NIAID), National Institute Of Neurological Disorders And Stroke (NINDS), National Institute Of Mental Health (NIMH), National Institute On Drug Abuse (NIDA), National Institute Of Nursing Research (NINR), National Cancer Institute (NCI), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute on Deafness and Other Communication Disorders (NIDCD), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institute on Minority Health and Health Disparities (NIMHD), and in coordination and alignment with the research priorities of the National Institutes of Health, Office of AIDS Research (OAR). MWCCS data collection is also supported by UL1-TR000004 (UCSF CTSA), UL1-TR003098 (JHU ICTR), P30-AI-050409 (Atlanta CFAR), P30-AI-050410 (UNC CFAR), P30-AI-027767 (UAB CFAR), UL1-TR001409 (DC CTSA), KL2-TR001432 (DC CTSA), and TL1-TR001431 (DC CTSA).This research was also supported by grant number R01-HL155226 (NHLBI), K01-MH125724 (NIMH) and R01-MH131177 (NIMH).This work was facilitated though the use of advanced computational, storage, and networking infrastructure provided by the Center for Studies in Demography & Ecology at the University of Washington, which is supported by a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828, as well as the College of Arts & Sciences, the UW Provost, eSciences Institute, the Evans School of Public Policy & Governance, College of Built Environment, School of Public Health, the Foster School of Business, and the School of Social Work. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.The authors gratefully acknowledge the contributions of the study participants and dedication of the staff at the MWCCS sites.
dc.description.versionPublished Version
dc.identifier.ScopusPercentile98
dc.identifier.ScopusQuartileQ1
dc.identifier.WoSPercentile92.7
dc.identifier.WoSQuartileQ1
dc.identifier.doi10.1016/j.socscimed.2026.119408
dc.identifier.eissn1873-5347
dc.identifier.embargoN/A
dc.identifier.grantnoP30-AI-050409
dc.identifier.grantnoUL1-TR003098
dc.identifier.grantnoP30-AI-050410
dc.identifier.grantnoKL2-TR001432
dc.identifier.grantnoR01-MH131177
dc.identifier.grantnoR01-HL155226
dc.identifier.grantnoUL1-TR001409
dc.identifier.grantnoTL1-TR001431
dc.identifier.grantnoP30-AI-027767
dc.identifier.issn0277-9536
dc.identifier.pubmed42224814
dc.identifier.scopus2-s2.0-105040669012
dc.identifier.urihttp://doi.org/10.1016/j.socscimed.2026.119408
dc.identifier.urihttps://hdl.handle.net/20.500.14288/33434
dc.identifier.volume403
dc.identifier.wos001789020500001
dc.keywordsFinancial insecurity
dc.keywordsHousing insecurity
dc.keywordsFood insecurity
dc.keywordsHealthcare insecurity
dc.keywordsMental health
dc.keywordsIntersecting needs
dc.keywordsBifactor models
dc.languageeng
dc.publisherElsevier
dc.relation.affiliationKoç University
dc.relation.collectionKoç University Institutional Repository
dc.relation.ispartofSocial Science and Medicine
dc.relation.openaccessN/A
dc.rightsN/A
dc.rights.uriN/A
dc.subjectOccupational health
dc.subjectBiomedical social sciences
dc.titleFinancial, housing, food, and healthcare insecurities and their independent and joint associations with depressive symptoms and stress in a U.S. cohort of adults with and without HIV
dc.typeJournal Article
dspace.entity.typePublication
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