Financial Toxicity and Depression among Florida Hispanics: Comparing Pre-pandemic (2017–2018) and Post-pandemic (2022–2023) Cohorts
Presented by Carlos Acosta Batista
Background
Financial toxicity is a critical social determinant of health, yet its impact on Hispanic psychiatric resilience remains undercharacterized. This study aims to quantify the association between financial toxicity and depression among Florida Hispanic adults, examining the modifying role of age across pre-pandemic (2017–2018) and post-pandemic (2022–2023) cohorts.
Methods / Case Presentation
A repeated cross-sectional analysis was conducted using CDC Behavioral Risk Factor Surveillance System (BRFSS) data for Florida. Financial toxicity was defined as the inability to afford medical care. Disparities were quantified using Mantel-Haenszel adjusted odds ratios (aOR). To stabilize post-pandemic sample variance, a Bayesian parameter estimation was implemented, utilizing pre-pandemic risk as an informative prior to calculate Posterior Odds Ratios and 95% Credible Intervals (CrI).
Results / Findings
Overall, financial toxicity doubled the odds of psychiatric morbidity (aOR=2.00). Post-2020, this association was mitigated among young Hispanic adults (18–24 years), demonstrating strong post-pandemic resilience (Posterior OR=1.64). Conversely, in the geriatric cohort (≥65 years), economic insolvency emerged as a severe exacerbating factor (Posterior OR=2.74), quadrupling the crude odds of clinical depression in this subgroup.
Discussion & Conclusion
The cultural shield of the "Hispanic Paradox" is highly permeable to structural economic disparities. While young adults demonstrated post-pandemic resilience, economic insolvency shattered the psychiatric safety nets of older Hispanics. It is imperative to implement routine primary care screening to identify financial barriers in geriatric populations, preventing healthcare access disparities from calcifying into psychiatric morbidity.