Economic Hardship Index in United States

United States

The economic hardship index compares economic conditions between communities. The measure combines six population-level social and economic measures, providing a more comprehensive picture of the difficulties faced in a community than a single measure could provide. The measure includes:

• Unemployment: Proportion of the population ages 16-64 that is unemployed. Unemployment places financial stress on individuals and their families, leading to community-wide impacts.
• Dependency: Proportion of the population younger than 18 or older than 64. While having dependents can be a positive experience, there are also hardships associated with caring for them. Taking care of an aging parent costs approximately $7,200 annually. Meanwhile, the cost of raising a child from birth to age 17 has risen sharply in just the last few years, to an estimated average of $310,605.
• Education: Proportion of the population ages 25 and older without a high school degree. More education leads to better job prospects and higher income, though this can vary depending on other factors such as industry and location.
• Per capita income: The community’s per capita income, averaged by dividing the sum total income of that population by the number of people in it. It is a measure that represents the relative wealth of the community.
• Crowded housing: Proportion of housing units with more than one person per room. Living in a home with multiple occupants per room can negatively impact mental health, sleep and relationships.
• Poverty: Proportion of the population living below the poverty level. There is strong evidence linking poverty with adverse health outcomes.

Income inequality can cause chronic stress, which contributes to poor health outcomes and decreased life expectancy, educational attainment and social mobility. Income inequality is also associated with increases in mental illness, obesity, infant mortality, teenage births, homicides and imprisonment.

Economic hardship and its indicators tend to be clustered geographically, reflecting pockets of hardship and contrasting areas of concentrated wealth. American Indian/Alaska Native, Black and Hispanic adults are disproportionately affected by the social and health inequities that comprise economic hardship. The effects of structural racism and health inequities are evident in the higher rates of poverty, unemployment, crowded housing and lower per capita income among racial and ethnic minority groups.

The economic hardship index is sensitive to interventions that affect any of its six underlying components. Unemployment, education, housing and poverty can all be improved through targeted interventions.

Employment and poverty are key social determinants of health in Healthy People 2030’s economic stability domain. Related objectives include:

• Increasing employment among the working-age population. 
• Reducing the proportion of people living in poverty. 
• Increasing the proportion of students who graduate high school in four years with a regular diploma.

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