E70: The Financial Domain of Stress

Kirtly: Welcome to the "7 Domains of Women's Health" podcast. We are continuing our deep dive into stress.

Did you know that 4 in 10 Americans would be unable to cover an unexpected expense of $400 without having to go into debt or use a credit card that they couldn't pay off that month? That's not a very big car repair or a visit to a doctor with some tests.

And many Americans are on the edge and very stressed financially. About one in five Americans have no emergency savings whatsoever. They may be one paycheck away from losing their car or their housing. And one in four Americans had to use emergency savings to cover living expenses in the last year. The median amount of emergency savings for men was $1,000, but for women, that's $500. So financial stress is a woman's issue.

I'm Dr. Kirtly Jones from obstetrics and gynecology at the University of Utah, and with me in the virtual studio is my co-host, Katie Ward. Katie is a women's health nurse practitioner and a specialist in midlife women's health with a doctorate in nursing practice and a good friend for almost 40 years.

This is the Kirtly and Katie show, and we're talking about financial stress.

Most people know the importance of having an emergency savings, but financial stress is huge, with 54% of Americans in a survey recently doubting that they could cover emergency expenses. With millennials, that's 60% who stress over financial worries.

I know that my family had financial worries when I was young. I was a saver, and my parents got me a bank account when I was little, and my mom often borrowed my babysitting money to cover groceries at the end of the month. So it must have been tight.

And I remember when my husband and I got our first jobs out of medical residency, and we moved to Utah and were looking to buy a house. The real estate agent kept showing us huge and very expensive houses, and I told her we were looking for a little bitty house in the $80,000 range. This was 40 years ago. And she kept showing us houses that we couldn't afford. She said we were an economic battleship. That's her quote. Unmarried couple with two fancy medical trainings.

Well, I knew we were a battleship with a torpedo-sized hole amidship, and we owed Harvard what was the equivalent of a quarter of a million dollars in today's money. So we couldn't afford those big houses, but she really wanted us to get one.

We finally found an agent who would listen to me and found us a little tiny home in our price range for which we had to take out a first and a second mortgage. We had no savings. We couldn't pay for our wedding and our rent in the same month.

So, Katie, you've had some short times too, huh?

Katie: Oh my gosh. And I probably wasn't as smart as you about saying, "Don't sell me that big house." But yeah, when I started out, right out of college . . . It's interesting. In college, student loans, there were sort of endless student loans, and I think any time I needed more money, I could borrow that somehow.

When I got out of college, the very first thing . . . In fact, I remember this vividly. I took my first paycheck, and I ran straight to the Subaru dealership, and I bought myself a brand-new car. I probably opened some credit cards. And then my student loans came due, and I was in over my head kind of before I knew it. I had obligations beyond what I was earning.

That was a lot of stress. I was nervous that my new car would be repossessed. I couldn't sell it because when it's brand new and you drive it off the lot, now you're completely upside down in it, and you have to pay to get out of it.

And so, yeah, I got in a cycle where I would pay one bill late so I could pay the other, and then sort of just juggle what was late this month from what was late that month. It just snowballs.

I remember getting collection calls from threatening companies and then trying to pick up extra work to make up some extra money or get a second job, but that meant I needed more childcare, or I had to work through the night and give up my sleep. I got to the point where I was pretty much on the verge of bankruptcy, and it was awful.

So, yeah, talking about just how finances cause stress, I look back on this as one of the most stressful times of my life. It's so easy because people are willing to lend you more money than you can pay back. And once you get behind, it's almost impossible to dig out.

And then there's another stress. There's a stress of being embarrassed about it.

Kirtly: Oh, yeah.

Katie: So that's the other thing of just not wanting to talk about it or admit to anybody where you are financially. In the end, I ended up using a credit counseling agency, and I think we'll talk about that in resources, but I can't say enough about that service. They offer a program where they get you on a debt management plan, and they negotiate down some of your interest rates and put you on a budget. You make one payment to them, and they pay all your creditors. And it took a long time, but I managed to get myself out of debt.

The other thing that happened was I married a very frugal person who wasn't okay with taking on more debt. So over the course of my life, my financial picture changed, and I got away from that stress of being in that place and kind of "Gone with the Wind" stuff.

Kirtly: Tomorrow is another day.

Katie: I'm not going back there again. So that financial peace of mind, I wish I could tell my young self . . . In fact, my water heater went out this morning, and I thought, "Not a problem. I can afford another water heater." That peace of mind is worth so much more than the new car. In fact, I've never ever bought another new car. I've bought nicer cars, but they're always quite used.

Kirtly: Yeah. Well, I think you're so right about the shame because people who have cancer or even if they're fighting with their beloved, they will talk to their girlfriends or their family or something. But there's something about financial distress that leads to isolation and shame. People just don't want to talk about it.

And I have great concerns about young people starting out as we were and what I call predatory lending, encouraging people to put things on credit that they can't afford. Or payday lending, for God's sake for people who are already underwater. This is a problem, and more and more people find themselves in this spiral.

Katie: The payday lending, that is just . . . I mean, if I could think of one issue that as a society we should really take a look at. There are emergencies, and fair enough if something comes up and you don't have the money and you need to borrow short-term. But I think banks and credit unions, that is a business model that I wish that they would offer of very short-term loans for people that maybe don't have the credit to take out a bigger loan, but to fill in that gap.

Those payday loan places, what people don't know is they're paying . . . I guess I don't know enough about it, but hundreds of a percentage of interest. It's not even 100%. It's like 400%. It's something astronomical.

Kirtly: It's almost like a mafia debt. It's a gambling debt. God.

Katie: But then their business model is to get you coming back. So you borrow some money from them, and then the next week they're like, "Oh, you can have some more. We'll roll your loan over and give you a little more extra money." And so people just get in a place where they absolutely can't get out of that cycle. That is a votable issue that I hope everybody's paying attention to.

Kirtly: So couples can combine their resources for rent and transportation, and they can do better than singles, for sure. But everyone does better as a group than single women with children. They are the most vulnerable, and they're the largest group of people who live under the poverty line. But couples admit that arguing over money and financial straits is one of the biggest causes of conflict in their relationship. It's a stress.

Katie: Yeah, for sure. I mean, there's the finances themselves, and then there is the differences in how you value money and the role it plays in your life and how much should you work and how much should you earn. That becomes a source of conflict in all couples of, "Can we afford this, or should we buy that?"

Kirtly: I think studies show it's the number one source of conflict in relationships, is money. But then you end up falling over into all the things that you might have a conflict about. So once you fight about money, then you fight about fighting styles, and you fight about sex, and you fight about everything.

Well, I'll admit that financial styles were a source of differences of opinion in my 50-year relationship. And my husband never subtracted his checkbook. So I would see him enter things, but he never subtracted. I know half the listeners don't even know what that means because they don't have a checkbook, and they can look online to see what they have, and they trust the bank. I never trusted the bank to get the numbers right.

So we had to come to an agreement about who took care of the money in our house. Of course, it was me. My husband never bought anything, and he believed in the New England motto of "use it up, wear it out, make it do, then do without." So he was a great person to be married to because he just never bought anything.

I had to sneak his holey t-shirts and underwear out of his drawer and into the rag pile. I guess his mom never convinced him always to have nice undies on in case you got into an accident. Was my mother the only one who said that? Did you ever hear that?

Katie: No, she did not.

Kirtly: Oh, no. My mom, who is from New England, said, "You always have to have your good undies on because you might get a car accident, and there you'll be with holey undies." Anyway . . .

Katie: I wish as I was getting into a relationship . . . On the one hand, getting married was certainly a really good thing for me financially for a lot of reasons, but we had different values around money. And now, you can go to a lot of websites . . . I mean, you can just put it in Google and say, "Questions to ask before you get into a relationship." But I think it's a really important conversation to have.

Even though you're in love and you think this is going to be the relationship you want for the rest of your life, I think it's really good for couples to sit down and talk about it.

And there are just some standard questions about do you know your credit score? Do you have a budget? How much money do you think you're going to need for retirement? What are your thoughts on debt, and how much debt are you comfortable with? And what are your credit card balances? And do you write the entries in the checkbook or use some kind of app to help you budget?

So I think knowing a little bit about how your partner manages money is important, but I think even deeper than that is what's your family's financial backstory?

You kind of just hit on this, and it's a thing I've been thinking about. Sometimes there's a generational influence. So for men, it might be that you saw your father, who was a workaholic, and he was working all the time to earn money for the family. And so you don't want to be like that. You want to have more time, and maybe that means giving up some money.

But your father might have been the way he was because his father didn't support his family. And so I think you see sometimes these generational changes in how people manage money.

So you were saying your mother raided your piggy bank, and now you're the one that's carefully managing the checkbook. My mother stressed about every single penny. She had this complicated budget book, and she'd write these numbers down in columns, and she was saving for Christmas and saving for birthdays, and she managed her money down to the half a cent. 

What I saw, the lesson I learned that was never really talked about was just that that was an awful lot of stress, and I wasn't going to have that. So I sort of swung in the opposite direction.

But my mother was the way she was because her mother was completely reckless with money. And I think my mother didn't want to be like her mother.

So I think those stories about where does your family come from and how did they get there are going to tell you a lot about your partner and understanding what those issues are when you do fight about money. Because it's not just the money. It's historical. 

Kirtly: There's been the question "Is there some amount of money that means people are not feeling financial stress? Is there a certain amount of money that buys happiness, and more than that, you don't get more happy?" One well-reported study from some years ago suggested that $75,000 a year led to peak financial happiness, and more than that didn't make people happier. That was a couple of years ago. But that seems to me kind of a low number.

And that's for one person. People who have a family with two kids on $75,000 a year, that's going to be still tight.

I think the current thoughts have changed that it might be more, and maybe it really boosts happiness up to an earnings of $500,000 a year. Meaning after $500,000 a year, it doesn't make you happier. Well, shoot, that is a boatload of money to me. And I think 98% of Americans are not going to make that much money each year.

So that means everybody would do a little bit better with a little bit more money. But the vast majority of Americans aren't going to get that $500,000 a year of peak financial security.

So let's get back to women and financial stress. Women are more likely to experience poverty and financial stress than men. And between 18- to 24-year-olds, 24% of women live below the poverty line. So a quarter of women between 18 to 24 live below the poverty line compared to 14% of men.

Of course, number of women over 75 living in poverty is 20% compared to 14%. And of course, children living in poverty with single mothers is stressful and leads to those adverse childhood events that can increase the risks of behavioral changes and health changes for the rest of their lives.

So the business of childhood poverty and young mothers in poverty can lead to long-term issues with the kids, if not just that they get weird about money because their mom was poor.

Katie: Yeah. I mean, the sad thing is women still earn less than men do for the same work. They're penalized for leaving the workforce sort of intermittently to take care of their children.

I think we've made some strategic mistakes in our country in terms of how we have funded our health care system so it's tied to your employment. So if you're not working full time with benefits, you're priced out of full-spectrum health insurance.

And so, yeah, women who are working part-time and the sole caregivers for their children, they may be going without insurance. Therefore, that woman is not having access to cancer screening or health advice or medications or vaccinations. And if money is tight, that affects your ability to purchase healthy food. And lots of data that junk food is cheaper than organic vegetables and milk.

Then there may not be enough money to put your kids in sports, and stress and disappointment and fighting about money. And these might not be adverse events data worthy, but they definitely have a negative effect on children's health and children's weight and the women's weight and all of the physical things that we talked about previously in the Physical Domain of Stress. Just, again, that kind of constant low-grade disappointment about . . .

And it's not that people who are poor don't know what healthy eating looks like or they're not trying, but they're just having to make economic decisions that are hard. It just piles on.

Kirtly: So for people who are listening, if you have some resources but you just can't seem to get your debt under control and it stresses you out, look for some financial advice. There can be free financial advisors at your bank. Katie found some at her credit card.

Or maybe you can go to mymoney.gov, and click on MyMoney Five & Tools. It's an online educational and practical way of learning how to manage your money. Put things down, make a budget so you learn where you can probably cut things out. There are probably some hidden fees just for your TV that you're not aware of.

But what can people do who are low income and experience acute financial stress? Well, every community has some resources. United Way's 211 hotline . . . Not 911. It's 211 hotline. It can reach people who can direct you to those resources. They include SNAP, which is Supplemental Nutrition Assistance Program, and TANF, which is Temporary Assistance for Needy Families, and Section 8 Housing Choice Voucher Program, and Legal Aid. Those are all federally funded but locally administrated programs for people who are at risk of no housing, at risk of no food, and at risk of money to pay for stuff.

There are some nonprofit organizations that can help low-income families in acute financial stress. There's the Single Parent Advocate at singleparentadvocate.org. Modest Needs, which can do a short bit of money, at modestneeds.org. The Dollar Energy Fund can help you pay your energy bills. And Neighborhood Works America. So there are nonprofits and the government . . . Believe it or not, the government is here to help you.

And if you can't find a way, just remember 211 will get you to a well-informed United Way operator who can help direct you to some of these things.

Katie: I want to put a plug in for the organization that . . . I mean, it's changed a little bit. My personal history was a long time ago, but consumercredit.com.

So some of the government programs I think you have to be really low-income to qualify for. So many people fall in the where they're not qualifying for some of that need-based aid, but aren't making enough money to get by. Consumer Credit is something that anybody can use. They've got an app now.

There are honestly a bunch of great tools. If you're not at that place where you're needing public assistance but you're just trying to get a handle on your own budget, Rocket Money is one that . . . It costs a little bit, but it sort of helps you pay attention to what's going on in your budget.

I signed up for an account, and they keep wanting to reduce my "Washington Post" subscription fee. And I'm like, "No, it's okay. I want to support the 'Washington Post.'" But they keep offering me ways they can cut my bills.

Kirtly: That's great. Think they'll work for my CenturyLink? I really want my CenturyLink connection.

Katie: Actually, that was another one. They told me that they could get a discount on my phone bill. I think some of these tools that are out there . . . I don't know how they subsidize that, but they do offer to negotiate some of your bills down for you.

And then there are a bunch of interesting tools also that help you save for retirement or save for those emergency expenses. Acorns is another app that I'm going to put a plug in for again because I actually use it. So they round up my spending. Whenever I run a charge through my checking account, they round it up to the nearest dollar. So it might be 2 cents or 15 cents. But they kind of hang on to that money, and then they put it in a little investment account for me.

Kirtly: Great name, Acorns, because they squirrel away a little bit for the winter, that rainy, cold day. That's a great idea.

Katie: Exactly. So they kind of hold on to it. When it's big enough, then they invest it in something. And then I've also set it up so it just plucks $5 out of my checking account each week. I mean, it adds up really fast and earns about 8% interest.

Kirtly: Eight percent?

Katie: Yeah.

Kirtly: Wow.

Katie: Between the investment side of it and the savings account side. There are a bunch of these little tools out there. They're not particularly painful to use, and it's kind of fun to start to see your money grow.

There's a bunch of interesting data about economic mobility for people, and there's been a real change. So if you were born in 1940, 92% of people born in 1940 were going to do better than their parents in terms of what they earned. And for people born when I was born, and I'll give away my age here, in the '60s, that number had dropped a bit. But now it's less than 50% of people who are going to earn more than their parents earn.

So for folks just up and coming in the world right now, there's a lot stacked against you. And so it's not just avocado toast or getting Starbucks coffee that's keeping people out of the housing market. Truly, the next generation is not doing better than their parents. And parents are living a long time and using up everything that they've saved for retirement because they live so long that they there's not money to pass on to the next generation.

And so there is a lot of financial stress. I'm glad we're talking about it. I'm glad we've been able to provide some resources that people can use. But these are big systemic problems.

Kirtly: The happiest nations on the planet are those who have foundational policies that help women and men and families avoid financial stress. They have good childcare so people can work, they have free healthcare, they have free post-secondary education.

Not everyone agrees, I know, with the ways these countries manage these resources for everyone. But these policies lead to less financial stress, more work security, and more happiness on a global scale for their nation.

So if you're facing financial stress, you don't have to do it alone, pretending it will go away. Ignoring your bills as they pile up isn't a good coping strategy. Look realistically at your resources and debt, and prioritize your expenses.

You can get help through your bank, or they may be able to refer you to a no-cost or low-cost financial help. Maybe it feels shameful, but you are in good company. Talk to your friends and family so you're not isolated. There are resources in your community that you can reach out to get you focused.

And if you're listening and have no financial stress, I'm happy for you. But consider helping out in your community in ways that are helpful for those who do. It will make everybody feel better.

So that wraps up the 7 Domains of Stress, the financial domain. And if you are just listening to the 7 Domains of Stress and this is your first episode, check out the other domains of stress. Katie and I will invite you to consider the ways that stress affects your life.

Listen to stress and all of our other topics on the "7 Domains of Women's Health" wherever you get your podcasts, or at womens7.com. Share these podcasts with friends and family, and use them to spark a conversation about stress. Thanks for listening.