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ACCI 2026 Conference

April 13–15, 2026

Hilton Long Beach, Long Beach, CA, USA

IMPORTANT NOTICE: The date, time, and room assignment of YOUR presentation is SUBJECT TO CHANGE.

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A4c Material hardship, risky health behaviors, and mental health

Tuesday, April 14, 2026 at 8:30 AM–10:00 AM PDT
Room 4
Short Description

This study investigates the relationship between material hardship and population-level mental health outcomes, focusing on depression and frequent mental distress (FMD). Drawing on the stress process framework, we examine whether risky health behaviors—smoking, binge drinking, and physical inactivity—mediate these associations. We constructed a geo-coded dataset by merging tract-level estimates from the 2024 CDC PLACES release with sociodemographic indicators from the 2022 American Community Survey. Structural Equation Models (SEMs) were estimated with a latent construct of material hardship composed of housing instability, utility threats, transportation barriers, SNAP reliance, and lack of insurance. Results show that material hardship is associated with higher prevalence of depression and FMD. Smoking emerges as a key mediator, exerting a large and positive indirect effect, while binge drinking and physical inactivity exhibited negative effects that modestly attenuate overall associations. These findings highlight smoking as a critical behavioral pathway linking hardship to mental health burdens. This study calls for coupling economic supports with integrated behavioral health interventions and expanding smoking cessation and physical activity programs to reduce the mental health effects of economic hardship.

Type of presentation

Accepted Oral Presentation

Submitter

Tae-Young Pak, PhD, Sungkyunkwan University

Authors

Youngjoo Choung, Inha University
Dr. Swarn Chatterjee, PhD, University of Georgia
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