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.

Accepted Oral Presentation