Almost half of our sample of urban ED patients
reported at least one exposure to economic deprivation,
and almost a third reported tw^o or more
exposures to economic deprivation. The two most
common adverse financial circumstances among
these ED patients were an inability to afford needed
medications due to cost and an inability to see a doctor
when needed due to cost. We found a striking
dose response between the number of exposures to
economic deprivation and multiple markers of risk
for the leading causes of disease and death in adults.
Compared with patients unexposed to economic
deprivation, patients who had experienced five
categories of adverse financial circumstances had a
threefold increase in poor/fair self-rated health, a 17-
fold increase in depressed mood, a 24-fold increase in high stress, a sixfold increase in smoking, and a
fivefold increase in illicit drug use. These findings
suggest that the impact of economic deprivation on
patient health status is strong and cumulative.