Economic Instability is a Public Health Emergency – and Financial Capability Services Can Drive Lasting Solutions

Cliff’s Notes Summary: Financial Instability — America’s Overlooked Public Health Emergency

The Core Argument

• Financial instability is a chronic public health threat affecting tens of millions through housing insecurity, medical debt, poor nutrition, and rising mental and physical illness
• It meets criteria for a Public Health Emergency (PHE) under Section 319 of the Public Health Service Act and the requirements of declaring a state or local PHE.
• If declared, it would be the second-largest PHE in U.S. history, behind COVID-19 – yet one of the most preventable.

Social Determinants of Health (SDOH) Connection

The CDC outlines five core SDOH – all deeply affected by financial instability:

1. Economic Stability – Financial hardship causes food insecurity, utility shutoffs, evictions, and stress.
2. Education Access & Quality – Financial barriers reduce access to quality education and perpetuate poverty cycles.
3. Health Care Access – Millions delay care or lack insurance due to costs.
4. Neighborhood Conditions – Low-income areas face environmental hazards, violence, and housing instability.
5. Social & Community Context – Financial hardship increases stress, isolation, and mental health decline.

Precedents for Declaring Public Health Emergencies

• Past federal PHE declarations include the Opioid Epidemic and the Youth Mental Health Emergency – both based on non-infectious, system-level threats.
  
• Financial instability fits the same model: systemic, generational, and tied to measurable health deterioration.
• Declarations have also occurred at state and local levels for crises like gun violence, vaping, and homelessness.

The Solution: Financial Education & Counseling

Proactive Strategy – Financial Education

• Mandate financial education in schools from K–12 through college.
  
• Teach budgeting, credit, insurance, and decision-making early to reduce long-term health and financial risk.
  
• Improve economic mobility and reduce reliance on emergency systems.

Reactive Strategy – Financial Coaching/Counseling

• Expand access to certified financial professionals in workforce, health, and social services.
  
• Help vulnerable adults reduce stress, set goals, and navigate crises.
• Proven effective by programs like the CFPB Financial Coaching Initiative.

Public Health Impact of Financial Capability Services

Financial education & counseling improves outcomes across all 5 SDOH:

• Stabilizes income and reduces need for social aid.
  
• Increases access to education and informed career choices.
  
• Improves use of healthcare by reducing cost-based avoidance.
  
• Supports housing stability through better planning and credit use.
• Builds healthier communities by reducing stress and increasing resilience.

Implementation Pathways

• Integrate financial capability services into:
• Public health systems (e.g., Medicaid, SNAP, TANF).
  
  • Schools and higher education.
    
  • Workforce development programs.
    
  • Housing and community-based nonprofits
    
• Require outcome-based measurement and long-term behavior change tracking.
• Fund through federal and state grants with PHE alignment.

Call to Action

We urge the U.S. Secretary of Health and Human Services to:

1. Declare financial instability a Public Health Emergency.
   
2. Recognize financial education and coaching as essential interventions.
   
3. Embed financial education into all major public systems.
   
4. Scale community-based programs through federal support.
5. Establish a national Financial Education Task Force.

Why It Matters

• Financial instability affects over 100 million Americans.
  
• Annual cost: estimated $2–3 trillion in lost productivity, health expenses, and social burden.
  
• Declaring a PHE would unlock funding, infrastructure, and urgency to respond effectively.
  
• Financial education is not just a solution – it’s prevention, empowerment, and equality.