Contribution of the Lions Quest Programme "Skills for Action" to the Social-Emotional Learning of Secondary School Students.

It is proposed that up to 85% of health is determined by unmet social needs, or social determinants of health (SDOH) (Fenton, ). Economic stability is a SDOH and an important driver for the health disparities observed in low-income individuals (Kessler & Clearly, , Metlock et al., ; Seeman & Crimmins, ; Turner et al., ). The relationship between income and health falls on a socioeconomic spectrum and the gradient appears to be a stronger predictor of health than race or ethnicity (Woolf et al., ). In fact, the County Health Rankings Model assigns social and economic factors a weight of 40% for overall health, half of which is comprised by income and employment (Hood et al., ). Social Determinants of Health are considered a public health priority. In the United States, the Healthy People, framework emphasize SDOH as an approach to addressing health equity and disease prevention ((U.S. Department of Health and Human Services, ). Financial stress has been operationalized as “the physical or mental health symptoms that arise from having difficulty meeting basic needs, difficulty paying bills, and money leftover at the end of the month” (Friedline et al., ). Financial stress has been implicated in cardiovascular disease risk (Eaker et al., ; Ma et al., ; Rosengren et al., ). A recent study found that chronic financial stress was associated with elevated risks of stroke, myocardial infarction, and heart failure (Ma et al., ). A review of literature from 2010–2019 indicated that women have poorer physical and mental health because of financial stress when compared to males. Financial stress has historically impacted a disproportionate number of women and minorities, especially African Americans. Data from the 2017 Diary of Consumer Payment Choice indicated a mean savings of $2,173 for African Americans versus $13,564 for Whites (Stavins, ). Likewise, more African Americans are unable to save at all as compared to Whites (39.9% versus 22.4%) (Stavins, ). Economic stress is on the rise in the United States. In 2019, 46% of Americans reported economic stress which increased to 63% in 2020 (presumably due to COVID-19), and increased further to 75% in 2025 (American Psychological Association, ; American Psychological Association, ). Not only did COVID-19-associated job loss impact women and low-income individuals more than others, the economic fallout impacted these individuals disproportionately, too (Parker et al., ). Compared to middle-income households, low-income households were more likely to report using money from savings or retirement to pay bills, had trouble paying bills, or had trouble paying rent or mortgage while women were more likely to report trouble paying bills compared to men (Parker et al., ). Persons under financial strain are more likely to engage in smoking, alcohol consumption, overspending, poor diet, and reduced exercise (Probst et al., ; Vohs, ). This can be explained by the limited-resource model of self-control that suggests self-control is a limited resource and depletion leads to decision fatigue (Mullainathan & Shafir, ). Because of less money, food, and bandwidth, low-income individuals make more difficult decisions more frequently than individuals with higher incomes. This increased behavior regulation depletes mental function, exhausts self-control, and leads to behaviors that are harmful to financial and physical health. Such “bandwidth tax” (Mullainathan & Shafir, , p. 39) is also why interventions to promote health in low income individuals are often unsuccessful (Mullainathan & Shafir, ; Pearlin et al., ). A modality to address the limitations of other health interventions in single mother, low-income, households is the Financial Success Program (FSP).