Toward a conceptual framework of economic security for health research: a scoping review
Background Personal economic security, including stable income, employment, affordable housing, and protection against economic shocks, is fundamental to health. However, multiple and varied frameworks exist for defining or measuring economic security in health research and practice. Methods We conducted a scoping review of the economic (in)security literature published 2015–2025. We searched PubMed and PsycINFO for articles that defined or measured economic (in)security, or that examined the impact of economic (in)security on health-related outcomes. From 881 sources, 53 articles were reviewed. Definitions and methods of operationalizing economic security were extracted and coded based on thematic dimensions, domains, and sub-domains. Results There is wide variability in definitions and measurement of economic security. Economic security was defined multi-dimensionally across thematic domains, subjectivity and objectivity, and temporal dimensions (present versus future risk). Operationally, six domain areas of economic security were identified: income/finances, healthcare, employment, housing, food, and wealth/assets. Conclusions This six-domain framework of economic security for health research provides a foundation for more consistent measurement, improved intervention design, and specification of pathways linking economic conditions to health outcomes. Further investigation is needed to examine the framework's utility in elucidating economic security's multi-dimensional nature and devising measurement strategies to advance the science and practice of improving economic security.
Authors
- Kendra E. Pugh (ORCID: https://orcid.org/0000-0001-8509-6221)
- Mayumi Okada Gianoli (ORCID: https://orcid.org/0000-0002-3476-4143)
- Amanda K. Falcón (ORCID: https://orcid.org/0000-0001-5714-6391)
- Brian J. Stevenson (ORCID: https://orcid.org/0000-0002-1053-1927)
- James P. LePage (ORCID: https://orcid.org/0000-0003-4061-0121)
- Jack Tsai (ORCID: https://orcid.org/0000-0002-0329-648X)
- Marc I. Rosen (ORCID: https://orcid.org/0000-0002-5460-354X)
- Bo Kim (ORCID: https://orcid.org/0000-0001-7730-1627)
- Taylor Hunt
Institutions
- United States Department of Veterans Affairs (US)
- Harvard University (US)
- University of Massachusetts Chan Medical School (US)
- VA Boston Healthcare System (US)
- Yale University (US)
- VA Connecticut Healthcare System (US)
- VA North Texas Health Care System (US)
- The University of Texas Southwestern Medical Center (US)
- The University of Texas Health Science Center at Houston (US)
Publication Details
- Journal
- Frontiers in Public Health
- Published
- 2026-10-26
- DOI
- https://doi.org/10.3389/fpubh.2026.1887796
- Primary Topic
- Employment and Welfare Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00