The document summarizes research on the relationship between health and wealth. It provides an overview of several studies conducted using data from the Personal Health and Finance Quiz. The studies found moderate positive associations between health and financial behaviors. Participants who engaged in planning, budgeting and other disciplined behaviors tended to score higher on both health and financial measures. The research implications are that health and financial education programs should consider integrating these topics.

1. Improving Health and
Increasing Wealth:
Informing Programs
With Research Insights
Barbara O’Neill, Ph.D., CFP®, Rutgers University
boneill@njaes.rutgers.edu
@moneytalk1 (Twitter)

2. “The Greatest Wealth is Health”
Virgil (BC)

3. Objectives
• Provide a brief review of research on health and
wealth associations
• Provide a description of the Personal Health and
Finance Quiz
• Provide quiz research findings to date
• Provide research implications

4. Health and Wealth Relationships
• The “cost” of better health is the need for greater wealth
(higher total lifetime health care costs for healthier people)
– More years of out-of-pocket expenses
– Increased likelihood of chronic condition in later life
– Increased likelihood of need for long-term care
– http://crr.bc.edu/wp-content/uploads/2010/05/IB_10-8.pdf (Sun, Webb, & Zhivan, 2010)
• Healthy living habits improve during tough economic times
– http://www.stlouisfed.org/publications/re/articles/?id=2018
– http://libres.uncg.edu/ir/uncg/f/C_Ruhm_Healthy_2005.pdf (Ruhm, 2005))

5. Retirement Plan Savings and
Health Behavior Study
• Published in Psychological Science in 2014:
http://pss.sagepub.com/content/early/2014/06/25/0956797614540467.abstract
• An employee’s decision to contribute to a 401(k) predicted action to
correct poor physical health indicators that were revealed during an
employer-sponsored health examination
• Employees who saved for the future in a 401(k) showed
improvements in abnormal blood-test results and health behaviors
about 27% more often than non-contributors did
• Findings were attributed to individuals’ time-discounting trait that
predicts long-term behavior

6. Information Search: Another
Health and Personal Finance Link
• 2015 Study by Carr et al.: Individuals who engage in
health search behaviors (e.g., reading nutrition details of
food labels) are more likely to engage in financial planning
activities
• Financial planning was proxied through five different
retirement readiness activities
• N = 4,825 cases
• Cognitive process had significant health-wealth
relationship but direct physical activities (e.g., diet and
exercise) did not
http://afcpe.org/assets/pdf/volume_26_1/pages_3-16.pdf

7. Results from the Personal
Health and Finance Quiz

8. Data Set: Personal Health and
Finance Quiz
http://njaes.rutgers.edu/money/health-finance-quiz/
• Believed to be FIRST publicly available combined online health and
personal finance behavioral practice assessment tool; IRB approved
at Rutgers
• Three distinct uses:
– Stand-alone self-assessment tool for users
– To collect data for research
– For educators to use for SSHW program evaluation (pre- and
post-program score)

9. Key Points About the Quiz
• High quiz score: Respondent is frequently performing
activities that health and financial experts recommend
• Quiz questions: “Step in the right direction” activities; not
necessarily at the highest recommended level
– Example: Investing $3,650 annually for retirement

10. Personal Health and Finance
Quiz: Health Questions1 = Never
2 = Sometimes
3 = Usually
4 = Always
Daily Health Behaviors:
___ 1. I eat breakfast before starting my day (e.g., work, school, or other daily activities).
___ 2. I avoid drinking sugar-sweetened beverages (e.g., regular soda and sweetened coffee, tea, or waters).
___ 3. I eat 3 ½ to 4 ½ cups of fruits AND vegetables daily.
___ 4. I get at least 7 hours of sleep per night.
___ 5. I eat at least 1-2 high fiber foods each day (e.g., whole wheat bread and pasta, oat bran, beans, lentils, peas)
___ 6. I eat and drink fat-free and/or low-fat dairy products.
___ 7. I avoid high-calorie salad dressings, gravies, spreads, and/or sauces.
___ 8. I eat foods that are low in fat and/or saturated fat.
___ 9. I get at least 30 minutes of aerobic and/or muscle-strengthening physical activity at least 5 days per week.
___ 10. I read the Nutrition Facts Label on food products before making a purchase
Health Score: __________
• 10-16 points- Your health choices could be better, but don’t despair. It’s never too late to take action to improve your health.
• 17-24 points- You are doing a fair job of managing your health practices and have taken some steps in the right direction.
• 25-32 points- You are doing a good job and are above average in managing your health.
• 33-40 points- You are in excellent shape managing your health. Keep up the good work!
• Note: Items that you scored with a 1 or 2 are actions that you should consider taking in the future to improve your health.

11. Personal Health and Finance
Quiz: Finance Questions
Daily Financial Behaviors:
___ 11. I follow a hand-written or computer-generated spending plan (budget) to guide my spending and savings.
___ 12. I maintain an emergency fund equal to at least three months of basic, essential household expenses.
___ 13. I save the equivalent of at least $1 daily ($365 annually) in loose change in a savings account and/or or jar.
___ 14. I invest the equivalent of at least $10 daily ($3,650 annually) in investment accounts and/or retirement plans.
___ 15. I avoid payday loans, car title loans, pawn shop loans, cash advances, tax refund loans, and other high-cost debt.
___ 16. I owe less than 20% of my monthly net income on monthly consumer debt payments (e.g., credit cards, car loans) ___
___ 17. I eat at least two meals a day prepared at home instead of eating out (excluding traveling).
___ 18. I use advertisements, coupons, promo codes, sales, web sites, and/or discounts to save money on purchases.
___ 19. I live below my means (i.e., spend less than I earn).
___ 20. I make written “to do” lists or specific plans to organize my financial goals, spending, and/or daily activities.
Financial Score: __________
Score Interpretation
• 10-16 points- Your financial choices could be better, but don’t despair. It’s never too late to take action to improve your finances.
• 17-24 points -You are doing a fair job of managing your personal finances and have taken some steps in the right direction.
• 25-32 points -You are doing a good job and are above average in managing your finances.
• 33-40 points -You are in excellent shape managing your finances. Keep up the good work!
Note: Items that you scored with a 1 or 2 are actions that you should consider taking in the future to improve your personal finances.
TOTAL (Health + Financial) Score: __________

12. Rutgers Quiz Research
Research Papers
• O’Neill, B., Xiao, J.J., & Ensle, K. (2016a). Propensity to plan: A key to health and wealth? Journal of
Financial Planning, 29(3), 42-50. Retrieved from https://www.onefpa.org/journal/Pages/MAR16-
Propensity-to-Plan-A-Key-to-Health-and-Wealth.aspx.
• O’Neill, B., Xiao, J.J., & Ensle, K. (2016b). Positive health and financial behaviors: The impact of time
expenditure behavior and avoidance. Journal of Personal Finance, 15(2), 41-51. Retrieved from
http://www.iarfc.org/documents/issues/Vol%2015%20Issue2.pdf
• O’Neill, B., Xiao, J.J., & Ensle, K. (2017). Positive health and financial practices: Does budgeting make a
difference? Journal of Family and Consumer Sciences, 109(2), 27-36.
• O’Neill, B., Xiao, J.J., & Ensle, K. (2017). Improving Health and Increasing Wealth: Research Insights
and Program Outreach. Journal of NEAFCS, 17, 11-23. Retrieved from
http://www.neafcs.org/assets/documents/journal/2017%20jneafcs%20final%202.pdf.
• O’Neill, B., Xiao, J.J., & Ensle, K. (2017). Reading nutrition labels: A predictor of health and wealth?
Manuscript accepted for publication by the Journal of Human Sciences and Extension (October 2018).
• O’Neill, B., Xiao, J.J., & Ensle, K. (2018). Positive Financial Practices: Do Diet, Sleep, and Physical
Activity Make a Difference? Accepted as a poster for 2018 ACCI annual meeting and submitted to
Journal of Family and Consumer Sciences.
Overview Paper
• O’Neill, B. & Ensle, K. (2015). Personal health and Finance Quiz: A tool for outreach, research, and
evaluation. Journal of Human Sciences and Extension, 3(1). Retrieved from
https://media.wix.com/ugd/c8fe6e_25e2da24fc874dc58b88bd525acbb340.pdf.

13. #1: Planning Study
• Correlation of .463 between health behavior index (9
behaviors) and financial behavior index (9 behaviors);
moderate + association
• Lowest average quiz score (health behavior): eating 3 ½ to
4 ½ cups of fruits and vegetables daily
• Lowest average quiz score (financial behavior): following a
spending plan
• N = 942 (7/1/14-6/30/15 data)
O’Neill, B., Xiao, J.J., & Ensle, K. (2016, March). Propensity to plan: A key to health and wealth?
Journal of Financial Planning: https://www.onefpa.org/journal/Pages/MAR16-Propensity-to-
Plan-A-Key-to-Health-and-Wealth.aspx

14. All Three Hypotheses Supported
• Respondents who reported frequent planning
behavior had higher health behavior scores than
others
• Respondents who reported frequent planning
behavior had higher financial behavior scores
than others
• Respondents who had higher health behavior
scores also had higher financial behavior scores

15. #2: Time/Avoidance Behavior Study
• This study explored relationships between positive personal health
and financial practices that involve a routine time expenditure (e.g.,
30 minutes of physical activity and eating 2 meals per day prepared
at home) and those that involve avoidance of negative behaviors
(e.g., avoiding sugar-sweetened beverages and high cost debt)
• Same data set (942 observations)
• Correlational and multivariate analyses indicated weak, but positive
and statistically significant, relationships between health and
financial behaviors that involve a time commitment and those that
involve avoidance of certain negative practices
• White respondents and those with higher incomes and educational
levels were more likely than their respective counterparts to perform
recommended health and financial practices

16. #3: Budgeting Study
• Same data set (N =942)
• Explored relationships between the practice of following a formal
budget and frequency of performance of positive personal health
and financial practices
• Findings of multivariate analyses indicated positive and statistically
significant relationships between the practice of using a budget and
eighteen positive health and financial practices
• Specifically, the results suggested that consumers who reported
following a budget more often scored higher in both the health and
financial practice indexes
• Budgeting and weight control both require discipline. People who
budget their money may be inclined to budget their calories; i.e.,
have a daily calorie “allowance”

17. #4: Nutrition Label Study
• New data set (7/15-7/16); N = 3,414
• Support was found for four hypotheses:
– There are differences in demographic characteristics
between those who read Nutrition Facts labels and
others (i.e., female, older, higher education and income)
– Respondents who reported reading nutrition labels had
higher health practice scores and higher financial
practice scores than others
– Respondents who reported higher health practice
scores also had higher financial practice scores

18. #5: Diet, Sleep, and Physical
Activity Study
• Submitted for peer review
• Sample of 8,128 persons who completed the survey
instrument from July 2015 through June 2017.
• Four independent variables (diet index, time index,
sleep, and physical activity) showed positive associations
with positive financial behaviors
– Time Index: sleep and physical activity combined, both of
which take time to perform
• Dependent variable: an index comprised of ten positive
financial behaviors

19. #6: Emergency Funds, Cash Flow,
Saving, and Investing Study
• Submitted for peer review
• Same sample of 8,128 persons (7/15-6/17 respondents)
• Four independent variables (emergency fund, cash flow,
saving, and investing) showed positive associations with
positive health behaviors
• Higher ages and incomes were also associated with
performance of recommended health behaviors
• Dependent variable: an index comprised of ten positive
health behaviors

20. Personal Health and Finance Quiz
Research Summary
• All hypotheses to date have been supported (6 studies)
• Results clearly show associations between health and
financial practices at the individual level
• Personal traits such as discipline, future-mindedness, and
conscientiousness may be a key factor
• Behavior changes may require personalized education,
coaching, and/or mentoring
• Educators and researchers should consider integrating
health and finances in educational programs and research

21. Good Conversation Starter for Financial
Education and Counseling Clients
“Tell me what you are doing to take care of your health” (vs.
“Are you taking care of your health?”)
“Tell me” statements…
 Are less threatening than asking a question
 Express practitioners’ personal interest in clients
 Cannot be answered in a few words
 Can help practitioners better understand their clients

22. Questions and
Comments?
Barbara O'Neill, Ph.D., CFP®, CRPC
Extension Specialist in Financial Resource Management
and Distinguished Professor, Rutgers University
Phone: 848-932-9126
E-mail: boneill@njaes.rutgers.edu
Internet: http://njaes.rutgers.edu/money/
https://njaes.rutgers.edu/sshw/