Moderation of financial stress and cardiovascular disease risk in black catholics: A social-ecological pathway utilizing latent class and structural equation analyses.

BACKGROUND: Chronic financial stress drives cardiovascular disease (CVD), yet its impact within Black Catholic communities remains understudied. Using a profile-based, socio-ecological framework, we centered chronic financial stress and low Mental Component Summary (MCS) scores, as correlates of downstream health risk, and we modeled racial discrimination as an upstream moderator that intensifies this trajectory.

METHODS: Cross-sectional data from 285 racially and religiously diverse adults were analyzed. Latent class analysis (LCA) identified distinct stress profiles, and structural equation modeling (SEM) tested pathways from financial stress, perceived stress, discrimination, and low MCS to a Black Catholic profile and subsequent chronic stress risk (CHRONRSK). Model fit was evaluated with χ², RMSEA, CFI, TLI, and SRMR indices; indirect effects were estimated with bias-corrected bootstraps.

RESULTS: LCA revealed three profiles-Chronic, Life Trauma, and Daily Hassles. The SEM containing financial stress and discrimination showed excellent fit (χ²(3)= 3.98, p = .26; RMSEA = .034; CFI = .979), whereas substituting the Perceived Stress Scale (PSS) produced poor fit (RMSEA = .131; CFI = .747). Financial stress (β = .124, p = .045) and discrimination (β = .227, p < .001) significantly predicted the Black Catholic profile, which strongly predicted chronic stress (β = .761, p < .001). Low Mental Component Summary scores neither predicted the profile (β = -.009, p = .75) nor mediated the pathway. PSS was uninformative, reinforcing that these downstream health risks stem from upstream structural forces, not individual psychology.

CONCLUSIONS: Ninety percent (90.6%) of low-income Black Catholics fell below the national averages for Mental Component Summary scores. Chronic financial stress explained nearly half of this mental-health disparity (η² = 0.489)-evidence that upstream burdens, not individual pathology, drive downstream outcomes. For Black Catholics, chronic financial stress and racial discrimination-rather than generalized stress (PSS) or isolated mental-health scores-emerge as the most salient yet under-recognized moderators of chronic financial-stress risk. These findings call into question the adequacy of conventional stress models and underscore the need for upstream, equity-driven interventions. Public health strategies must advance upstream structural interventions to counter systemic forces sustaining financial stress and CVD risk.