Scoping Review Maps Six Domains of Economic Security for Health Research

Stable income, secure employment, affordable housing and protection against sudden financial shocks are widely recognized as foundations of health, yet researchers have lacked a common way to define and measure economic security. A new scoping review published in Frontiers in Public Health addresses that gap, proposing a six-domain conceptual framework intended to bring consistency to how the field studies the economic conditions that shape health outcomes.

The review, led by Brian Stevenson of Edith Nourse Rogers Memorial Veterans Hospital and the University of Massachusetts Chan Medical School, with colleagues from VA healthcare systems and academic centers including Harvard Medical School, Yale School of Medicine and the University of Texas Health Science Center at Houston, set out to map how economic security has been defined and operationalized across a decade of research.

The team searched PubMed and PsycINFO for articles published between 2015 and 2025 that either defined or measured economic security or insecurity, or examined the impact of economic security on health-related outcomes. From an initial pool of 881 sources, the reviewers screened down to 53 articles for detailed analysis. For each included article, they extracted the definitions used and the methods by which economic security was measured, then coded the material according to thematic dimensions, domains and sub-domains.

The central finding is one of fragmentation. Definitions and measurement approaches varied widely across the literature, making it difficult to compare findings between studies or to build cumulative knowledge about how economic conditions influence health. Rather than a single accepted construct, economic security emerged as a concept defined along several distinct axes.

Three of those axes stand out. First, economic security was treated as multi-dimensional, spanning thematic domains rather than reducing to income alone. Second, studies differed in whether they captured economic security subjectively, through individuals’ own perceptions of their financial situation, or objectively, through indicators such as income levels or housing status. Third, the concept carried a temporal dimension, distinguishing present security from future risk, so that a household may be economically stable today yet vulnerable to shocks such as job loss, illness or an unexpected expense tomorrow.

From the operational definitions in the reviewed articles, the authors identified six domain areas of economic security: income and finances, healthcare, employment, housing, food, and wealth and assets. Each domain captures a different facet of the economic circumstances that can buffer or undermine health, from the adequacy of day-to-day financial resources to the stability of shelter, access to care, reliable work, sufficient food and accumulated assets that provide a cushion against adversity.

The authors argue that this six-domain framework offers a foundation for more consistent measurement across studies, improved design of interventions aimed at strengthening economic security, and clearer specification of the pathways that link economic conditions to health outcomes. A shared vocabulary of domains could, for example, allow researchers to test whether interventions targeting housing stability produce different health effects than those targeting income supplementation, and to identify which domains matter most for particular outcomes or populations.

The review’s conclusions come with important caveats stated by the authors themselves. The framework is a synthesis of existing definitions rather than a validated measurement instrument, and further investigation is needed to examine its utility in elucidating the multi-dimensional nature of economic security and in devising measurement strategies that can advance both the science and the practice of improving economic security. As a scoping review, the work maps the landscape of the field; it does not itself establish causal relationships between economic security and specific health outcomes.

Even so, the contribution addresses a persistent methodological problem. When studies define economic security in incompatible ways, findings cannot be pooled or compared reliably, and the evidence base for policies that connect economic support to health remains harder to build. By organizing a heterogeneous literature into six operational domains, distinguished by objective and subjective measurement and by present versus future risk, the framework gives health researchers a structured starting point for designing studies and interventions. The work, received in May 2026 and accepted in September 2026, is published open access in the Health Economics section of Frontiers in Public Health, with Stevenson as corresponding author.

Subject of Research: A scoping review developing a conceptual framework of economic security for health research

Article Title: Toward a conceptual framework of economic security for health research: a scoping review

Article References: Stevenson, B. J., Falcón, A. K., Kim, B., Hunt, T., Rosen, M. I., Tsai, J., Pugh, K. E., Gianoli, M. O., & LePage, J. P. (2026). Toward a conceptual framework of economic security for health research: a scoping review. Frontiers in Public Health, 14, Article 1887796. https://doi.org/10.3389/fpubh.2026.1887796

Image Credits: AI Generated

DOI: 10.3389/fpubh.2026.1887796

Keywords: economic security, economic insecurity, health research, scoping review, health economics, measurement, income, housing, employment, food security, wealth, conceptual framework