Allison Laing
Financial management – how people make and manage their money – is critical to well-being. Debt is both a driver of financial strain and a key financial management tool that enables important purchases, bridges crises, and covers budgetary shortfalls. However, within socioeconomically disadvantaged communities, systematic exclusion from secure and affordable credit from traditional banks relegates people with lived and living experience of substance use (PWLLE) to potentially harmful credit sources: payday loans trap borrowers in “rollover” cycles; IOUs within social networks damage important relationships; and dealer-based credit engenders violence. Further, while employment is linked to better health, individual and structural barriers to employment among PWLLE create pressures toward street-based or illegal work, including binning, panhandling, dealing, theft, or sex work. Given established benefits of employment and potential risks of debt, this dissertation examines these two components of financial management (debt management and income generation) as key contributors to well-being among PWLLE. The first empirical chapter uses longitudinal data from two community-recruited prospective cohort studies of PWLLE. Generalized linear mixed-effects models explore associations of drug-related debt with drug use patterns and income generation, linking drug debt with street-based and illegal work, higher-intensity drug use, and violence. The second empirical chapter derives data from a randomized controlled structural intervention trial and employs a sequential explanatory mixed-methods approach: mixed-effects models assess whether modifying income assistance schedules impacts income, material security, debt, and debt-related consequences; and qualitative analysis identifies mechanisms to explain findings. This chapter complicates simplified associations between debt and violence, highlighting social dynamics and identity processes that shape budgeting and debt management. The third empirical chapter uses data from an open-prospective cohort of PWLLE facing barriers to employment. Generalized linear mixed-effects models link illicit debt, unregulated-drug use and prohibited (street-based and illegal) work. Pathway analyses estimate well-being effects of income activities including employment, and prohibited work, while mediating for debt and substance use. By examining debt, work, and budgetary practices across different data contexts, this dissertation highlights heterogeneity of approaches to making ends meet, recommending important adaptations to the design and implementation of social programs to support individual employment goals and financial management practices.