A sudden and dramatic loss of wealth increases the likelihood of death for U.S. adults — not just in the days that follow, but in the years and decades after that, new research shows.

Researchers at Northwestern University reported Tuesday that adults who lost 75 percent of their wealth in two years — perhaps due to a layoff or a medical emergency — were 50 percent more likely to die within the next two decades than adults with stable finances.

The study, published in the Journal of the American Medical Association, is one of the first to link the sudden loss of wealth with a heightened risk of death over time.

But it was hardly surprising to leaders of Twin Cities homeless shelters, social service agencies and medical clinics, who have seen firsthand how money influences health.

Falling into poverty creates constant fear and anxiety, and that takes a physical toll, said Daniel Gumnit, chief executive of People Serving People, which operates a shelter and services for the homeless in Minneapolis.

“The human body wasn’t meant to be in fight-or-flight mode continuously,” he said. “It affects so many of your [body’s] systems. It has a really negative impact on your health.”

Research assessing the short-term impact of financial losses on health emerged after the nation’s last economic downturn, the so-called Great Recession. But the Northwestern study took an unusually long-term look at how those “wealth shocks” corresponded to death rates over 20 years.

The study didn’t prove that a loss of wealth causes more deaths, only that there is a relationship between the two, said Lindsay Pool, the lead author. It’s plausible that extreme financial losses exacerbate depression and result in suicide attempts, or drive people to abuse dangerous substances such as opioids, or cause stress that over years results in diabetes or a heart attack, she added.

“When I talk to people out in the world about my research, it seems like everyone has a story of someone going through a wealth shock,” Pool said. “I think this is putting data to someone’s lived experience.”

Pool’s study was based on survey responses provided between 1994 and 2014 by 8,714 adults aged 51 to 61 as part of the University of Michigan’s Health and Retirement Study. The researchers used statistical methods to factor out illnesses people had before any loss of wealth, so Pool said the results accurately reflect the health changes after that loss.

More than a quarter of respondents in the retirement survey had experienced a wealth shock — indicating that this is a widespread public health concern, she added.

Stress hormones

While most people entering the People Serving People shelter have lived with “generational” poverty, Gumnit said there was a memorable case of a father who lost his job and house after his wife died. After entering the shelter, he was newly diagnosed with diabetes and mental disorders.

“Clearly the poverty and the stress … dramatically increases stress hormones like cortisol, which have a big effect on blood sugar and all sorts of things,” Gumnit said. “This man became fairly sick. He was unable to work full time. He got lots of job interviews but the health issues kept getting in the way of his stable employment.”

A University of Minnesota researcher who is studying an opposite trend — how low-income wage increases improve health — said that even the loss of social status that comes with the loss of wealth can lead to physical or mental health problems.

“There’s just so many pathways by which wealth can affect health,” said Caitlin Caspi, a health disparities researcher at the U. “A loss of wealth can affect health care access and the ability of people to take care of themselves.”

How doctors and health care providers should intervene is unclear, but an accompanying JAMA editorial by Dr. Alan Garber of Harvard University said doctors at least need to have the issue of financial loss on their radar when talking with older patients.

“An opportunity to build empathy and offer support,” he wrote, “will elude clinicians who fail to recognize such a profound event and its meaning for their patient’s future.”