Maintaining good health involves more than getting a regular checkup and not showing any obvious signs of illness. There are multiple reasons people don’t live healthy lives.

Enter Creighton University’s Cura Project, named after the Jesuit value of cura personalis, which involves care and concern for the entirety of a person’s well-being. The university program is studying chronic health issues in Omaha. The Cura Project began with a focus on those impacted by Type 2 diabetes, but it has since expanded to other health issues. The project emphasizes that the path to better health often runs right through a person’s pocketbook.

Money matters when it comes to health. The social determinants of health, such as economic stability and access to affordable care, can have as much of an impact on an individual’s well-being as their genetic code. 

The Cura Project is working to show that financial stability can improve health outcomes and reduce health disparities. It is the first financial-medical partnership in the state and one of just a dozen or so in the country. The Nebraska Department of Economic Development (DED) is supporting Creighton University’s Cura Project with a $1 million Financial Literacy Grant as the State seeks to empower people with the ability and confidence to improve their finances. In turn, DED expects to make an impact on the overall well-being of Nebraskans currently experiencing financial stress.

“In April, WalletHub ranked Nebraska as the most financially literate state in the country,” said Joe Fox, interim director of DED. “In helping families build wealth, financial literacy also has major benefits for physical health–allowing greater access to medical care, nutritious foods, and exercise opportunities. DED is grateful to support the Cura Project’s tremendous work to address the link between financial well-being and overall health.” 

DED funding followed a $2.3 million investment in 2021 from The Diabetes Care Foundation. The initial funding also helped the Cura Project secure an additional $500,000 from United Healthcare of Nebraska.

Nicole White and Kevin Fuji are associate professors in the Creighton University School of Pharmacy and Health, and they are co-directors of the Cura Project. The duo are supported in the effort by Maggie Kalkowski, a financial social worker; Kim Sauer, a health and wellness coach; and Hannah Bergwell, the research coordinator. They partner with co-investigators from the medical clinic across the street from their university offices. Julie Kalkowski serves as executive director of the Financial Hope Collaborative which includes financial success and financial literacy programs.

The Cura Project has three main objectives:

  1. Demonstrate the effect of stress on economic stability – as financial stress is reduced, income through a higher salary provides access to benefits.
  2. Demonstrate improvements in health behaviors – seen through healthier eating of more fruits and vegetables, increased physical activity, and smoking cessation.
  3. Demonstrate improvements in health outcomes – particularly among people with diabetes.

“Health is related to finances, which is very clear,” White said. “And it’s not just about the money, although that does impact where a person lives and what they can afford to eat and if it’s safe to get exercise near their home.” “It (the issue of health) has more to do with the stress that you have when you can’t make ends meet,” she stated. “Financial stress is a major driver for a lot of the health disparities that we see.” 

Stress can affect the daily decisions a person must make when they have limited financial assets, such as deciding between doing something for their children, keeping the lights turned on, fixing their car, or picking up monthly medications. 

“They have a lot of difficult decisions to make,” White said of those dealing with financial stress. That pressure can result in excessive alcohol consumption, stress eating, and smoking as ways to cope, she explained. Those actions make it more difficult for traditional health promotion strategies to succeed. “The central idea behind this project is that if we can help to decrease financial stress, we may be able to have an impact on all those other factors,” White offered.

Fuji said the Cura Project is looking to enroll 300 people in the program. There are now around 125 participants. “We have people as young as 22 and as old as 84,” Fuji said. Participants are at different points in their life, and many are racial or ethnic minorities from North or South Omaha.

The program begins with nine weeks of group financial education classes, followed by 12 months of one-on-one financial coaching for each person. As participants develop a budget and learn other financial best practices, the expectation is to see an increase in hope and a reduction of stress. Additionally, participants receive financial social work services to address housing and transportation needs, along with assistance planning how to afford medications.

“Change is difficult and sometimes it takes a long time,” Fuji said. He noted that quantitative results are tracked to measure progress of program participants. Previous studies have shown the program works to help people increase their earnings and live healthier, less stressful lives. In particular, it has helped to reduce smoking and junk food consumption.

The Cura Project team said that research funding can be hard to acquire, and thanked DED for providing the Financial Literacy Grant. 

“The support from the Nebraska Department of Economic Development allows our program to reach its potential. We hope this is just the beginning, that our collaboration builds the foundation to scale our efforts to reach a greater number of Nebraskans in the future,” White said

The Financial Literacy Grant is an authorized use of federal American Rescue Plan Act funds, intended to respond to the adverse effects of the coronavirus pandemic.