Financial precarity among French health students is shaped by economic and academic factors, with family support protective and low socio-economic background increasing vulnerability, and is strongly associated with poorer mental health, reduced healthcare access, and academic difficulties.
Key Findings
Results
Financial precarity prevalence varied significantly across health academic fields, ranging from 4.6% in first-year health students to 12% in paramedical students.
Financial precarity was defined as a composite indicator combining financial insecurity, frequent overdrafts, and foregoing essential purchases.
Paramedical students had the highest prevalence of financial precarity at 12%.
First-year health students had the lowest prevalence at 4.6%.
The study included 12,565 health students across all 34 French health universities.
The sample comprised medical (56%), paramedical (21%), midwifery/odontology/pharmacy/physiotherapy (12%), and first-year health students (11%).
Results
Medical students and several other health student groups had significantly lower odds of financial precarity compared to paramedical students.
Medical students had lower odds of precarity (aOR=0.69; 95% CI 0.52 to 0.83) compared to paramedical students.
Midwifery, odontology, pharmacy or physiotherapy students also had lower odds (aOR=0.55; 95% CI 0.43 to 0.72).
First-year health students similarly showed lower odds (aOR=0.54; 95% CI 0.38 to 0.77).
Paramedical students served as the reference group in adjusted analyses.
Results
Very low parental socio-economic status and student loans were major risk factors for financial precarity.
Very low parental socio-economic status was associated with nearly three times higher odds of precarity (aOR=2.96; 95% CI 2.33 to 3.89).
Having a student loan was associated with approximately 2.8 times higher odds of precarity (aOR=2.78; 95% CI 2.33 to 3.32).
Family support was identified as a protective factor against financial precarity.
These associations were derived from multivariate logistic regression models.
Results
Financial precarity was strongly associated with depressive symptoms among health students.
Students with financial precarity had nearly five times higher odds of depressive symptoms (aOR=4.90; 95% CI 4.13 to 5.80).
Depressive symptoms were listed as a primary outcome of the study.
The association remained significant after adjustment for other variables in multivariate logistic regression.
Results
Financial precarity was strongly associated with anxiety among health students.
Students with financial precarity had approximately 3.8 times higher odds of anxiety (aOR=3.84; 95% CI 3.13 to 4.52).
Anxiety was a primary outcome measure in the study.
The association was derived from adjusted multivariate logistic regression analyses.
Results
Financial precarity was most strongly associated with emotional exhaustion among all mental health outcomes measured.
Students with financial precarity had over eight times higher odds of emotional exhaustion (aOR=8.49; 95% CI 5.98 to 12.06).
Emotional exhaustion showed the strongest association with financial precarity among all outcomes examined.
Emotional exhaustion was listed as a primary outcome alongside depressive symptoms and anxiety.
Results
Financial precarity was strongly associated with renouncing healthcare among health students.
Students with financial precarity had over six times higher odds of renouncing healthcare (aOR=6.21; 95% CI 5.01 to 7.70).
Healthcare avoidance was a secondary outcome of the study.
This finding is particularly notable given that the population studied are themselves future healthcare providers.
Results
Financial precarity was associated with poorer academic outcomes, specifically repeating a year of study.
Students with financial precarity had 1.8 times higher odds of repeating a year (aOR=1.80; 95% CI 1.54 to 2.10).
Academic outcomes were classified as secondary outcomes in the study.
The association was significant after adjustment in multivariate logistic regression models.
What This Means
This research suggests that financial hardship is a significant and widespread problem among French health students, affecting between 4.6% and 12% of students depending on their field of study, with paramedical students being the most affected group. The study, which surveyed over 12,500 students across all 34 French health universities, found that students from lower-income family backgrounds and those with student loans were most likely to experience financial precarity — defined as a combination of financial insecurity, frequent bank overdrafts, and having to forgo essential purchases.
The findings reveal that financial precarity is closely linked to serious mental health problems. Students experiencing financial hardship were nearly five times more likely to have depressive symptoms, nearly four times more likely to experience anxiety, and over eight times more likely to suffer from emotional exhaustion compared to students without financial hardship. Strikingly, financially precarious students were also more than six times as likely to avoid seeking healthcare for themselves — a concerning finding given that these students are training to provide healthcare to others. Additionally, financially precarious students were almost twice as likely to have to repeat an academic year, suggesting that financial stress undermines academic performance.
This research suggests that financial difficulties among health students are not merely an individual concern but a systemic issue with broad consequences for student wellbeing and the future healthcare workforce. The findings highlight that students from disadvantaged family backgrounds are particularly vulnerable, and that financial support structures — or their absence — play a meaningful role in shaping both mental health and academic success in health education programs.
Tavolacci M, Berthelot P, Dellamonica J, Josseran L, Veber B, Ladner J. (2026). Financial precarity and mental health among French health students: a nationwide cross-sectional study.. BMJ open. https://doi.org/10.1136/bmjopen-2025-104484