A Heavy Mental Load Is Breaking Down The Health Of Women Living On Low Incomes

Republicans have promised to cut billions of dollars in public funding. It won’t help poor families’ mental health.

The concept of the mental load—the combination of emotional and cognitive work a person does to keep themselves and those they care for functioning—has entered mainstream conversations about gender inequality and the modern household at a remarkable pace. Its rapid adoption suggests it resonates. Yet, the mental load, much like the work-family balance discourse, has remained mostly associated with and circulated most prominently among white and professional-class people. This happens even though low-income, Black, Hispanic, and working-class families are likely to report higher levels of stress, less time, and more work-family conflict, many of the major concerns of mental load discourse.

The Better Life Lab’s recent research on the impact of the end of pandemic-related federal spending on families, children, and workers revealed a major and often-overlooked facet of the mental load—the mental load of just not having enough to go around. Time and again, women on low incomes whom we interviewed for the study described being burdened by the stress of decision-making related to resources and desired outcomes for themselves and their children.

Julia Craven and Haley Swenson co-authored this piece using participant stories from that research to highlight the roles of financial- and resource-related problem solving and worrying in women’s lives. We hope it showcases and models the importance of including these concerns alongside more commonly thought-of types of unpaid work. We also hope to advance the conversation on the health consequences of women’s growing mental loads—a limited but growing area of research.

Julia, Healthy Futures

Haley, Happy Families

Courtesy of Latoya Dyer

In 2022, Latoya Dyer could feel the stress clawing its way back. The expanded federal benefits that workers and families received during the COVID-19 pandemic were ending. During the height of that relief, her household of six in Deltona, Florida, had a fridge full of groceries thanks to P-EBT, consistent doctor visits through Medicaid, and enough wiggle room in their budget to finally take a trip to visit family in New York. Her daughters got new beds. The car got fixed. Life felt manageable. Maybe even joyful. For once, the bills got paid without panic. “I was thanking God every time,” she told us in December.

But then the expansion of policies like unemployment insurance, the monthly distributed child tax credit, and Medicaid began to wind down. When the aid disappeared, so did the fragile sense of peace it brought families. “It’s almost like we’re robotic,” said Dyer. “We know all of our money’s going to go towards a set of bills, and it’s like you don’t get to enjoy none of the fruit of your labor.”

Now, the American economy could get worse for families struggling to make ends meet, and hurt their already struggling health and well-being in the process. The Trump administration and its allies in Congress have their eye on cutting programs that are critical to helping families living on low incomes, potentially leaving many families to face the stress of poverty without support. On May 22, the House narrowly passed the One Big Beautiful Bill Act, which calls for work requirements for able-bodied recipients without children, increased eligibility checks, and slashes to funding to states that insure undocumented immigrants. It also makes it more difficult to qualify for SNAP benefits. (One small bright spot is a $500 bump in the Child Tax Credit until 2028, although it will not be available to the lowest earners.)

Though the bill must still face the Senate and the reconciliation process, these cuts are a staggering departure from U.S. policy since the pandemic began, including when Trump was in office the first time. Between 2020 and 2021, Congress passed unprecedented expanded aid to workers and families, from increasing access to Medicaid to extending and expanding unemployment benefits and increasing tax credits to parents of young children. With our colleagues at the Better Life Lab at New America, a non-partisan think tank in Washington, D.C., we researched the impact of these policies on families’ lives and how their lives have changed since these policies ended. In addition to greater financial security and a historic drop in child poverty rates, these policies also gave families struggling to get by a boost to their mental health and outlook.

For Dyer—and many other women like her—the return to financial stress also meant a return to a constant, grinding mental load. Our recent qualitative study with families living on low incomes revealed a clear theme: the relief offered by pandemic-era policies didn’t just help families materially. It briefly lightened the cognitive and emotional burden of poverty. And when that support vanished, the weight came crashing back.

Mental load, the combination of emotional and cognitive labor it takes a caregiver to get themselves and their loved ones through the day, is a real, measurable tax on the brain and body, especially for women navigating poverty. Women figuring out how to feed their families on low incomes are twice as likely to experience depression as women living on a middle-class income. Their mental health isn’t the only casualty; physical well-being takes a hit, too. Dealing with the ever-present toxic stress associated with a heavy mental load can raise blood pressure, increase the risk for or worsen diabetes, increase the risk of stroke, and shorten a person’s lifespan. It’s a form of weathering, a term coined by Dr. Arline Geronimus at the University of Michigan to describe how prolonged exposure to stress—especially when it is caused by racism and poverty—literally wears down the body over time. It’s one reason why Black women face higher rates of maternal mortality and chronic illness, for instance.

“Behavioral health treatment in the United States is tough [to access], even when you're not low-income,” said Swapna Reddy, a clinical associate professor at Arizona State University’s College of Health Solutions. But getting the care required “tends to be much more difficult for lower-income folks. And then once lower-income women, and especially those of color, are starting treatment, they're less likely to stay in treatment or finish treatment.” That’s because inadequate transportation, inflexible work schedules, and a lack of child care compound the problem, alongside the other social determinants of health like unaffordable housing, issues with health insurance, and wage inequality.

The bureaucracy of applying for and seeking out benefits to keep families in poverty afloat creates additional stress. We saw this play out for Kel and their children. When the pandemic-era Medicaid benefits were active, the various appointments the children needed to support their mental health, including treatment for depression and support navigating their gender identity transitions, were covered. While the family is still on Medicaid, the expired automatic renewal policy, which meant those enrolled did not need to reapply for enrollment every 12 months, has reignited the strain for Kel, who has to make sure their children can get the care they need.

“When [renewals] came back, it was a nightmare to deal with, to submit all of these different things. And they had to be faxed. Oh my gosh. What? Fax machine? And they wanted you to fax your entire tax return—fax 30 pages of documents,” they said. “If I had to go somewhere and pay per page to fax it, I couldn’t do it. I ended up signing up for what I thought was a free fax service that sneakily signed me up for a premium service.” Getting out of the contract to pay for a premium service then became yet another thing to worry about.

If the mental load seems unrelenting, that’s because it is. Keely Muscatell, an associate professor of psychology and neuroscience at the University of North Carolina at Chapel Hill, emphasized that living in poverty forces people to operate in a state of near-constant decision-making. People with lower socioeconomic status often have higher baseline levels of cortisol, a stress hormone that, when chronically elevated, can lead to a range of health problems, including high blood pressure, insulin resistance, a weakened immune system, and muscle loss, due to these demands on their time and cognition.

Comprehensive caregiving policies—like universal child care, paid family leave, elder care subsidies, and flexible work protections—can radically ease the mental load for people living on low incomes, particularly if they are universal or automatic, to reduce the stress of applying and qualifying for benefits. When caregiving isn’t treated as a personal problem to solve but as a shared societal responsibility, it lifts the daily burden of scrambling for last-minute help, missing work to care for a sick loved one, or juggling caregiving with multiple low-wage jobs. For women living on low incomes, especially, these supports would free up critical cognitive space, reduce chronic stress, and create more stable conditions to care for themselves and their families.

“Managing money and thinking through the impacts of everyday decisions of what to spend money on—food, child care, those sorts of things—can take a toll cognitively,” Muscatell said. “It can be a distraction from the ability to regulate one's emotions. It's a competing demand on people who are living in these circumstances that people who aren't living in poverty just don’t have.”