New research shows your economic well-being can play a strong role in your overall health, especially the strength of your heart. Poor food choices, limited exercise and smoking have been known for some time to have negative impacts on your heart. Now, researchers say sharp fluctuations in your income may also put your heart at risk.

A University of Miami study has found a strong link between income volatility and heart problems, including cardiovascular disease and even premature death. The study of nearly 4,000 workers from 1990 to 2005 found those who had two or more drops in income of at least 25 percent in that period had a higher risk of death. In fact, their risk of heart problems doubled.

Even slight changes in income can cause an increased amount of stress and hardships on individuals and families. The researchers noted other effects income volatility has on participants, including changes in behavior, access to medical care and psychological stress.

People working in sales, freelancers and independent contractors were found to have the highest health fluctuations, partially because of their unpredictable incomes and schedules.

Is there a solution to all of this? You could say it’s in the works.

The study’s authors said the next step is to better understand the underlying connections between income variability and a person’s health. They also suggested that clinicians consider putting their patients with unstable incomes into a high-priority group for cardiovascular disease screenings and interventions, and refer these patients for stress-reduction assistance.

Because it turns out your wallet isn’t the only thing affected by your income.