Selling one's future : over-indebtedness and the risk of poor mental health and the role of precarious employment - results from the Scania Public Health Cohort, Sweden
Östergren, Per-Olof LU ; Bodin, Theo LU ; Canivet, Catarina LU ; Moghaddassi, Mahnaz LU and Vilhelmsson, Andreas LU
(2022)
In BMJ Open
12(11).
p.1-10
- Abstract
OBJECTIVES: The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.
METHODS: This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in... (More)
OBJECTIVES: The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.
METHODS: This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in paying household bills. Mental health was assessed by General Health Questionnaire-12. Those with poor mental health at baseline were excluded, and the analyses were further restricted to vocationally active individuals with complete data on main variables, resulting in 1256 men and 1539 women.
RESULTS: Over-indebtedness was more common among women, among persons with a low educational level, born abroad and with a precarious employment at baseline. The age-adjusted incidence rate ratio (IRR) for poor mental health in 2010 among individuals exposed to over-indebtedness in 1999/2000 or 2005 was 2.2 (95% CI 1.7 to 2.8). Adjusting for educational level, country of origin and precarious employment in 1999/2000 or 2005, yielded an IRR of 2.0 (95% CI 1.6 to 2.6). An interaction analysis indicated that a high level of education may act synergistically with over-indebtedness, regarding poor mental health among men.
CONCLUSIONS: Over-indebtedness was related to unfavourable societal power relations, regarding social class, gender and foreign birth. Precarious employment was independently linked to poor mental health and may also mediate the effect by over-indebtedness. The COVID-19 pandemic might entail increased over-indebtedness, which should be acknowledged in policies aiming at buffering social effects of the pandemic.
(Less)- Abstract (Swedish)
- Objectives: The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.
Methods: This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in... (More) - Objectives: The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.
Methods: This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in paying household bills. Mental health was assessed by General Health Questionnaire-12. Those with poor mental health at baseline were excluded, and the analyses were further restricted to vocationally active individuals with complete data on main variables, resulting in 1256 men and 1539 women.
Results: Over-indebtedness was more common among women, among persons with a low educational level, born abroad and with a precarious employment at baseline. The age-adjusted incidence rate ratio (IRR) for poor mental health in 2010 among individuals exposed to over-indebtedness in 1999/2000 or 2005 was 2.2 (95% CI 1.7 to 2.8). Adjusting for educational level, country of origin and precarious employment in 1999/2000 or 2005, yielded an IRR of 2.0 (95% CI 1.6 to 2.6). An interaction analysis indicated that a high level of education may act synergistically with over-indebtedness, regarding poor mental health among men.
Conclusions: Over-indebtedness was related to unfavourable societal power relations, regarding social class, gender and foreign birth. Precarious employment was independently linked to poor mental health and may also mediate the effect by over-indebtedness. The COVID-19 pandemic might entail increased over-indebtedness, which should be acknowledged in policies aiming at buffering social effects of the pandemic. (Less)
- author
- Östergren, Per-Olof
LU
; Bodin, Theo
LU
; Canivet, Catarina
LU
; Moghaddassi, Mahnaz
LU
and Vilhelmsson, Andreas
LU
- organization
- publishing date
- 2022-11-22
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Adult, Male, Female, Humans, Mental Health, Public Health, Sweden/epidemiology, Cohort Studies, Pandemics, Cross-Sectional Studies, COVID-19/epidemiology, Employment/psychology
- in
- BMJ Open
- volume
- 12
- issue
- 11
- article number
- e061797
- pages
- 1 - 10
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:36414307
- scopus:85142483225
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2022-061797
- language
- English
- LU publication?
- yes
- additional info
- © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
- id
- 9fb73f20-69b3-4483-8db1-24253ec01a92
- date added to LUP
- 2022-11-26 09:44:28
- date last changed
- 2024-06-13 22:29:34
@article{9fb73f20-69b3-4483-8db1-24253ec01a92,
abstract = {{<p>OBJECTIVES: The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.</p><p>METHODS: This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in paying household bills. Mental health was assessed by General Health Questionnaire-12. Those with poor mental health at baseline were excluded, and the analyses were further restricted to vocationally active individuals with complete data on main variables, resulting in 1256 men and 1539 women.</p><p>RESULTS: Over-indebtedness was more common among women, among persons with a low educational level, born abroad and with a precarious employment at baseline. The age-adjusted incidence rate ratio (IRR) for poor mental health in 2010 among individuals exposed to over-indebtedness in 1999/2000 or 2005 was 2.2 (95% CI 1.7 to 2.8). Adjusting for educational level, country of origin and precarious employment in 1999/2000 or 2005, yielded an IRR of 2.0 (95% CI 1.6 to 2.6). An interaction analysis indicated that a high level of education may act synergistically with over-indebtedness, regarding poor mental health among men.</p><p>CONCLUSIONS: Over-indebtedness was related to unfavourable societal power relations, regarding social class, gender and foreign birth. Precarious employment was independently linked to poor mental health and may also mediate the effect by over-indebtedness. The COVID-19 pandemic might entail increased over-indebtedness, which should be acknowledged in policies aiming at buffering social effects of the pandemic.</p>}},
author = {{Östergren, Per-Olof and Bodin, Theo and Canivet, Catarina and Moghaddassi, Mahnaz and Vilhelmsson, Andreas}},
issn = {{2044-6055}},
keywords = {{Adult; Male; Female; Humans; Mental Health; Public Health; Sweden/epidemiology; Cohort Studies; Pandemics; Cross-Sectional Studies; COVID-19/epidemiology; Employment/psychology}},
language = {{eng}},
month = {{11}},
number = {{11}},
pages = {{1--10}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Open}},
title = {{Selling one's future : over-indebtedness and the risk of poor mental health and the role of precarious employment - results from the Scania Public Health Cohort, Sweden}},
url = {{http://dx.doi.org/10.1136/bmjopen-2022-061797}},
doi = {{10.1136/bmjopen-2022-061797}},
volume = {{12}},
year = {{2022}},
}