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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

Economic hardships in adulthood and mental health in Sweden. the Swedish National Public Health Survey 2009

Authors: Johanna Ahnquist, Sarah P Wamala

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Possible accumulative effects of a combined economic hardship's measure, including both income and non-income related economic hardships measures, on mental health has not been well investigated. The aim of this paper was to investigate; (i) independent associations between multiple measures of economic hardships and mental health problems, and (ii) associations between a combined economic hardships measure and mental health problems.

Methods

We analysed data from the 2009 Swedish National Survey of Public Health comprising a randomly selected representative national sample combined with a randomly selected supplementary sample from four county councils and three municipalities consisting of 23,153 men and 28,261 women aged 16-84 years. Mental health problems included; psychological distress (GHQ-12), severe anxiety and use of antidepressant medication. Economic hardship was measured by a combined economic hardships measure including low household income, inability to meet expenses and lacking cash reserves.

Results

The results from multivariate adjusted (age, country of birth, educational level, occupational status, employment status, family status and long term illness) logistic regression analysis indicate that self-reported current economic difficulties (inability to pay for ordinary bills and lack of cash reserves), were significantly associated with both women's and men's mental health problems (all indicators), while low income was not. In addition, we found a statistically significant graded association between mental health problems and levels of economic hardships.

Conclusions

The findings indicate that indicators of self-reported current economic difficulties seem to be more strongly associated with poor mental health outcomes than the more conventional measure low income. Furthermore, the likelihood of mental health problems differed significantly in a graded fashion in relation to levels of economic hardships.
Literature
1.
Marmot MG, Fuhrer R, Ettner SL, Marks NF, Bumpass LL, Ryff CD: Contribution of psychosocial factors to socioeconomic differences in health. Milbank Q. 1998, 76 (3): 403-448. 305CrossRefPubMedPubMedCentral
2.
3.
Der G, Macintyre S, Ford G, Hunt K, West P: The relationship of household income to a range of health measures in three age cohorts from the West of Scotland. Eur J Public Health. 1999, 9 (4): 271-277.CrossRef
4.
Viinamaki H, Kontula O, Niskanen L, Koskela K: The association between economic and social factors and mental health in Finland. Acta Psychiatr Scand. 1995, 92 (3): 208-213.CrossRefPubMed
5.
Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic inequalities in depression: a meta-analysis. Am J Epidemiol. 2003, 157 (2): 98-112.CrossRefPubMed
6.
Lynch JW, Kaplan GA, Shema SJ: Cumulative impact of sustained economic hardship on physical, cognitive, psychological, and social functioning. N Engl J Med. 1997, 337 (26): 1889-1895.CrossRefPubMed
7.
Harper S, Lynch J, Hsu WL, Everson SA, Hillemeier MM, Raghunathan TE, Salonen JT, Kaplan GA: Life course socioeconomic conditions and adult psychosocial functioning. Int J Epidemiol. 2002, 31 (2): 395-403.CrossRefPubMed
8.
Andersen I, Thielen K, Nygaard E, Diderichsen F: Social inequality in the prevalence of depressive disorders. J Epidemiol Community Health. 2009, 63 (7): 575-81.CrossRefPubMed
9.
Lorant V, Croux C, Weich S, Deliege D, Mackenbach J, Ansseau M: Depression and socio-economic risk factors: 7-year longitudinal population study. Br J Psychiatry. 2007, 190: 293-298.CrossRefPubMed
10.
Lorant V, Deliege D, Eaton W, Robert A, Philippot P, Ansseau M: Socioeconomic Inequalities in Depression: A Meta-Analysis. Am J Epidemiol. 2003, 157 (2): 98-112.CrossRefPubMed
11.
Ahnquist J, Fredlund P, Wamala SP: Is cumulative exposure to economic hardships more hazardous to women's health than men's? A 16-year follow-up study of the Swedish Survey of Living Conditions. J Epidemiol Community Health. 2007, 61 (4): 331-336.CrossRefPubMedPubMedCentral
12.
Laaksonen E, Martikainen P, Lahelma E, Lallukka T, Rahkonen O, Head J, Marmot M: Socioeconomic circumstances and common mental disorders among Finnish and British public sector employees: evidence from the Helsinki Health Study and the Whitehall II Study. Int J Epidemiol. 2007, 36 (4): 776-786.CrossRefPubMed
13.
14.
Ringen S: Direct and Indirect Measures of Poverty. Journal of Social Policy. 1988, 17 (3): 351-365.CrossRef
15.
Whelan C, Layte R, Nolan B, Mailtre B: Income, Deprivation and Economic Strain: An analysis of the European Community Household Panel. European Sociological Review. 2001, 17 (4): 357-372.CrossRef
16.
Halleröd B, Bask M: Accumulation of Welfare Problems in a Longitudinal Perspective. Social Indicators Research. 2008, 88 (2): 311-327.CrossRef
17.
Wilkinson R: Unhealthy Societies: The Afflictions of Inequality. 1996, London: RoutledgeCrossRef
18.
WHO: The world health report 2001. Mental health: new understanding, new hope. 2001, Geneva: World Health Organization
19.
Martin K: Economic evaluation and mental health: sparse past . . . fertile future?. The Journal of Mental Health Policy and Economics. 1999, 2 (4): 163-167.CrossRef
20.
Lundström S, Särndal C: Estimation in the presence of non-response and frame imperfection. 2001, Stockholm: SCB, [Statistics Sweden]
21.
Goldberg D, Williams P: A user's guide to the General Health Questionnaire. 1988, Windsdor: NFER-Nelson
22.
Goldberg DP, Gater R, Sartorius N, Ustun TB, Piccinelli M, Gureje O, Rutter C: The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol Med. 1997, 27 (1): 191-197.CrossRefPubMed
23.
Makowska Z, Merecz D, Moscicka A, Kolasa W: The validity of general health questionnaires, GHQ-12 and GHQ-28, in mental health studies of working people. Int J Occup Med Environ Health. 2002, 15 (4): 353-362.PubMed
24.
Jacob KS, Bhugra D, Mann AH: The validation of the 12-item General Health Questionnaire among ethnic Indian women living in the United Kingdom. Psychol Med. 1997, 27 (5): 1215-1217.CrossRefPubMed
25.
Penninkilampi-Kerola V, Miettunen J, Ebeling H: A comparative assessment of the factor structures and psychometric properties of the GHQ-12 and the GHQ-20 based on data from a Finnish population-based sample. Scand J Psychol. 2006, 47 (5): 431-440.CrossRefPubMed
26.
Sanchez-Lopez Mdel P, Dresch V: The 12-Item General Health Questionnaire (GHQ-12): reliability, external validity and factor structure in the Spanish population. Psicothema. 2008, 20 (4): 839-843.PubMed
27.
Ringback Weitoft G, Rosen M: Is perceived nervousness and anxiety a predictor of premature mortality and severe morbidity? A longitudinal follow up of the Swedish survey of living conditions. J Epidemiol Community Health. 2005, 59 (9): 794-798.CrossRefPubMed
28.
Kwon A, Bungay KM, Pei Y, Rogers WH, Wilson IB, Zhou Q, Adler DA: Antidepressant use: concordance between self-report and claims records. Med Care. 2003, 41 (3): 368-374.PubMed
29.
Fritzell J, Nermo M, Lundberg O: The impact of income: assessing the relationship between income and health in Sweden. Scand J Public Health. 2004, 32 (1): 6-16.CrossRefPubMed
30.
Persson G: Health in Sweden: the national public health report 2001. 2001, Oslo: Scandinavian Univ. Press
31.
Fritzell S, Burstrom B: Economic strain and self-rated health among lone and couple mothers in Sweden during the 1990s compared to the 1980s. Health Policy. 2006, 79 (2-3): 253-264.CrossRefPubMed
32.
Nash M, McDermott J: Mental health and long-term conditions 2: Managing depression. Nurs Times. 2011, 107 (26): 21-23.PubMed
33.
Wang JL, Schmitz N, Dewa CS: Socioeconomic status and the risk of major depression: the Canadian National Population Health Survey. J Epidemiol Community Health. 64 (5): 447-452.
34.
Weich S, Lewis G: Material standard of living, social class, and the prevalence of the common mental disorders in Great Britain. J Epidemiol Community Health. 1998, 52 (1): 8-14.CrossRefPubMedPubMedCentral
35.
Zimmerman FJ, Katon W: Socioeconomic status, depression disparities, and financial strain: what lies behind the income-depression relationship?. Health Econ. 2005, 14 (12): 1197-1215.CrossRefPubMed
36.
Skapinakis P, Weich S, Lewis G, Singleton N, Araya R: Socio-economic position and common mental disorders. Longitudinal study in the general population in the UK. Br J Psychiatry. 2006, 189: 109-117.CrossRefPubMed
37.
Skapinakis P: Commentary: Socioeconomic position and common mental disorders: what do we need to know?. Int J Epidemiol. 2007, 36 (4): 786-788.CrossRefPubMed
38.
Laaksonen M, Silventoinen K, Martikainen P, Rahkonen O, Pitkäniemi J, Lahelma E: The Effects of Childhood Circumstances, Adult Socioeconomic Status, and Material Circumstances on Physical and Mental Functioning: A Structural Equation Modelling Approach. Annals of Epidemiology. 2007, 17 (6): 431-439.CrossRefPubMed
39.
Ringback-Weitoft G: Chapter 9. Social differences, vulnerability and ill-health. Health in Sweden: The National Public Health Report 2001. Scand J Public Health Suppl. 2001, 58: 199-218.CrossRefPubMed
40.
Laaksonen E, Martikainen P, Lallukka T, Lahelma E, Ferrie J, Rahkonen O, Marmot M, Head J: Economic difficulties and common mental disorders among Finnish and British white-collar employees: the contribution of social and behavioural factors. J Epidemiol Community Health. 2009, 63 (6): 439-446.CrossRefPubMedPubMedCentral
41.
Lahelma E, Laaksonen M, Martikainen P, Rahkonen O, Sarlio-Lähteenkorva S: Multiple measures of socioeconomic circumstances and common mental disorders. Social Science & Medicine. 2006, 63 (5): 1383-1399.CrossRef
42.
43.
Laaksonen E, Martikainen P, Head J, Rahkonen O, Marmot MG, Lahelma E: Associations of multiple socio-economic circumstances with physical functioning among Finnish and British employees. Eur J Public Health. 2009, 19 (1): 38-45.CrossRefPubMed
44.
Martikainen P, Adda J, Ferrie JE, Davey Smith G, Marmot M: Effects of income and wealth on GHQ depression and poor self rated health in white collar women and men in the Whitehall II study. J Epidemiol Community Health. 2003, 57 (9): 718-723.CrossRefPubMedPubMedCentral
45.
Lewis G, Bebbington P, Brugha T, Farrell M, Gill B, Jenkins R, Meltzer H: Socioeconomic status, standard of living, and neurotic disorder. Lancet. 1998, 352 (9128): 605-609.CrossRefPubMed
46.
Muntaner C, Borrell C, Benach J, Pasarin MI, Fernandez E: The associations of social class and social stratification with patterns of general and mental health in a Spanish population. Int J Epidemiol. 2003, 32 (6): 950-958.CrossRefPubMed
47.
Eaton WW, Muntaner C, Bovasso G, Smith C: Socioeconomic status and depressive syndrome: the role of inter- and intra-generational mobility, government assistance, and work environment. J Health Soc Behav. 2001, 42 (3): 277-294.CrossRefPubMedPubMedCentral
48.
Berndt ER, Koran LM, Finkelstein SN, Gelenberg AJ, Kornstein SG, Miller IM, Thase ME, Trapp GA, Keller MB: Lost human capital from early-onset chronic depression. Am J Psychiatry. 2000, 157 (6): 940-947.CrossRefPubMed
49.
Berndt ER, Finkelstein SN, Greenberg PE, Howland RH, Keith A, Rush AJ, Russell J, Keller MB: Workplace performance effects from chronic depression and its treatment. J Health Econ. 1998, 17 (5): 511-535.CrossRefPubMed
50.
Muntaner C, Lynch J, Smith GD: Social capital, disorganized communities, and the third way: understanding the retreat from structural inequalities in epidemiology and public health. Int J Health Serv. 2001, 31 (2): 213-237.CrossRefPubMed
51.
Ferrie JE, Shipley MJ, Marmot MG, Stansfeld S, Davey Smith G: The health effects of major organisational change and job insecurity. Soc Sci Med. 1998, 46 (2): 243-254.CrossRefPubMed
52.
Watson D: Intraindividual and interindividual analyses of positive and negative affect: their relation to health complaints, perceived stress, and daily activities. J Pers Soc Psychol. 1988, 54 (6): 1020-1030.CrossRefPubMed
53.
Hassan E: Recall bias can be a threat to retrospective and prospective research designs. The Internet Journal of Epidemiology. 2006, 3 (2):
54.
Blazer DG, Kessler RC, McGonagle KA, Swartz MS: The prevalence and distribution of major depression in a national community sample: the National Comorbidity Survey. Am J Psychiatry. 1994, 151 (7): 979-986.CrossRefPubMed
55.
Statistiska centralbyrån: Hälsa på lika villkor 2009; Teknisk rapport av det totala urvalet: [Health on equal terms 2009; Technical report of the total selection]. 2009, SCB: [Statistics Sweden]
56.
Sen A: Inequality reexamined. 1992, Oxford: Clarendon Press
57.
Sen AK: Commodities and capabilities. 1999, New Delhi: Oxford university press
Metadata
Title
Economic hardships in adulthood and mental health in Sweden. the Swedish National Public Health Survey 2009
Authors
Johanna Ahnquist
Sarah P Wamala
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-788

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