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International Journal of Public Health

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01-05-2019 | Original article

The impact of savings and credit on health and health behaviours: an outcome-wide longitudinal approach

Authors: Piotr Białowolski, Dorota Węziak-Białowolska, Tyler J. VanderWeele

Published in: International Journal of Public Health | Issue 4/2019

Abstract

Objectives

This study evaluated decisions related to debt and savings on physical health, emotional health and health behaviours.

Methods

The longitudinal data from the Polish biennial household panel—Social Diagnosis Survey—were used. Evidence for a link between credit/savings and health/health behaviours was presented using three waves of the data and an outcome-wide regression analysis. To circumvent endogeneity, variables temporally prior to exposure were used as controls. Sensitivity analysis for unmeasured confounding, conducted using E-values, provided a check for robustness.

Results

Debt proved a significant stressor, affecting three of five physical health measures. Over-indebted individuals suffered even more in terms of physical health outcomes. The role of savings in physical health was much less significant, yet had significant bearing on measures of emotional health. In terms of emotional health, debt (over-indebtedness in particular) influenced loneliness and increased suicidal thoughts. With respect to health behaviours, savings appeared significant in reducing smoking and increasing uptake of sport activities, while debt had no significant effect in these areas.

Conclusions

Recommendations are formulated to foster saving activity and develop institutional solutions for over-indebtedness.

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Such products, although probably not sufficiently strengthening the link by economic incentive, are already present on the market. Allegacy Federal Credit Union offers all health account that links interest payments to physical activity of its members (https://www.allegacy.org/savings/allhealth-wellness-savings).

Angel S (2016) The effect of over-indebtedness on health: comparative analyses for Europe. Kyklos 69:208–227. https://doi.org/10.1111/kykl.12109 CrossRef

Becker GS, Mulligan CB (1997) The endogenous determination of time preference. Q J Econ 09:729–758CrossRef

Berlin M, Kaunitz N (2015) Beyond income: the importance for life satisfaction of having access to a cash margin. J Happiness Stud 16:1557–1573. https://doi.org/10.1007/s10902-014-9575-7 CrossRef

Bertola G, Hochguertel S (2007) Household debt and credit: economic issues and data problems. Econ Notes 36:115–146. https://doi.org/10.1111/j.1468-0300.2007.00181.x CrossRef

Białowolski P (2014) Patterns of debt possession among households in Poland—a multi-group latent class approach. Bank Credit 45:79–104

Białowolski P, Węziak-Białowolska D (2017) What does a Swiss franc mortgage cost? The tale of Polish trust for foreign currency denominated mortgages: implications for well-being and health. Soc Indic Res 133:285–301. https://doi.org/10.1007/s11205-016-1363-9 CrossRefPubMed

Blázquez M, Budría S (2015) The effects of over-indebtedness on individual health. Discussion paper series—IZA

Brown S, Taylor K, Wheatley Price S (2005) Debt and distress: evaluating the psychological cost of credit. J Econ Psychol 26:642–663. https://doi.org/10.1016/j.joep.2005.01.002 CrossRef

Cawley J, Ruhm CJ (2011) The economics of risky health behaviors. Elsevier B.V, AmsterdamCrossRef

Curley J, Ssewamala F, Sherraden M (2009) Institutions and savings in low-income households. J Sociol Soc Welf 36:9–32

Cwynar A, Cwynar W, Wais K, Parda R (2017) Personal loan companies in Poland: does empirical evidence justify regulatory transition? Prague Econ Pap. https://doi.org/10.18267/j.pep.627 CrossRef

Czapiński J, Panek T (2015) Social diagnosis. www.diagnoza.com. Accessed 17 Oct 2017

D’Alessio G, Iezzi S (2013) Household over-indebtedness: definition and measurement with Italian data. IFC Bull Chapters 36:496–517

Diener E, Fujita F (1995) Resources, personal strivings, and subjective well-being: a nomothetic and idiographic approach. J Pers Soc Psychol 68:926–935. https://doi.org/10.1037//0022-3514.68.5.926 CrossRefPubMed

Drentea P, Lavrakas PJ (2000) Over the limit: the association among health, race and debt. Soc Sci Med 50:517–529. https://doi.org/10.1016/S0277-9536(99)00298-1 CrossRefPubMed

Dunnett CW (1955) A multiple comparison procedure for comparing several treatments with a control. J Am Stat Assoc 50:1096–1121. https://doi.org/10.1080/01621459.1955.10501294 CrossRef

Emami S (2010) Consumer over-indebtedness and health care costs: how to approach the question from a global perspective. In: Background Paper 3, World Health Report, 2010. https://www.who.int/healthsystems/topics/financing/healthreport/3BackgroundPaperMedBankruptcy.pdf

European Commission (2008) Towards a common operational European definition of over-indebtedness. http://www.oee.fr/files/study_overindebtedness_en.pdf

European Commission (2016) Financial products and services—special eurobarometer 446. https://doi.org/10.2874/863808

Fitch C, Chaplin R, Trend C, Collard S (2007) Debt and mental health: the role of psychiatrists. Adv Psychiatr Treat 13:194–202. https://doi.org/10.1192/apt.bp.106.002527 CrossRef

Gathergood J (2012) Debt and depression: causal links and social norm effects. Econ J 122:1094–1114. https://doi.org/10.1111/j.1468-0297.2012.02519.x CrossRef

Georgarakos D, Lojschova A, Ward-Warmedinger M (2010) Mortgage, indebtedness and household financial distress

Grafova IB (2007) Your money or your life: managing health, managing money. J Fam Econ Issues 28:285–303. https://doi.org/10.1007/s10834-007-9060-0 CrossRef

Komlos J, Smith PK, Bogin B (2004) Obesity and the rate of time preference: is there a connection? J Biosoc Sci 36:209–219. https://doi.org/10.1017/S0021932003006205 CrossRefPubMed

Kyriopoulos I-I, Zavras D, Charonis A et al (2016) Indebtedness, socioeconomic status, and self-rated health: empirical evidence from Greece. Poverty Public Policy 8:387–397CrossRef

Lawless L, Drichoutis AC, Nayga RM Jr (2013) Time preferences and health behaviour: a review. Agric Food Econ 1:1–19. https://doi.org/10.1186/2193-7532-1-17 CrossRef

Loewenstein G (2000) Emotions in economic theory and economic behavior. Am Econ Rev 90:426–432CrossRef

Münster E, Rüger H, Ochsmann E et al (2009) Over-indebtedness as a marker of socioeconomic status and its association with obesity: a cross-sectional study. BMC Public Health 9:1–6. https://doi.org/10.1186/1471-2458-9-286 CrossRef

Richardson T, Elliott P, Roberts R (2013) The relationship between personal unsecured debt and mental and physical health: a systematic review and meta-analysis. Clin Psychol Rev 33:1148–1162. https://doi.org/10.1016/j.cpr.2013.08.009 CrossRefPubMed

Scanlon E, Adams D (2008) Do assets affect well-being? Perceptions of youth in a matched savings program. J Soc Serv Res 35:33–46. https://doi.org/10.1080/01488370802477048 CrossRef

Sherraden M (1991) Assets and the poor. M.E. Sharpe Inc., Armonk

Shim S, Serido J, Tang C (2012) The ant and the grasshopper revisited: the present psychological benefits of saving and future oriented financial behaviors. J Econ Psychol 33:155–165. https://doi.org/10.1016/j.joep.2011.08.005 CrossRef

Sweet E, Nandi A, Adam EK, McDade TW (2013) The high price of debt: household financial debt and its impact on mental and physical health. Soc Sci Med 91:94–100. https://doi.org/10.1016/j.socscimed.2013.05.009 CrossRefPubMedPubMedCentral

Tay L, Batz C, Parrigon S, Kuykendall L (2017) Debt and subjective well-being: the other side of the income-happiness coin. J Happiness Stud 18:903–937. https://doi.org/10.1007/s10902-016-9758-5 CrossRef

Turunen E, Hiilamo H (2014) Health effects of indebtedness: a systematic review. BMC Public Health 14:489. https://doi.org/10.1186/1471-2458-14-489 CrossRefPubMedPubMedCentral

VanderWeele TJ (2017) Outcome-wide epidemiology. Epidemiology 28:399–402. https://doi.org/10.1097/EDE.0000000000000641 CrossRefPubMedPubMedCentral

VanderWeele TJ, Ding P (2017) Sensitivity analysis in observational research: introducing the E-value. Ann Internal Med 167:268–274CrossRef

VanderWeele TJ, Yu J, Cozier YC et al (2017) Religious service attendance, prayer, religious coping, and religious-spiritual identity as predictors of all-cause mortality in the Black Women’s Health Study. Am J Epidemiol 185:515–522CrossRefPubMedPubMedCentral

Wang Y, Sareen J, Afifi TO et al (2012) Recent stressful life events and suicide attempt. Psychiatr Ann 42:101–108. https://doi.org/10.3928/00485713-20120217-07 CrossRef

Węziak-Białowolska D, Białowolski P (2016) Cultural events—does attendance improve health? Evidence from a Polish longitudinal study. BMC Public Health. https://doi.org/10.1186/s12889-016-3433-y CrossRefPubMedPubMedCentral

Title: The impact of savings and credit on health and health behaviours: an outcome-wide longitudinal approach
Authors: Piotr Białowolski
Dorota Węziak-Białowolska
Tyler J. VanderWeele
Publication date: 01-05-2019
Publisher: Springer International Publishing
Published in: International Journal of Public Health / Issue 4/2019
Print ISSN: 1661-8556
Electronic ISSN: 1661-8564
DOI: https://doi.org/10.1007/s00038-019-01214-3

At a glance: The STEP trials

Springer Medicine

The impact of savings and credit on health and health behaviours: an outcome-wide longitudinal approach

Abstract

Objectives

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

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