Abstract
BackgroundPossible 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.MethodsWe 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.ResultsThe 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.ConclusionsThe 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.
Highlights
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
One fifth of the women and one sixth of the men reported inability to pay for ordinary bills
Analysis of the combined economic hardships measure revealed that 17% of the women suffered from severe or very severe levels of economic hardships compared to 12% of the men. 19% of the women and 14% of the men reported that they suffered from psychological distress, 6% of women and 4% of men reported that they suffered from severe anxiety and 5% of the men and 9% of the women reported use of antidepressant medications
Summary
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. A majority of previous studies analysing conventional indicators of poverty or economic hardships based on income have found evident associations with poor mental health outcomes such as psychological distress [1,2,3,4] and depression [5,6,7,8,9,10]. Less attention has been paid to other ‘non income related’ dimensions of economic hardships like material deprivation or economic difficulties/financial strain and their relation to mental health. It has been proposed that the knowledge of having less than others may create feelings of relative depression which in the end may affect health [17]
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