Do Debts Make You Sick? A 15-Year Follow-up Study of Long-Term Over-Indebtedness
Abstract
This study explores the health consequences of long-term over-indebtedness in Finland. The focus is on persons who became over-indebted during the 1990s recession at the latest and who remained indebted for the next 15 years or more. Previous research has indicated that indebtedness may be associated with health problems, but there are no register-based long-term follow-up studies of those who became indebted mainly during the recession.
Using Finland’s leading database of consumer and business credit history, we identified those individuals whose debts had been subject to foreclosure for at least 15 years but whose debt records were erased in 2010 because of new legislation. For each long-term over-indebted person we identified one control matched for age, sex and municipality through random sampling from the population register. Register data on age, sex, municipality, entitlements to special reimbursements for medicines, disability pensions and sickness absence were linked for both the over-indebted persons and
for the controls (total N=64,363). Health status and morbidity were measured based on the prevalence and incidence of entitlements to special reimbursements for certain severe and chronic diseases. The data were analysed using cross-tabulation, Kaplan-Meier survival estimates and Cox proportional hazards models.
The results show that the incidence of special reimbursement entitlements due to diabetes, psychosis, coronary heart disease and chronic bronchial asthma and chronic obstructive pulmonary disease was higher among the long-term over-indebted women and men than among their controls. The elevated risk of morbidity was highest for diabetes and psychosis, and in all cases higher among women than among men. Among women, the higher risk of morbidity among the over-indebted was also detected when looking at all reimbursement entitlements in respect of medicines, but among men no difference was seen between the two groups. An anomaly was observed in arterial hypertension: over-indebted men were less likely to
receive an entitlement to medicine reimbursements due to this disease, whereas among women the results were opposite and similar to those for other diseases.
The analyses show that long-term indebtedness was indeed associated with decreased health status among those who had been under foreclosure for at least 15 years. The pathway from debt to ill health may go through direct stress caused by the debt burden, through low income because of continuing foreclosure, or through harmful health behaviour, for example. In Finland, over-indebtedness seems to have affected women more strongly than men. Social policy makers should consider taking steps to prevent over-indebtedness by regulating the supply of credit, by
debt counselling and by increasing the awareness of social and health service professionals of the harmful effects of over-indebtedness.
Authors
Jenni Blomgren, Nico Maunula, Heikki Hiilamo
Additional Information
- Peer-Reviewed: yes.
- Open Access: yes.
- Cite as: Blomgren, J., Maunula, N., & Hiilamo, H. (2014). Sairastuttaako velka? 15 vuoden seurantatutkimus pitkäaikaisesti ylivelkaantuneista. Yhteiskuntapolitiikka, 79(3), 245–263. https://urn.fi/URN:NBN:fi-fe2014061126415
