Over-indebtedness and its association with pain and pain medication use

Abstract

In developed countries, millions of households are over-indebted, and the number continues to rise. Studies have found an increased risk of adverse health effects among individuals that cannot cover payment obligations with available assets persistently. However, little is known about the role of over-indebtedness in pain. This study examined the association between over-indebtedness and pain and pain medication use.A cross-sectional study conducted among over-indebted individuals in 70 debt advisory centres in Germany (OID-survey; n = 699) was linked to the nationally representative German Health Interview and Examination Survey for Adults (DEGS1; n = 7987). Descriptive statistics and logistic regression analyses were used to examine the association between over-indebtedness and pain and pain medication use among participants with valid data on both outcome variables (n = 7560).Pain was experienced by over-indebted individuals more frequently (71.3%) compared to the general population (59.6%) whereas the prevalence of pain medication use was similar in both samples (DEGS1 12.6% vs. OID-survey 13.1%). Over-indebtedness significantly increased the odds of pain (aOR 1.30; 95%-CI 1.07–1.59) after adjusting for socioeconomic, demographic and health factors. The over-indebted were significantly less likely to use pain medication compared to the general population after adjustment (aOR 0.76; 95%-CI 0.58–0.99).Taking over-indebtedness into account as risk factor for pain and restricted pain medication use in research and clinical practice will help to advance the understanding of pain disparities, develop suitable interventions for preventive action and promote accessible pain management among those at risk.

Trajectories of unsecured debt and health at midlife

“…Nevertheless, even respondents who had paid down debt over time reported worse health than those who remained at relatively low levels of debt, demonstrating that the lasting strain of unsecured debt for midlife health. Therefore, future research should more closely examine the contribution of indebtedness to onset and persistence of chronic pain problems ( Warth et al, 2019 ), including specific pain problems that might reflect cumulative stress burden at midlife, such as migraine, lower back pain, and complex regional pain syndrome (CRPS) ( Goebel, 2011 ; Shmagel et al, 2016 ; Victor et al, 2010 ).…”

Association between over-indebtedness and antidepressant use: A cross-sectional analysis

“…Besides physical morbidity, e.g. diabetes [7], obesity [8] and pain [9,10], over-indebtedness has consistently been found to be associated with mental illness, including psychoses [7] and depression [11][12][13][14][15][16][17].…”

Role of Gambling in Payback Failure in Consumer Credit—Data from a Large Body of Material Regarding Consumer Loan Recipients in Sweden

“…Over-indebtedness, characterized by the inability to fulfill one's financial obligations, has been shown to be associated with both physical and mental health conditions [3], even including suicidal ideation [4] and completed suicide [1]. Other health hazards associated with over-indebtedness include obesity [5], pain [6,7], sleeping problems and sleep medication use [8], psychosis, diabetes [9], and poor adherence to prescribed medication [10].…”