Over-indebtedness as a marker of socioeconomic status and its association with obesity: a cross-sectional study

Münster, Eva; Rüger, Heiko; Ochsmann, Elke; Letzel, Stephan; Toschke, André Michael

doi:10.1186/1471-2458-9-286

Cited by 69 publications

(58 citation statements)

References 25 publications

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“…A small literature extends the aforementioned research to examine the relationship between health and debt. Münster et al (2009) find that over-indebtedness in Germany is negatively associated with physical health. Evidence also suggests that debt can result in a decline in physical health due to socio-economic hardship and material deprivation (Cohen et al, 2007;Reading & Reynolds, 2001).…”

Section: Literature Reviewmentioning

confidence: 75%

Does debt affect health? Cross country evidence on the debt-health nexus

Clayton

Liñares-Zegarra

Wilson

2015

Social Science & Medicine

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We investigate the relationship between household debt and health outcomes for OECD countries over the period 1995 to 2012. Using a dataset of aggregated, standardized and objective measures of household debt and health outcomes, we estimate an instrumental variable (GMM) model in order to deal with endogeneity and reverse causality concerns between health and debt. We find that higher household debt is linked to poorer general health. The results are also significant in extreme cases where households are among the most financially distressed (overindebted). We also find a link between debt maturity and health. Long-term household debt reduces life expectancy and increases premature mortality. The opposite holds for the relation between short and medium term debt and health. The results are robust after controlling for other socio-economic factors (including GDP per capita, government expenditure on health, percentage of rural population and alcohol consumption) that affect health. We investigate the relationship between household debt and health outcomes for OECD countries over the period 1995 to 2012. Using a dataset of aggregated, standardized and objective measures of household debt and health outcomes, we estimate an instrumental variable (GMM) model in order to deal with endogeneity and reverse causality concerns between health and debt. We find that higher household debt is linked to poorer general health. The results are also significant in extreme cases where households are among the most financially distressed (overindebted). We also find a link between debt maturity and health. Long-term household debt reduces life expectancy and increases premature mortality. The opposite holds for the relation between short and medium term debt and health. The results are robust after controlling for other socio-economic factors (including GDP per capita, government expenditure on health, percentage of rural population and alcohol consumption) that affect health.JEL Classification: D12, D14, I12

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Section: Literature Reviewmentioning

confidence: 75%

Does debt affect health? Cross country evidence on the debt-health nexus

Clayton

Liñares-Zegarra

Wilson

2015

Social Science & Medicine

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“…According to Puhl & Peterson (99), weight stigmatization and discrimination are particularly pronounced in the workplace setting. Their conclusions are supported by evidence that shows how obese individuals face stigma and prejudice at many stages of the employment process, including hiring, wage determination, and job promotions (74,103,105). Intentional efforts to focus on respect may address stigma and reflect a reasonable approach to appreciate human-centered cultures.…”

Section: Ethics Trust Respect and Human-centered Culturesmentioning

confidence: 94%

Fitness of the US Workforce

Pronk

2015

Annu. Rev. Public Health

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Fitness matters for the prevention of premature death, chronic diseases, productivity loss, excess medical care costs, loss of income or family earnings, and other social and economic concerns. The workforce may be viewed as a corporate strategic asset, yet its fitness level appears to be relatively low and declining. Over the past half-century, obesity rates have doubled, physical activity levels are below par, and cardiorespiratory fitness often does not meet minimum acceptable job standards. During this time, daily occupational energy expenditure has decreased by more than 100 calories. Employers should consider best practices and design workplace wellness programs accordingly. Particular attention should be paid to human-centered cultures. Research should address ongoing surveillance needs regarding fitness of the US workforce and close gaps in the evidence base for fitness and business-relevant outcomes. Policy priorities should consider the impact of both state and federal regulations, adherence to current regulations that protect and promote worker health, and the introduction of incentives that allow employers to optimize the fitness of their workforce through supportive legislation and organizational policies.

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“…Four studies examined the health of those undergoing debt counselling; these are shown in appendix F. Two cohort studies compared over-indebted clients to the general population, finding an increased likelihood being overweight and reporting back pain after controlling for confounds (Munster, Ruger, Ochsmann, Letzel, & Toschke, 2009;Ochsmann, Rueger, Letzel, Drexler, & Muenster, 2009). O"Neill, Sorhaindo, Xiao, and Garman (2005) found that self-rated health was linked to reduced debts after a debt management intervention.…”

Section: Debt Management Clientsmentioning

confidence: 99%

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

Richardson

Elliott

Roberts

2013

Clinical Psychology Review

343

278

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This paper systematically reviews the relationship between personal unsecured debt and health. Psychinfo, Embase and Medline were searched and 52 papers were accepted. A hand and citedby search produced an additional 13 references leading to 65 papers in total. Panel surveys, nationally representative epidemiological surveys and psychological autopsy studies have examined the relationship, as have studies on specific populations such as university students, debt management clients and older adults. Most studies examined relationships with mental health and depression in particular. Studies of physical health have also shown a relationship with self-rated health and outcomes such as obesity. There is also a strong relationship with suicide completion, and relationships with drug and alcohol abuse. The majority of studies found that more severe debt is related to worse health; however causality is hard to establish. A meta-analysis of pooled odds ratios showed a significant relationship between debt and mental disorder (OR=3.24), depression (OR=2.77), suicide completion (OR=7.9), suicide completion or attempt (OR=5.76), problem drinking (OR=2.68), drug dependence (OR=8.57), neurotic disorder (OR=3.21) and psychotic disorders (OR=4.03). There was no significant relationship with smoking (OR=1.35, p>.05). Future longitudinal research is needed to determine causality and establish potential mechanisms and mediators of the relationship.Dr Bellack, Please find attached a response to the reviewer's comments and an amended manuscript. We hope that these changes address the concerns raised, and the paper can now be accepted for -This relationship is especially strong for mental health in particular depression.-There are also relationships with substance use and suicide.-Research suffers from inconsistent use of standardised measures.-A lack of longitudinal studies makes it difficult to demonstrate causality. *Highlights (for review)We would like to thank the reviewer for their detailed comments. In relation to these we have made the following changes, which have all been marked in the main manuscript via track changes:-We have now clarified in the title, abstract, introduction, discussion and highlights that this examines personal unsecured debt specifically.-In the Method, Search Procedure we have changed "Classes" into "Classed" -In Appendix B (Characteristics of Panel Surveys) we have added "years" to 4-6. The formatting of the tables meant that some words were cut off: this has now been corrected for all the tables.-Page 17, fifth line of first paragraph, "self-related" has been changed to "self-rated." -Page 19, second paragraph, a new paragraph has been started after the line beginning "The advantage." -Page 20, first line of second paragraph, "somewhat unclear" has been changed to "unclear".-Page 21, second paragraph, the first line has been amended to specify about "personal, unsecured debt".-Page 5: more detail has been added to justify why studies on secured loans and mortgage debt were excluded.-Resul...

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Over-indebtedness as a marker of socioeconomic status and its association with obesity: a cross-sectional study

Cited by 69 publications

References 25 publications

Does debt affect health? Cross country evidence on the debt-health nexus

Does debt affect health? Cross country evidence on the debt-health nexus

Fitness of the US Workforce

The relationship between personal unsecured debt and mental and physical health: A systematic review and meta-analysis

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