Worried Sick: The Experience of Debt Problems and their Relationship with Health, Illness and Disability

Balmer, Nigel J.; Pleasence, Pascoe; Buck, Alexy; Walker, Heather C.

doi:10.1017/s147474640500271x

Cited by 76 publications

(46 citation statements)

References 22 publications

(47 reference statements)

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“…Firstly, in addition to financial difficulties causing health problems, poor health may also cause financial problems. Balmer et al (2006) report that long-term illness or disability was the strongest predictor of debt problems in their analysis. Healthcare costs due to serious medical conditions may drive patients into bankruptcy (Himmelstein et al, 2009).…”

Section: Modelling Strategymentioning

confidence: 97%

The impact of debt and financial stress on health in Northern Irish households

French

McKillop

2017

Journal of European Social Policy

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We analyse data collected from a survey of Northern Irish low-income households experiencing varying degrees of financial hardship and examine how debt affects health and health-related behaviours. Our results indicate that the subjective experience of feeling financially stressed has a robust relationship with most aspects of health, including ability to self-care, problems performing usual activities, pain problems and psychological health. In contrast, the size of the debt, the type of debt or the number of different lenders does not add any extra explanatory power. Additionally, our results indicate that the pathway from financial difficulties to worse health runs through worse diets and increased consumption of cigarettes and drugs. This research is timely as household debt burdens will soon surpass the high levels seen at the time of the financial crisis and the introduction of welfare reform in Northern Ireland will put additional strain on low-income households.

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Section: Modelling Strategymentioning

confidence: 97%

The impact of debt and financial stress on health in Northern Irish households

French

McKillop

2017

Journal of European Social Policy

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“…Lyons and Yilmazer (2005) found no relationship between debt and self-reported health, whilst a longitudinal study by Polprasert, et al (2006) found that debt did not predict death from disease in Thailand. Balmer, Pleasence, Buck, and Walker (2006) found that long term illness or disability increased the likelihood of legal problems resulting from debt.…”

Section: Nationally Representative Surveysmentioning

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

326

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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“…Financial stressors may lead to or result from poor health, or both, and financial difficulties may be experienced as several interconnected events, or changes accumulating in no particular order (Balmer et al, 2005;Nettleton & Burrows, 1998).…”

Section: Introductionmentioning

confidence: 99%