Household debt and depressive symptoms among older adults in three continental European countries

Financial debt, worry about debt and mental health in Japan

BACKGROUND

Financial debt has been linked to poorer mental health. However, most research has been undertaken in western countries. This study examined the association between financial debt, worry about debt, and mental health in Japan, where there has been little specific focus on debt and its effects on mental health.

METHODS

Data were analyzed from 3717 respondents collected in an online survey in 2023. Information on financial debt and worry about debt was collected with single-item questions. The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scale were used to respectively collect information on depression and anxiety symptoms, while a single-item measure was used to obtain information on a recent history of suicidal ideation. Logistic regression was used to assess associations.

RESULTS

Both financial debt (17.7%) and worry about debt (14.8%) were prevalent in the study sample. In fully adjusted analyses, compared to those with no debt and worry about debt, individuals who were worried about debt but had no debt, or who had debts and were worried about debt had significantly higher odds for suicidal ideation and depressive symptoms. In contrast, having debt but not being worried about debt was not associated with any of the mental health outcomes.

CONCLUSION

The results of this study suggest that worrying about debt is strongly associated with poorer mental health among Japanese adults. Interventions to address debt and its associated worries may be important for improving public mental health in Japan.

How does debt shape health outcomes for older Americans?

The deleterious effects that debt can have on health outcomes are well documented, yet comprehensive studies of the debt-health link for older adults remain limited even as their indebtedness has increased dramatically in recent decades. Additionally, the literature cannot explain the causal pathway linking poor health with debt. Using data from the Health and Retirement Study (1998-2016), we examine a range of physical and mental health measures and assess how they may be shaped by the amount and type of debt held by older adults. To address the likely endogeneity of debt and health, we employ marginal structural models, developed specifically as an identification strategy in the presence of possible endogeneity, alongside population-averaged models that allow us to compare outcomes for populations with and without debt without relying on unverifiable assumptions regarding the underlying population distribution as is the case with random- and fixed-effects models. Findings indicate that carrying any debt has a negative effect on a range of health outcomes for older adults, including objective and subjective physical and mental health. In addition, the more debt older adults carry, the more detrimental it is for their health. Finally, the type of debt matters: while secured debt has a limited, if any, negative impact on health outcomes, unsecured debt has a substantial negative impact on health. Policymakers should design policies that promote the prudent use of debt and discourage carrying large debt burdens, especially unsecured debt, into retirement as this would promote better health outcomes for older Americans.

Media use degree and depression: A latent profile analysis from Chinese residents

Background

Previous studies have emphasized the media as an essential channel for understanding information about depression. However, they have not divided groups according to the degree of media use to study their differences in depression. Therefore, this study aims to explore the influence of media use on depression and the influencing factors of depression in people with different media use degrees.

Methods

Based on seven items related to media use, a total of 11, 031 respondents were categorized by the frequency of media use using latent profile analysis (LPA). Secondly, multiple linear regression analyzes were conducted to analyze the effects of depression in people with different degrees of media use. Finally, factors influencing depression among people with different degrees of media use were explored separately.

Results

All respondents were classified into three groups: media use low-frequency (9.7%), media use general (67.1%), and media use high-frequency (23.2%). Compared with media use general group, media use low-frequency (β = 0.019, p = 0.044) and media use high-frequency (β = 0.238, p < 0.001) groups are significantly associated with depression. The factors influencing depression in the population differed between media use low-frequency, media use general, and media use high-frequency groups.

Conclusion

The government and the appropriate departments should develop targeted strategies for improving the overall health status of people with different media use degrees.

Financial stress and depression in adults: A systematic review

Financial stress has been proposed as an economic determinant of depression. However, there is little systematic analysis of different dimensions of financial stress and their association with depression. This paper reports a systematic review of 40 observational studies quantifying the relationship between various measures of financial stress and depression outcomes in adults. Most of the reviewed studies show that financial stress is positively associated with depression. A positive association between financial stress and depression is found in both high-income and low-and middle-income countries, but is generally stronger among populations with low income or wealth. In addition to the "social causation" pathway, other pathways such as "psychological stress" and "social selection" can also explain the effects of financial stress on depression. More longitudinal research would be useful to investigate the causal relationship and mechanisms linking different dimensions of financial stress and depression. Furthermore, exploration of effects in subgroups could help target interventions to break the cycle of financial stress and depression.

Household indebtedness and depressive symptoms among older adults in China: The moderating role of social network and anticipated support

BACKGROUND

Examine the association of household financial indebtedness with depressive symptoms in old age, and investigate whether social network and support anticipation moderate the association.

METHODS

Data were obtained from Sample Survey on Vulnerable Populations from Poor Families in Urban/Rural China (2018), with a sample of 5 934 older adults included. Center for Epidemiologic Studies Depression Scales was applied to measure depressive symptoms. Household indebtedness was measured in several ways, including whether the household was indebted, the amount of debts, and types of debts. We used the 6-item Lubben Social Network Scale to measure individual's social network. Socio-demographic, socioeconomic status and physical health variables were included as covariates.

RESULTS

Household indebtedness, in form of being indebted and increased amount of debts, was associated with greater depressive symptoms in the Chinese elderly. The association of indebtedness and depressive symptoms may be driven by consumption and emergency debts. The moderating roles of social network and anticipation of support in the association of household indebtedness and depressive symptoms were found. Among those with household debts, older adults with larger size of social network and/or higher anticipation of being supported in the future reported with less symptoms of depressed.

LIMITATIONS

Due to a lack of information on the duration and debtor of household debt, we were not able to present a precise estimate for the exact impact of household indebtedness on mental health of elderly.

CONCLUSION

Familial financial strain was associated with aging mental well-being, increased social networks and social protections benefit aging health.

The Relationship Between Financial Worries and Psychological Distress Among U.S. Adults

This study examines the association between financial worries and psychological distress among US adults and tests its moderating effects by gender, marital status, employment status, education, and income levels. Data were derived from the cross-sectional 2018 National Health Interview Survey (NHIS) of the adult population. The hierarchical regression analysis revealed that higher financial worries were significantly associated with higher psychological distress. Additionally, the association between financial worries and psychological distress was more pronounced among the unmarried, the unemployed, lower-income households, and renters than their counterparts. The findings suggest that accessible financial counseling programs and public health intervention programs are needed to mitigate financial worries and its negative influences on overall psychological health, with greater attention devoted to vulnerable populations.

The role of consumer and mortgage debt for financial stress

OBJECTIVES

Financial debt held by older adults in the U.S. has grown over the past two decades. This study examines the extent to which credit cards, other consumer debts, and mortgage debt increase financial stress. Outcome measures of financial stress include the material domain ("bill-paying difficulty") and psychological domain ("ongoing financial strain").

METHOD

We analyzed adults age 62 and older in the 2004 to 2016 waves of the Health and Retirement Study using random-effects logit regressions.

RESULTS

Unsecured consumer debt is associated with more financial stress per dollar than mortgage debt. A detailed assessment of mortgage debt finds that greater levels of both first and secondary mortgages are associated with greater bill-paying difficulty and greater ongoing financial strain. An increase in new mortgage debt obtained after age 62 is associated with an increase in bill-paying difficulty, but is not significantly associated with ongoing financial strain. In contrast, a reduction in mortgage debt since age 62 is associated with lower bill-paying difficulty and lower levels of ongoing financial strain.

CONCLUSION

The relationship between consumer debt, mortgages, and financial stress is nuanced, and depends on both the type and timing of the debt.

Catastrophic health expenditure and mental health in the older Chinese population: The moderating role of social health insurance

OBJECTIVES

Catastrophic health expenditure (CHE) has considerable effects on household living standards, but little is known regarding the relationships between CHE and people's mental health. Using China as an example, this study examines the association between CHE and mental health and investigates whether the association differs between those with and without social health insurance (SHI).

METHODS

The data came from three waves of the China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, and 2015, N = 13,166). We focused on older people aged 60 and above. We built panel data regression and quantile regression models to analyse the data.

RESULTS

Incurring CHE is significantly associated with poor mental health. The association is weakened among older people receiving SHI, which indicates that SHI has a protective effect. Moreover, the association between CHE and mental health and the protective effect of SHI are stronger among those with mild or moderate mental health problems.

DISCUSSION

Our findings provide empirical evidence that encourages the integration of psychologically informed approaches in health services. We also urge governments in low- and middle-income countries to consider more generous health financing mechanisms for older people with greater healthcare needs.

The Able Worry More? Debt Delinquency, Financial Capability, and Financial Stress

Research on the link between debt and financial stress is emerging. This study was one of the first attempts to examine the association between debt delinquency and financial stress and the moderating role of financial capability in the association. Delinquencies in three types of debts were examined: (a) mortgage, (b) credit card, and (c) student loan. With data from the 2018 U.S. National Financial Capability Study, multivariate regression results showed that payment delinquencies of mortgage, credit card and student loans were positively, while financial capability was negatively associated with financial stress. Further, surprisingly, the results implied that among consumers with debt delinquencies, financial capability may increase financial stress. If both financial capability's direct and interactive effect were considered, financial capability may decrease financial stress at much smaller rates than those without debt delinquencies. The situation was the worst among consumers with multiple delinquencies, in which the potential net effect of financial capability on financial stress was positive. The results of this study have implications for consumer financial service practices.

Association between household debt and depressive mood among Chinese residents

OBJECTIVES

The aim of this study was to examine the association of household debt and depressive mood among Chinese adults and to evaluate whether the association varies across types of debt.

STUDY DESIGN

This is a secondary data analysis of a nationally representative survey.

METHODS

A prospective cohort study of participants was drawn from the China Family Panel Studies (CFPS). In total, 5135 participants had their depressive mood measured in the CFPS starting from 2014 to 2016 and had participated in the biennial survey. We used logistic regression models to identify predictors of depressive mood with debts, sociodemographic factors, health status factors and health behaviors factors. Adjusted for all measured covariates, we conducted an independent analysis for the experience of housing loans from formal institutions (HLFI), other loans from formal institutions (OLFI), housing loans from relatives and friends (HLRF) and other loans from relatives and friends (OLRF).

RESULTS

Multiple logistic regression analyses revealed that household debt was a significant risk factor for depressive mood (1.35; 95% confidence interval [CI], 1.19-1.54), after controlling for potential confounders. Independent analysis revealed that HLFI was not a significant predictor, while HLRF (1.26; 95% CI, 1.08-1.48), OLFI (1.45; 95% CI, 1.13-1.87) and OLRF (1.23; 95% CI, 1.02-1.47) remained significant risk factors.

CONCLUSION

OLFI, HLRF and OLRF were associated with depressive mood, while HLFI was not. To address the problem of individual depressive mood, its apparent association with household debt should be paid more attention.

Worry about debt is related to social loneliness in older adults in the Netherlands

The amount of financial debt held by older adults has grown substantially over the past two decades in Europe. This study examines the association of objective and subjective debt burden with social and emotional loneliness among 1,606 older adults in the Netherlands. Objective debt burden is based on financial terms, such as debt-to-income ratio; whereas subjective debt burden measures the psychological distress caused by financial debt. Data are from the 2015/2016 wave of the Longitudinal Aging Study Amsterdam. First, we use means-comparison tests to examine whether older adults who experience social and emotional loneliness differ from older adults who do not experience loneliness regarding their subjective and objective debt burdens. Subsequently, using linear regression models we address two questions: whether social loneliness and emotional loneliness are associated with objective and subjective debt burden; and whether social participation, social network size, anxiety and depression mediate these relationships. We find that subjective debt burden (i.e. the worry related to debt) is a significant predictor of social loneliness, above and beyond the role of social and psychological measures. Objective debt burden, in contrast, is unrelated to social and emotional loneliness. Social participation, social network size, anxiety and depression do not mediate the debt-burden-to-loneliness relationships. The results point to the importance of subjective debt burden in understanding social loneliness and designing interventions.

Debt matters? Mental wellbeing of older adults with household debt in England

Background

A record number of older individuals have household debt, but little is known about possible links between debts and their mental wellbeing. This study examines the extent to which different aspects of household indebtedness predict mental wellbeing among this population.

Methods

A sample of 17,091 individuals (72,700 observations) aged 50 and over in England was derived from waves 1–8 of the English Longitudinal Study of Ageing. Mental wellbeing was assessed by two outcome measures: number of depressive symptoms (CES-D 8) and quality of life (CASP-19 score). The predictors of mental wellbeing were examined using quartiles of non-zero overall debt amount, debt-to-income and debt-to-non-housing wealth ratios as alternative measures of debt burden. Linear regression models estimated the associations of mortgage and non-mortgage debt measures with mental wellbeing while adjusting for observable socioeconomic confounding factors. Individual fixed effect models were used to control for all time-constant factors among a longitudinal subsample.

Results

Individuals in the highest debt-to-wealth quartile were particularly at risk of lower mental wellbeing, that is, a higher number of depressive symptoms and lower quality of life. After covariate adjustment, non-mortgage debt predicted lower mental wellbeing on both measures but mortgage debt was only linked to lower quality of life. Among the subsample who experienced changes in high non-mortgage debt levels, a small association of these changes with mental wellbeing outcomes were observed. Asymmetric within-individual estimation showed that both getting rid of and acquiring new debts during the study period predicted symmetrically (small) increases and decreases, respectively, in mental wellbeing.

Conclusion

These findings indicate that among older individuals in England, non-mortgage debt status is linked to poor mental wellbeing. High, non-mortgage, debt-to-wealth ratios may help identify risk of mental wellbeing issues in older people with debts.

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Little is known on debt and mental wellbeing among older individuals in England.

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Debt type and debt measures matter for mental wellbeing.

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Non-mortgage debt was linked to lower mental wellbeing between observations.

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However, smaller effects of non-mortgage debts were observed within-individuals.

Financial debt amongst older women in the United Kingdom – shame, abuse and resilience

Long-term poverty, precarious employment, low pay, the increased pension age and real-term reductions in welfare benefits, including bereavement allowances, have brought into focus the financial vulnerability of many older women aged 55 years and older in the United Kingdom. In this article, survey data were analysed alongside evidence from observations of debt support meetings and interviews with older women who were receiving debt advice from a support charity. The findings suggest that older women were more likely to have financial problems than older men, particularly those women who were living on low incomes and who were separated or divorced. Following the breakdown of a relationship, many older women were at increased risk of more debt and bankruptcy, particularly those aged between 55 and 64 years and those in routine and semi-routine occupations. Many women had kept their financial problems hidden due to fear and shame whilst bringing up their children and some had been subject to coercive control and economic abuse by their former husbands or partners. It is important that any pension reforms, changes to minimum wage rates, and new divorce and domestic abuse legislation and welfare policies take account of the circumstances of separated, divorced and widowed older women. More financial support and advice needs to be provided to older women facing financial difficulties.