On the Relation Between Over-Indebtedness and Well-Being: An Analysis of the Mechanisms Influencing Health, Sleep, Life Satisfaction, and Emotional Well-Being

Overindebtedness, unemployment, and poor mental health - and the role of sense of control: a population-based Swiss study

Background

Both overindebtedness and unemployment are critical life events that can result in or lead to poor mental health. What is less known is that the two partly interrelated events frequently go along with a feeling of loss or lack of control in life, which could be the main reason why they are associated with poor mental health. This has not been examined in previous research, particularly not in this combination.

Methods

This study used and merged two cross-sectional data sets. Data collected in 2019 on 219 overindebted clients of the four official debt advisory centers in the Canton of Zurich were linked with a comparable subsample of 1,997 respondents from the Swiss Health Survey of 2017. The entire study population covered 2,216 adult individuals living in the Canton of Zurich.

Results

The prevalence of no or low sense of control, medium to high psychological distress, and moderate to major depression was much higher among the 44 solely unemployed (36/30/12%), the 189 solely overindebted (73/83/53%), and particularly among the 30 unemployed and overindebted (93/97/60%) than among all 1,953 other survey participants (21/13/7%). Unemployment, overindebtedness, and a (resulting) lack or loss of control were all found to be strong risk factors for the two mental health outcomes under study. Associations, or rather negative health effects, were partly but not fully mediated by the sense of control. Overindebtedness much more strongly predicted psychological distress (ß = -0.37) and depression (ß = 0.17) than unemployment (ß = -0.05/0.01). The sense of control turned out to be an independent explanatory factor for poor mental health and even the strongest of all (ß = 0.49/-0.59).

Conclusion

Improving a person's control beliefs could be a promising measure for preventing mental health disorders in general and in people who are unemployed and/or overindebted in particular.

Poor mental health is associated with the exacerbation of personal debt problems: A study of debt advice adherence

BACKGROUND

It is known that there is an association between debt and poor mental health. However, much of the literature is observational and focuses on how debt may lead to poor mental health. Here, we are interested in how poor mental health may be associated with debt advice adherence.

AIMS

The aim of the study was to investigate the relationship between mental health and debt advice adherence in individuals applying for a formal debt resolution mechanism (an Individual Voluntary Arrangement, IVA).

METHOD

Eighty-six participants completed a survey measuring mental health (MHI-5), memory for information discussed during the appointment, attitudes towards IVAs, and trust in the advisor shortly after having a debt advice appointment. Adherence to the advice (whether participants completed the IVA application) was measured 10 weeks later.

RESULTS

The study found that the sample demonstrated poor levels of mental health overall but that non-adherent participants had significantly poorer mental health than those who adhered to the advice.

CONCLUSION

These results suggest that (a) mental health needs to be considered when advising people with problem debt and (b) future research might examine if mental health support should coincide with important decision points in the debtor's journey out of debt.

Personal well-being and financial threats in Peruvian adults: The mediating role of financial well-being

Crises negatively affect the economy of a country, increasing financial risk, as they affect work activities and the well-being of the population. This study aimed to examine the mediating role of financial well-being in the relationship between personal well-being and financial threats. A predictive cross-sectional study was conducted. The variables analyzed were personal well-being, financial threats, and financial well-being. A total of 416 Peruvian adults from the three regions of Peru participated. The mean age was M = 35.36, SD = 8.84, with a range of 19-62 years. To represent the statistical mediation model, a structural equation model (SEM) was used. The analysis showed that the variables were significantly related (p < 0.001). The theoretical model indicated a perfect mediation, also obtaining a good fit, χ ²(168) = 394.3, CFI = 0.931, RMSEA = 0.057, SRMR = 0.062. The study showed that personal well-being serves as a basis for promoting financial well-being and this contributes to the reduction of financial threats.

Selling one's future: over-indebtedness and the risk of poor mental health and the role of precarious employment - results from the Scania Public Health Cohort, Sweden

OBJECTIVES

The credit market has expanded rapidly, increasing the risk of over-indebtedness among those who lack secure employment or adequate income, an issue of concern in the COVID-19 aftermath. We investigated the role of over-indebtedness for developing poor mental health, and whether this impact is modified by age, gender, educational level or being in precarious employment.

METHODS

This is a cohort study using data from the Swedish Scania Public Health Cohort, based on individuals randomly selected from the general adult population in Scania, southern Sweden, initiated in 1999/2000 (response rate 58%) with follow-ups in 2005 and 2010. Over-indebtedness was assessed by combining information on cash margin and difficulty in paying household bills. Mental health was assessed by General Health Questionnaire-12. Those with poor mental health at baseline were excluded, and the analyses were further restricted to vocationally active individuals with complete data on main variables, resulting in 1256 men and 1539 women.

RESULTS

Over-indebtedness was more common among women, among persons with a low educational level, born abroad and with a precarious employment at baseline. The age-adjusted incidence rate ratio (IRR) for poor mental health in 2010 among individuals exposed to over-indebtedness in 1999/2000 or 2005 was 2.2 (95% CI 1.7 to 2.8). Adjusting for educational level, country of origin and precarious employment in 1999/2000 or 2005, yielded an IRR of 2.0 (95% CI 1.6 to 2.6). An interaction analysis indicated that a high level of education may act synergistically with over-indebtedness, regarding poor mental health among men.

CONCLUSIONS

Over-indebtedness was related to unfavourable societal power relations, regarding social class, gender and foreign birth. Precarious employment was independently linked to poor mental health and may also mediate the effect by over-indebtedness. The COVID-19 pandemic might entail increased over-indebtedness, which should be acknowledged in policies aiming at buffering social effects of the pandemic.

The Relationship of Social Media Addiction With Internet Use and Perceived Health: The Moderating Effects of Regular Exercise Intervention

The popularity of online social media in recent years has not only brought information and social convenience to people's lives, but has also given rise to many problems, among which social media addiction (SMA) has become a concern of many scholars and experts. Past research has shown that regular exercise (REx) can have many health benefits for the body, so numerous scholars and experts believe that this may be one possible strategy for reducing the health effects of online community addiction and Internet use (IU). Therefore, this study adopted a secondary data research approach to explore and predict the effect of age on social media use and personal health, and therefore included age as a control variable to investigate whether the intervention of REx, excluding the effect of age, moderates the effect of SMA on IU and on perceived health (PH). The participants of this study were adults aged 18 years or older in Taiwan, using the 2019 “Survey Research Data Archive,” Vol. 7, No. 5 data. A total of 1,933 questionnaires were retrieved, and after elimination of invalid responses, 1,163 data were analyzed using Partial Least Squares Structural Equation Modeling, PLS-SEM. The results were as follows: (1) SMA positively affected IU, (2) SMA could negatively affect PH, (3) there was no statistical effect of IU on PH, (4) SMA did not indirectly affect PH through IU, (5) REx had a moderating effect on SMA and IU, and (6) REx did not regulate the effect of SMA on PH. First, from these results, it is clear that the negative health effects of SMA may not be simply due to prolonged IU. Secondly, while it is true that the moderating effect for people with low levels of SMA can reduce IU, for people with high levels of SMA, the moderating effect of REx becomes a catalyst for increased Internet usage behavior. Finally, we draw conclusions based on the results of the study and propose directions and recommendations for follow-up research.

Financial Hardship, Hope, and Life Satisfaction Among Un/Underemployed Individuals With Psychiatric Diagnoses: A Mediation Analysis

BACKGROUND

Individuals with psychiatric diagnoses who are unemployed or underemployed are likely to disproportionately experience financial hardship and, in turn, lower life satisfaction (LS). Understanding the mechanisms though which financial hardship affects LS is essential to inform effective economic empowerment interventions for this population.

AIM

To examine if subjective financial hardship (SFH) mediates the relationship between objective financial hardship (OFH) and LS, and whether hope, and its agency and pathways components, further mediate the effect of SFH on LS among individuals with psychiatric diagnoses seeking employment.

METHODS

We conducted structured interviews with participants (N = 215) of two peer-run employment programs using indicators of OFH and SFH and standardized scales for hope (overall hope, hope agency, and hope pathways) and LS. Three structural equation models were employed to test measurement models for OFH and SFH, and mediational relationships. Covariates included gender, age, psychiatric diagnosis, race/ethnicity, education, income, employment status, SSI/SSDI receipt, and site.

RESULTS

Confirmatory factor analysis (CFA) for items measuring OFH and SFH supported two separate hypothesized factors. OFH had a strong and significant total effect on SFH [standardized beta (B) = 0.68] and LS (B = 0.49), and a weak-to-moderate effect on hope (B = -0.31). SFH alone mediated up to 94% of the effect of OFH on LS (indirect effect B = -0.46, p < 0.01). The effect of SFH on LS through hope was small (indirect effect B = -0.09, p < 0.05), primarily through hope agency (indirect effect B = -0.13, p < 0.01) and not hope pathways. Black and Hispanic ethno-racial identification seemed to buffer the effect of financial hardship on hope and LS. Individuals identifying as Black reported significantly higher overall hope (B = 0.41-0.47) and higher LS (B = 0.29-0.46), net of the effect of OFH and SFH.

CONCLUSION

SFH is a strong mediator of the relationship between OFH and LS in our study of unemployed and underemployed individuals with psychiatric diagnoses. Hope, and particularly its agency component, further mediate a modest but significant proportion of the association between SFH and LS. Economic empowerment interventions for this population should address objective and subjective financial stressors, foster a sense of agency, and consider the diverse effects of financial hardship across ethno-racial groups.

The role of financial conditions for physical and mental health. Evidence from a longitudinal survey and insurance claims data

BACKGROUND

Both theory and empirical evidence suggest that financial conditions are influential for mental health and might contribute to physical health outcomes.

METHODS

Using longitudinal survey data and health insurance claims data from 1209 employees in a large U.S. health insurance company, we examined temporal associations between measures of financial safety, financial capability, financial distress, their summary index (financial security) and six subsequently measured mental and physical health outcomes.

RESULTS

We found that financial safety and financial capability were positively associated, while financial distress was negatively associated, with subsequent self-reported measures of physical and mental health, even after controlling for these health measures at baseline and other confounders. Additionally, financial conditions were associated with reduced risk of depression based on health insurance claims data. Financial safety was also associated with anxiety.

CONCLUSIONS

Policy-makers might consider the introduction of more effective measures for ensuring favorable financial conditions as an important contributor to better population health. Furthermore, policy could encourage teaching adequate financial management techniques and the importance of understanding of long-term consequences of financial decisions, as those might be pivotal for health outcomes.