Department of Economics, Lund University, Lund, Sweden.
Department of Clinical Sciences (Malmö), Lund University, Lund, Sweden.
Eur J Public Health. 2019 Jun 1;29(3):488-493. doi: 10.1093/eurpub/ckz002.
Empirical research suggests that household debt and payment difficulties are detrimental to mental health. Despite well-known measurement problems that may contaminate analyses using subjective self-reported health measures, our knowledge is very limited concerning the effect of payment difficulties on 'objective' measures of mental health. Moreover, few studies use longitudinal data to examine the relationship. This study combines rich survey data and longitudinal data from administrative registers on a representative sample of the Swedish population to examine the relationship between payment difficulties and subjective and objective measures of mental health.
We use data from a large survey of Swedish inhabitants (The Swedish Living Conditions Surveys) combined with data from administrative registers. We investigate both directions of the relationship between mental ill health and payment difficulties, controlling for previous mental health status and previous experiences of payment difficulties. We compare the association between payment difficulties and a self-reported measure of anxiety with the associations between payment difficulties and objective measures of mental ill health from a register of psychopharmaceutical drug consumption.
Payment difficulties associate with subjectively reported mental ill health, but less to psychopharmaca use. For objective measures, we find stronger evidence of a link running from mental ill health to later payment difficulties.
Self-reported and objective measures of mental problems may convey different messages regarding the impact of payment difficulties on mental health. Policy measures depend on whether the primary target group is individuals with severe mental problems or individuals with mild anxiety.
实证研究表明，家庭债务和还款困难对心理健康有害。尽管使用主观自我报告的健康措施进行分析时存在众所周知的测量问题，但我们对还款困难对“客观”心理健康措施的影响知之甚少。此外，很少有研究使用纵向数据来研究这种关系。本研究结合了来自瑞典代表性人群的大型调查数据和来自行政登记的纵向数据，以研究还款困难与主观和客观心理健康措施之间的关系。
我们使用来自瑞典居民的一项大型调查（瑞典生活条件调查）的数据，并结合行政登记数据。我们调查了心理健康状况不佳和还款困难之间的关系的两个方向，控制了以前的心理健康状况和以前的还款困难经历。我们将还款困难与焦虑的自我报告衡量标准之间的关联与从精神药物消费登记处获得的客观心理健康衡量标准与还款困难之间的关联进行了比较。
还款困难与主观报告的心理健康问题相关，但与精神药物使用的相关性较小。对于客观衡量标准，我们发现从心理健康状况不佳到以后的还款困难之间存在更强的关联。
自我报告和客观的心理健康问题衡量标准可能会对还款困难对心理健康的影响产生不同的信息。政策措施取决于主要目标群体是有严重心理健康问题的个体还是有轻度焦虑的个体。
