title: Parental economic stress: evidence of an overlooked public health risk among Swedish families.
abstract: BACKGROUND
  Studies have demonstrated that when parents shoulder considerable financial responsibilities, adverse health outcomes may occur. The present study assesses the association between economic stress and self-rated health in a sample of Swedish parents, and especially how this relation is affected by foreign origin and employment status.
  
  
  METHODS
  A questionnaire was sent to a random sample of 5,600 individuals between the ages of 21 and 81 in Malmö, Sweden. The total response rate was 69%. Among the respondents, 824 were parents having at least one child living at home. The main exposures were such sociodemographic variables as country of origin and employment status, and economic stress. The outcome variable was self-rated health.
  
  
  RESULTS
  Of the parents in the study, the 34.7% coded as exposed to economic stress showed a significantly increased odds ratio for poor self-rated health (OR=3.12, 95% CI: 2.01-4.84) adjusted for age and sex. After controlling for foreign origin and unemployment, the odds ratio remained statistically significant regarding exposure to economic stress (OR=1.94; 1.16-3.23). In the multivariate model, foreign origin and unemployment were also strongly associated with poor self-rated health (OR=1.78, 95% CI: 1.12-2.88; OR=1.67, 95% CI: 1.01-2.75, respectively). The adjusted population-attributable risk for poor self-rated health was estimated to be 27.4% for economic stress, 26.6% for foreign origin, and 16.7% for unemployment.
  
  
  CONCLUSIONS
  Parental economic stress was associated with low self-rated health to a statistically significant degree, even when accounting for employment status and foreign origin. It, therefore, deserves to be seriously considered as an potential public health risk factor among Swedish families.
authors.affiliation: Department of Community Medicine, Malmö University Hospital, Lund University, Malmö, Sweden.
authors.forename: Gunilla
authors.initials: G
authors.lastname: Olivius
authors.forename: Per-Olof
authors.initials: PO
authors.lastname: Ostergren
authors.forename: Bertil S
authors.initials: BS
authors.lastname: Hanson
authors.forename: C H
authors.initials: CH
authors.lastname: Lyttkens
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004641:Emigration and Immigration; D004651:Employment / Q000191:economics; D005190:Family / Q000523:psychology; D005260:Female; D005382:Financing, Personal; D006304:Health Status; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology