Is cumulative exposure to economic hardships more hazardous to women's health than men's? A 16-year follow-up study of the Swedish Survey of Living Conditions.
BACKGROUND
Previous research has shown an association between cumulative economic hardships and various health outcomes. However, the cumulative effects of economic hardships in regard to gender differences have not been given enough attention.


METHODS
1981 women and 1799 men were followed up over a period of 16 years (1981-1997), using data from the Swedish Survey of Living Conditions panel study. The temporal association between economic hardships and self-rated health, psychological distress and musculoskeletal disorders was analysed.


RESULTS
A dose-response effect on women's health was observed with increasing scores of cumulative exposure to financial stress but not with low income. Women exposed to financial stress at both T(1) and T(2) had an increased risk of 1.4-1.6 for all health measures compared with those who were not exposed. A similar consistent dose-response effect was not observed among men.


CONCLUSIONS
There is a temporal relationship between cumulative economic hardships and health outcomes, and health effects differ by gender. Financial stress seems to be a stronger predictor of poor health outcomes than low income, particularly among women. Policies geared towards reducing health inequalities should recognise that long-term exposure to economic hardships damages health, and actions need to be taken with a gender perspective.
Ahnquist
Johanna
J
Swedish National Institute of Public Health, Olof Palmes gata 17, SE-103 52 Stockholm, Sweden. johanna.ahnquist@ki.se
Fredlund
Peeter
P
Wamala
Sarah P
SP
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005382:Financing, Personal; D005500:Follow-Up Studies; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000191:economics / Q000453:epidemiology*; D018570:Risk Assessment / Q000379:methods; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000191:economics / Q000453:epidemiology*; D013548:Sweden / Q000453:epidemiology; D035862:Vulnerable Populations; D016387:Women's Health