title: Financial stress in late adulthood and diverse risks of incident cardiovascular disease and all-cause mortality in women and men.
abstract: BACKGROUND
  Financial stress may have adverse health effects. The main aim of this study was to investigate whether having a cash margin and living alone or cohabiting is associated with incident cardiovascular disease (CVD) and all-cause mortality.
  
  
  METHODS
  Representative population-based prospective cohort study of 60-year-old women (n = 2065) and men (n = 1939) in Stockholm County, Sweden. National registers were used to identify cases of incident CVD (n = 375) and all-cause mortality (n = 385). The presence of a cash margin was determined in the questionnaire with the following question: Would you, if an unexpected situation occurred, be able to raise 10,000 SEK within a week? (This was equivalent to US$ 1250 in 1998).
  
  
  RESULTS
  Compared with cohabiting women with a cash margin, the risk of all-cause mortality was higher among cohabiting women without a cash margin, with hazard ratios (HRs) of 1.97 (95% confidence interval (CI) 1.06-3.66). Using cohabiting men with cash margin as referent, single men without a cash margin were at an increased risk of both incident CVD and all-cause mortality: HR 2.84 (95% CI 1.61-4.99) and 2.78 (95% CI 1.69-4.56), respectively. Single men with cash margins still had an increased risk of all-cause mortality when compared with cohabiting men with a cash margin: HR 1.67 (95% CI 1.22-2.28).
  
  
  CONCLUSIONS
  Financial stress may increase the risks of incident CVD and all-cause mortality, especially among men. Furthermore these risks are likely to be greater in men living in single households and in women without cash margins. Living with a partner seems to protect men, but not women, from ill-health associated with financial stress due to the lack of a cash margin.
authors.affiliation: Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. axelcefam@hotmail.com.
authors.forename: Axel C
authors.initials: AC
authors.lastname: Carlsson
authors.forename: Bengt
authors.initials: B
authors.lastname: Starrin
authors.forename: Bruna
authors.initials: B
authors.lastname: Gigante
authors.forename: Karin
authors.initials: K
authors.lastname: Leander
authors.forename: Mai-Lis
authors.initials: ML
authors.lastname: Hellenius
authors.forename: Ulf
authors.initials: U
authors.lastname: de Faire
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality*; D002423:Cause of Death / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007182:Income / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000401:mortality*; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology