title: Over-indebtedness and chronic disease: a linked register-based study of Finnish men and women during 1995-2010.
abstract: OBJECTIVE
  More knowledge of the associations between over-indebtedness and health is needed. This study is the first longitudinal register-based study analysing long-term health consequences of severe over-indebtedness.
  
  
  METHODS
  Adult Finnish persons, identified in 2010 as having been over-indebted for at least 15 years, were compared with matched controls (total N = 48,778). The analyses utilized register data on socio-demographic and health-related factors. Incidence of chronic disease during 1995-2010 was measured with entitlements to special reimbursement for medicines for treatment of severe and chronic diseases. Incidence of all diseases was examined, as well as incidence of hypertension, diabetes, bronchial asthma and COPD, coronary heart disease, and psychoses. Multivariate analyses were conducted with the Cox proportional hazards method.
  
  
  RESULTS
  Severe over-indebtedness was associated with increased incidence of any chronic disease, and most notably with increased risk of psychoses and diabetes. The associations were stronger among women than among men.
  
  
  CONCLUSIONS
  Over-indebtedness is associated with harmful health conditions. Policy makers should consider taking steps to prevent over-indebtedness and to increase the awareness of social and health service professionals of the problems associated with over-indebtedness.
authors.affiliation: The Social Insurance Institution of Finland, Helsinki, P.O. Box 450, FIN-00101, Finland. jenni.blomgren@kela.fi.
authors.forename: Jenni
authors.identifier: http://orcid.org/0000-0001-5466-0205
authors.initials: J
authors.lastname: Blomgren
authors.affiliation: The Social Insurance Institution of Finland, Helsinki, P.O. Box 450, FIN-00101, Finland.
authors.forename: Nico
authors.initials: N
authors.lastname: Maunula
authors.affiliation: Department of Social Research, University of Helsinki, Helsinki, P.O. Box 54, FIN-00014, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Hiilamo
mesh_terms: D000328:Adult; D002908:Chronic Disease / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D005387:Finland; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012042:Registries
keywords: Chronic disease; Mental health; Morbidity; Over-indebtedness; Recession; Somatic health