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Abstract
This paper systematically reviews the relationship between personal unsecured debt
and health. Psychinfo, Embase and Medline were searched and 52 papers were accepted.
A hand and cited-by search produced an additional 13 references leading to 65 papers
in total. Panel surveys, nationally representative epidemiological surveys and psychological
autopsy studies have examined the relationship, as have studies on specific populations
such as university students, debt management clients and older adults. Most studies
examined relationships with mental health and depression in particular. Studies of
physical health have also shown a relationship with self-rated health and outcomes
such as obesity. There is also a strong relationship with suicide completion, and
relationships with drug and alcohol abuse. The majority of studies found that more
severe debt is related to worse health; however causality is hard to establish. A
meta-analysis of pooled odds ratios showed a significant relationship between debt
and mental disorder (OR=3.24), depression (OR=2.77), suicide completion (OR=7.9),
suicide completion or attempt (OR=5.76), problem drinking (OR=2.68), drug dependence
(OR=8.57), neurotic disorder (OR=3.21) and psychotic disorders (OR=4.03). There was
no significant relationship with smoking (OR=1.35, p>.05). Future longitudinal research
is needed to determine causality and establish potential mechanisms and mediators
of the relationship.