Debt Problem of One Partner and Depressive Morbidity in the Other: A 2-Year Follow-up Register Study of Different-Sex Couples in Sweden.

This study sets out to examine whether depressive morbidity varies by status of financial indebtedness of a spouse or cohabiting partner. For this purpose, individuals aged between 20 and 60 with a different-sex spouse/cohabiting partner with a registration date for a debt at the Swedish Enforcement Authority (SEA) during 2017 (n = 6979) are followed-up for a 2-year period for prescriptions of antidepressants and compared with a sample from the general Swedish population (n = 29,708). The analysis is based on penalized maximum likelihood logistic regressions. Both women and men were more likely to suffer from depressive morbidity if the spouse/cohabiting partner had been registered at the SEA in 2017 and was still active for a debt in the SEA's register in 2018 (OR 1.31 and OR 1.57, respectively), irrespective of their own health, employment, socioeconomic status, and other background variables. This also held true for men if a wife/cohabiting partner had been registered at the SEA in 2017 but was no longer active for a debt in the SEA's register in 2018 (OR 1.29). For women, on the other hand, only those with no history (11-year period) of prescription of psychotropic medications were also at an enhanced risk of depressive morbidity if a husband/cohabiting partner had gone from being registered for a debt at the SEA in 2017, to not being registered as active for a debt in the SEA's register in 2018 (OR 1.24). The results reinforce the importance of acknowledging that negative effects of financial indebtedness extend beyond the individual debtor.

Status of Debtor Registration at an Enforcement Authority and Risk of Nonfatal Suicide Attempt.

Background: Not much is known about whether paying unpaid debt is related to a reduced risk of suicidal behavior. Aims: To examine whether nonfatal suicide attempt varied by status of nonpayment of debt as registered at the Swedish Enforcement Authority (SEA). Method: People aged between 20 and 64 years with a registration date for an unpaid debt at the SEA during 2016 (n = 57,039) and registered as either active or inactive for a debt and/or a decision of debt reconstruction in the register in 2018 were followed up for a 2-year period for suicide attempt and compared with a sample from the general Swedish population (n = 301,714). Results: Those who were still active for a debt and/or a decision of debt reconstruction were about twice (Odds Ratio = 2.21) as likely to attempt suicide than those who no longer had an active debt in the SEA register. Limitations: The study was limited to suicide attempts that were registered as such in the National Patient Register. Conclusion: The results, based on unique nationwide register data, reinforce the importance of making tackling debt and financial distress part of current suicide prevention strategies. Professionals and others who interact with indebted people may be important gatekeepers in preventing suicide attempts.

Unmet financial obligations and alcohol-related mortality: A nationwide register-based follow-up study.

This study sets out to explore whether experiencing financial indebtedness is related to alcohol-related mortality. For this purpose, people aged between 20 and 64 having a registration date for a debt in the Swedish Enforcement Authority's register during 2015 (n = 48,541) were followed up for a five-year period for alcohol-related mortality and were compared with a sample from the general Swedish population (n = 261,148). On the basis of logistic regression analysis, it is shown that people who had experienced financial indebtedness were almost two and a half times more likely to suffer from alcohol-related death than those who had not lived through this experience (OR = 2.43), controlling for several demographic, socio-economic, and health conditions prior to the date of the registration at the Enforcement Authority. The results provide support for the notion that debt repayment problems may, in itself, be an important indicator to consider in the study of alcohol-related harm. Consequently, debt counselling and other programs directed toward mitigating debt-related stress may play an important role in alleviating the adverse effects of indebtedness.

Financial indebtedness and suicide: A 1-year follow-up study of a population registered at the Swedish Enforcement Authority.

BACKGROUND: Economic hardship is an established suicidogenic factor. However, very little is known about whether financial difficulties in terms of debt problems, specifically, is related to suicide. This would seem to be an important research gap, not least at a time when the repercussions of the global financial crisis are still being felt by many people. AIMS: This study sets out to examine whether experiencing financial indebtedness is related to suicide. METHODS: For this purpose, people aged between 18 and 64 with a registration date for a debt in the Swedish Enforcement Authority register between 2015 and 2017 (n = 180,842) are followed up for a 1-year period for death by suicide and compared with a sample from the general Swedish population (n = 928,265). The analysis is based on penalized maximum likelihood logistic regressions. RESULTS: Those who had experienced financial indebtedness were two and a half times more likely to commit suicide than those who had not lived through this experience (OR = 2.50), controlling for several demographic, socio-economic, and mental health conditions prior to the date of the registration at the Enforcement Authority. CONCLUSION: Debt repayment problems have a significant and detrimental impact on individuals' risk of committing suicide, even when several other socioeconomic risk factors are controlled for. The results reinforce the importance of ongoing attempts to remove the issue of debt problem from its status as a rather hidden suicidogenic risk factor.

Association of Child Placement in Out-of-Home Care With Trajectories of Hospitalization Because of Suicide Attempts From Early to Late Adulthood.

Importance: Children placed in out-of-home care (OHC) have higher rates of suicidal behaviors, including suicide attempts, compared with those who grow up in their family of origin. Several studies have shown that this elevated risk persists into young adulthood. Yet, our knowledge about any longer-term associations of OHC with suicide attempts is limited. Objective: To examine how childhood experiences of placement in OHC are associated with trajectories of hospitalization because of suicide attempts (HSA) from early into late adulthood. Design, Setting, and Participants: This prospective birth cohort study that was conducted in Stockholm, Sweden, and analyzed in March 2020 included 14 559 individuals born in 1953 who were living in the greater metropolitan of Stockholm in November 1963 and followed through registers up until December 2016. Exposures: Childhood experiences of OHC based on information from the Social Register (age 0-19 years). Main Outcomes and Measures: Hospitalization because of suicide attempts based on in-patient care data from the National Patient Register. Group-based trajectory modeling was used to cluster individuals according to their probabilities of HSA across adulthood (age 20-63 years). Results: In this cohort of 14 559 individuals (7146 women [49.1%]), 1320 individuals (9.1%) had childhood experiences of OHC, whereas 525 individuals ( 3.6%) had HSA. A Cox regression analysis showed a substantially higher risk of HSA among those with childhood experiences of OHC (hazard ratio, 3.58; 95% CI, 2.93-4.36) and after adjusting for a range of adverse childhood living conditions (hazard ratio, 2.51; 95% CI, 2.00-3.15). Those with at least 1 HSA were grouped into 4 trajectories: (1) peak in middle adulthood (66 [12.6%]), (2) stable low across adulthood (167 [31.8%]), (3) peak in early adulthood (210 [40.0%]), and (4) peak in emerging adulthood (82 [15.6%]). A multinomial regression analysis suggested that those with experiences of OHC had higher risks of following any of these trajectories (trajectory 1: relative risk ratio [RRR], 2.91; 95% CI, 1.61-5.26; trajectory 2: RRR, 3.18; 95% CI, 2.21-4.59; trajectory 3: RRR, 4.32; 95% CI, 3.18-5.86; trajectory 4: RRR, 3.26; 95% CI, 1.94-5.46). The estimates were reduced after adjusting for adverse childhood living conditions. Conclusions and Relevance: The findings suggest that the elevated risk of suicide attempts among former child welfare clients does not cease after young adulthood, indicating the necessity for clinical attention to childhood experiences of OHC as a risk marker for suicidal behavior across the life span.

Peer Status Position within School-Based Hierarchies and Excessive Fat Accumulation in Adulthood-A 30 Year Follow up of a Stockholm Cohort.

Disadvantaged socioeconomic status is arguably the one exposure that has most consistently been linked to obesity, even more strongly so than diet and physical inactivity, which are the two main perceived root causes of weight gain. However, we still know very little about the relationship between having a disadvantaged social position and excessive fat accumulation, particularly when it comes to whether the relationship in question can also be seen as a long-term one, i.e., spanning from childhood to adulthood. By making use of the unique Stockholm Birth Cohort Multigenerational Study, the present study uses generalized ordered logistic regressions to examine the association between sociometrically assessed peer status position in school at age 13 and excessive fat accumulation at age 32. The results suggest that the odds of having excessive fat accumulation are about 0.5 times lower among popular and accepted children (ORs = 0.52 and 0.56, respectively), compared to those with a marginalized peer status position, independent of other obesogenic risk factors measured both prior and subsequent to peer status position. Our results give support to the notion that improved weight status may be another positive consequence of policies aiming to increase social inclusion within schools.

Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population.

OBJECTIVES: This study sets out to explore whether being forcibly removed from one's home is related to all-cause mortality. METHODS: With the help of unique register data covering all middle-aged persons registered at the Swedish Enforcement Authority with a case closed by an eviction during the period 2009-2011 (n = 2092), evictees' deaths from any cause that occurred within 3 years of the date of the eviction are compared with the all-cause mortality of a random sample of the Swedish population (n = 426,117). The analysis is based on penalized maximum likelihood logistic regressions. RESULTS: Those who had been evicted from their homes were found to be approximately one and a half times more likely to die from any cause than those who had not been exposed to this experience (OR = 1.59), controlling for several demographic, socio-economic and health conditions prior to the date of the eviction. CONCLUSIONS: The results provide support for the notion that the experience of losing one's dwelling place should be treated as a major life event in its own right, just like other well-established social stressors.

Evictions and suicide: a follow-up study of almost 22,000 Swedish households in the wake of the global financial crisis.

BACKGROUND: Millions of families across the world are evicted every year. However, very little is known about the impact that eviction has on their lives. This lack of knowledge is also starting to be noticed within the suicidological literature, and prominent scholars are arguing that there is an urgent need to explore the extent to which suicides may be considered a plausible consequence of being faced with eviction. METHOD: The present study's sample consists of all persons served with an application for execution of an eviction order during 2009-2012. This group is compared to a random 10% sample of the general Swedish population, ages 16 years and over. The analysis is based on penalised maximum likelihood logistic regressions. RESULTS: Those who had lost their legal right to their dwellings and for whom the landlord had applied for the eviction to be executed were approximately four times more likely to commit suicide than those who had not been exposed to this experience (OR=4.42), controlling for several demographic, socioeconomic and mental health conditions prior to the date of the judicial decision. CONCLUSIONS: Home evictions have a significant and detrimental impact on individuals' risk of committing suicide, even when several other well-known suicidogenic risk factors are controlled for. Our results reinforce the importance of ongoing attempts to remove the issue of evictions from its status as a hidden and neglected social problem.

Self-directed and interpersonal male violence in adolescence and young adulthood: a 30-year follow up of a Stockholm cohort.

In line with Wilkinson's theory on inequality and health, this study simultaneously analyses self-directed and interpersonal violence among men in a Stockholm birth cohort born in 1953 with respect to their early life experiences of stress, their lack of social connectedness and their relative deprivation. Multinomial logistic regressions with cluster-robust variance estimates were used. Self-directed violence was found to be related to self-rated loneliness and non-membership of voluntary associations but not to a lack of friendship in school at the age of 12-13, while the opposite was shown to be true for interpersonal violence. Growing up in a family that received means-tested social assistance at least once during the period 1953-1965 was taken as an objective indicator of relative deprivation and proved to be correlated with both self-directed and interpersonal violence. Disadvantaged social comparison at the age of 12-13, taken as a subjective indicator of relative deprivation, was only statistically related to a subsequent risk of interpersonal violence. It is suggested that different types of social connectedness and relative deprivation, respectively, explain these different patterns of violence. Furthermore, the study speculates on the possibility of frequent social comparison itself being a factor to consider when trying understanding violence in general.

Early life circumstances and male suicide--a 30-year follow-up of a Stockholm cohort born in 1953.

This study analyses the relationship between early life circumstances and suicide during adolescence and young adulthood among men in a Stockholm birth cohort born in 1953. Relevant variables were derived from Durkheim's proposition of social integration and suicide and Merton's strain theory of deviance. The links between our background variables and suicide were estimated with rare events logistic regression, a statistical method specially developed for situations in which rare events are endemic to the data. We found that self-rated loneliness at age 12-13 as an indicator of social isolation, school absenteeism at the same age as an indicator of school integration, and growing up in a family which received means-tested social assistance at least once during the period 1953-1965 as an indicator of childhood poverty, were statistically related to subsequent suicide risk between 1970 and 1984. Furthermore, following Bourdieu's rereading of Durkheim's Suicide, we argue that social isolation and school integration can be seen as important forms of deprivation, since "social integration" can also be understood in terms of "social recognition". This view emphasises the importance of taking the emotional and social poverty of children just as seriously as their material poverty when it comes to suicide.

The stratification of social capital and its consequences for self-rated health in Taganrog, Russia.

Russian public health and its social determinants have been the theme of several recent studies. In one of these, Rose [(2000). How much does social capital add to individual health? A survey study of Russians. Social Science & Medicine, 51(9), 1421-1435] puts forward a composite model as a way of getting away from two traditions: one that postulates that social capital influences health independently of human capital attributes (education, social class, income, etc.) and one that postulates that human capital is the main determinant of health, while social capital is more or less irrelevant. In this study, we investigate the composite model, conceptualising social capital as a type of capital, on the basis of Bourdieu. By doing this, not only do the relations between social capital and other types of capital become relevant, but also whether the effect of social capital on health differs depending on the possession of other types of capital. We used the Taganrog survey of 1998 which used structured interviews with the family members of 1,009 households and the response rate was 81%. We found that social capital is stratified by education, and also that its effect on health varies depending on the volume of educational capital possessed. It also seems to be extremely important to specify different types of social capital, in order to get a better overview of possible mechanisms by means of which different types of capital might affect health.