Factors associated with self-assessed increase in tobacco consumption among over-indebted individuals in Germany: a cross-sectional study.

BACKGROUND: Over-indebtedness is an increasing phenomenon in industrialised nations causing individual hardship and societal problems. Nonetheless, few studies have explored smoking among over-indebted individuals. METHODS: A cross-sectional survey (n=949) on retrospectively assessed changes in tobacco consumption was carried out in 2006 and 2007 among clients of 84 officially approved debt and insolvency counselling centres in Germany (response rate 39.7%). Logistic regressions were performed to explore factors associated with reports of increased smoking after onset of over-indebtedness. RESULTS: 63% of all respondents stated daily or occasional tobacco consumption. Almost one fifth reported an increase in smoking after becoming over-indebted. Females were less likely to report increased smoking than men (aOR 0.66, 95% CI 0.44-0.99) whereas respondents who had been over-indebted for more than 10 years were more likely to report increased smoking than those who had been over-indebted for less than five years (aOR 1.66; 95%-CI 1.00-2.76). The odds of increased smoking were also elevated among those who reported that their families and friends had withdrawn from them as a consequence of their over-indebtedness (aOR 1.82; 95%-CI 1.06-3.14). CONCLUSIONS: The study identifies over-indebted individuals and particularly over-indebted men as a high-risk group of smokers. Low levels of social embeddedness/support were associated with a further increase in smoking after becoming over-indebted. Given recent increases of over-indebtedness, the findings highlight the need to develop appropriate public health policies.

Association between overweight, obesity and self-perceived job insecurity in German employees.

BACKGROUND: Recent studies have shown an association between job insecurity and morbidity as well as mortality, however until now, knowledge about a potential association between job insecurity and overweight or obesity has been lacking. METHODS: In order to identify a possible association between job insecurity and overweight or obesity, we analysed data from the German Socioeconomic Panel (GSOEP) 2004/2005, a longitudinal study of private households in Germany. In this representative cohort of the German adult population, living and working conditions were observed. Data on Body Mass Index (BMI) and self-perceived probability of job loss within the next 2 years were available for 10,747 adults either employed or attending training programs. RESULTS: We identified 5,216 (49%) individuals as being overweight (BMI > 25 kg/m²) and 1,358(13%) individuals as being obese (BMI > 30 kg/m²). A total of 5,941 (55%) participants reported having concerns regarding job insecurity. In the multivariate analysis--after adjustment for relevant confounders--a statistically significant association between obesity and job insecurity (100% probability for losing the job in the following two years) could be observed with an adjusted odds ratio of 2.55 (95% confidence interval: 1.09-5.96). CONCLUSIONS: Because of these results, we were able to conclude that overweight and obese persons perceive job insecurity more often than their normal weight counterparts in Germany and that the concurrence of obesity and job insecurity might lead employees into a vicious cycle. Further research with an emphasis on the occupational setting might be necessary in order to establish useful preventive programmes at the workplace.

Health risks of separated or divorced over-indebted fathers: separation from children and financial distress.

The study examines over-indebted fathers after separation/divorce with respect to health-related lifestyles/state of health. A cross-sectional survey was conducted among over-indebted persons in Germany 2006/2007 (response rate 39.7%). Fathers in complete families (n = 73; M = 37 years) and single mothers (n = 72; M = 33.5 years) served as comparison groups to the separated fathers (n = 59; M = 37 years). Risks of depressive mood, unhealthy nutrition, and hypertension were higher compared to fathers in complete families. Tobacco use and low health awareness proved to be higher than among both comparison groups. The findings indicate problematic health-related behavior and health status among separated over-indebted fathers, and suggest recognizing them as a high risk group within social work.

Over-indebtedness and its association with the prevalence of back pain.

BACKGROUND: Over-indebtedness is an increasing phenomenon worldwide. Massive financial strain, as found in over-indebted persons, might influence the occurrence of back pain. In this explorative study we examined the prevalence of back pain in over-indebted persons in Germany for the first time ever and compared it to the prevalence of back pain in the German general population. METHODS: A cross sectional study comprising 949 participants (52.6% women) was conducted to collect data on the point prevalence of back pain in an over-indebted collective. A representative sample of the German general population (N = 8318, 53.4% women) was used as non-indebted reference group. RESULTS: The point prevalence of back pain was 80% in the over-indebted collective, compared to 20% in the general population. The influence of socioeconomic factors on the prevalence of back pain differed partially between the general population and the over-indebted collective. Being over-indebted was identified as an independent effect modifier and was associated with an eleven times increased probability to suffer from back pain (aOR: 10.92, 95%CI: 8.96 - 13.46). CONCLUSION: Until now, only little is known about the effects of intense financial strain like over-indebtedness on health. Our study suggests that over-indebted persons represent a risk group for back pain and that it might be sensible to take financial strain into account when taking a medical history on back pain. Over-indebtedness and private bankruptcy is of increasing importance in industrialized countries, therefore more research on the subject seems to be necessary.