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Is Financial Hardship Associated with Reduced Health in Disability? The Case of Spinal Cord Injury in Switzerland

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Listed:
  • Christine Fekete
  • Johannes Siegrist
  • Jan D Reinhardt
  • Martin W G Brinkhof
  • for the SwiSCI Study Group

Abstract

Objective: To investigate socioeconomic inequalities in a comprehensive set of health indicators among persons with spinal cord injury in a wealthy country, Switzerland. Methods: Observational cross-sectional data from 1549 participants of the Swiss Spinal Cord Injury Cohort Study (SwiSCI), aged over 16 years, and living in Switzerland were analyzed. Socioeconomic circumstances were operationalized by years of formal education, net equivalent household income and financial hardship. Health indicators including secondary conditions, comorbidities, pain, mental health, participation and quality of life were used as outcomes. Associations between socioeconomic circumstances and health indicators were evaluated using ordinal regressions. Results: Financial hardship was consistently associated with more secondary conditions (OR 3.37, 95% CI 2.18–5.21), comorbidities (OR 2.88, 95% CI 1.83–4.53) and pain (OR 3.32, 95% CI 2.21–4.99), whereas mental health (OR 0.23, 95% CI 0.15–0.36), participation (OR 0.30, 95% CI 0.21–0.43) and quality of life (OR 0.22, 95% CI 0.15–0.33) were reduced. Persons with higher education reported better mental health (OR 1.04, 95% CI 1.00–1.07) and higher quality of life (OR 1.06, 95% CI 1.02–1.09); other health indicators were not associated with education. Household income was not related to any of the studied health indicators when models were controlled for financial hardship. Conclusions: Suffering from financial hardship goes along with significant reductions in physical health, functioning and quality of life, even in a wealthy country with comprehensive social and health policies.

Suggested Citation

  • Christine Fekete & Johannes Siegrist & Jan D Reinhardt & Martin W G Brinkhof & for the SwiSCI Study Group, 2014. "Is Financial Hardship Associated with Reduced Health in Disability? The Case of Spinal Cord Injury in Switzerland," PLOS ONE, Public Library of Science, vol. 9(2), pages 1-7, February.
    • Handle: RePEc:plo:pone00:0090130
    DOI: 10.1371/journal.pone.0090130
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    References listed on IDEAS

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    1. Butterworth, Peter & Rodgers, Bryan & Windsor, Tim D., 2009. "Financial hardship, socio-economic position and depression: Results from the PATH Through Life Survey," Social Science & Medicine, Elsevier, vol. 69(2), pages 229-237, July.
    2. Jan D Reinhardt & Erik von Elm & Christine Fekete & Johannes Siegrist, 2012. "Social Inequalities of Functioning and Perceived Health in Switzerland–A Representative Cross-Sectional Analysis," PLOS ONE, Public Library of Science, vol. 7(6), pages 1-7, June.
    3. repec:dau:papers:123456789/10510 is not listed on IDEAS
    4. Richard Williams, 2006. "Generalized ordered logit/partial proportional odds models for ordinal dependent variables," Stata Journal, StataCorp LLC, vol. 6(1), pages 58-82, March.
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    1. Carmen Zürcher & Hannah Tough & Christine Fekete & for the SwiSCI Study Group, 2019. "Mental health in individuals with spinal cord injury: The role of socioeconomic conditions and social relationships," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-20, February.

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