Email updates

Keep up to date with the latest news and content from BMC Public Health and BioMed Central.

Open Access Research article

Financial stress in late adulthood and diverse risks of incident cardiovascular disease and all-cause mortality in women and men

Axel C Carlsson12*, Bengt Starrin3, Bruna Gigante4, Karin Leander4, Mai-Lis Hellenius5 and Ulf de Faire46

Author Affiliations

1 Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

2 Department of Medical Sciences, Molecular Epidemiology and Science for Life, Laboratory, Uppsala University, Uppsala, Sweden

3 Department for Social Studies, Faculty of Social and Life Sciences, Karlstad University, Karlstad, Sweden

4 Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

5 Department of Medicine, Karolinska Institutet and Karolinska University Hospital Solna, Stockholm, Sweden

6 Cardiology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden

For all author emails, please log on.

BMC Public Health 2014, 14:17  doi:10.1186/1471-2458-14-17

Published: 9 January 2014

Abstract

Background

Financial stress may have adverse health effects. The main aim of this study was to investigate whether having a cash margin and living alone or cohabiting is associated with incident cardiovascular disease (CVD) and all-cause mortality.

Methods

Representative population-based prospective cohort study of 60-year-old women (n = 2065) and men (n = 1939) in Stockholm County, Sweden. National registers were used to identify cases of incident CVD (n = 375) and all-cause mortality (n = 385). The presence of a cash margin was determined in the questionnaire with the following question: Would you, if an unexpected situation occurred, be able to raise 10 000 SEK within a week? (This was equivalent to US$ 1250 in 1998).

Results

Compared with cohabiting women with a cash margin, the risk of all-cause mortality was higher among cohabiting women without a cash margin, with hazard ratios (HRs) of 1.97 (95% confidence interval (CI) 1.06–3.66). Using cohabiting men with cash margin as referent, single men without a cash margin were at an increased risk of both incident CVD and all-cause mortality: HR 2.84 (95% CI 1.61–4.99) and 2.78 (95% CI 1.69–4.56), respectively. Single men with cash margins still had an increased risk of all-cause mortality when compared with cohabiting men with a cash margin: HR 1.67 (95% CI 1.22–2.28).

Conclusions

Financial stress may increase the risks of incident CVD and all-cause mortality, especially among men. Furthermore these risks are likely to be greater in men living in single households and in women without cash margins. Living with a partner seems to protect men, but not women, from ill-health associated with financial stress due to the lack of a cash margin.

Keywords:
Cash margin; Financial stress; Cohort study; All-cause mortality; Cardiovascular disease