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Open Access Highly Accessed Research article

Health effects of indebtedness: a systematic review

Elina Turunen1* and Heikki Hiilamo2

Author Affiliations

1 Research Department, The Social Insurance Institution of Finland, PL 450, 00101 Helsinki, Finland

2 Department of Social Research, Social and Public Policy, University of Helsinki, P.O. Box 16, 00014 Helsinki, Finland

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BMC Public Health 2014, 14:489  doi:10.1186/1471-2458-14-489

Published: 22 May 2014



In the aftermath of the global financial crisis, millions of households have been left with debts that they are unable to manage. Indebtedness may impair the wellbeing of those affected by it for years to come. This systematic review focuses on the long-term consequences of indebtedness on health.


The method used in the paper is a systematic review. First, bibliographic databases were searched for peer-reviewed articles. Second, the references and citations of the included articles were searched for additional articles.


The results from our sample of 33 peer-reviewed studies demonstrate serious health effects related to indebtedness. Individuals with unmet loan payments had suicidal ideation and suffered from depression more often than those without such financial problems. Unpaid financial obligations were also related to poorer subjective health and health-related behaviour. Debt counselling and other programmes to mitigate debt-related stress are needed to alleviate the adverse effects of indebtedness on health.


The results demonstrate that indebtedness has serious effects on health.

Indebtedness; Mental health; Depression; Suicidal behaviour; Mortality; Physical health; Health-related behaviour; Debt counselling