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Does chronic illness cause adverse social and economic consequences among Swedes?

Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden

Bo Burström

Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden

Finn Diderichsen

Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine, Stockholm, Sweden

Background: In an international comparison, the Swedish welfare system has been known for universal coverage and high benefit levels. Perhaps this is the reason why very few studies recently have dealt with the social and economic consequences of long-term illness in Sweden. Aims: The research question raised here is therefore to examine chronic illness ( defined as limiting longstanding illness, LLSI) as a causal factor contributing adverse financial conditions, unemployment or labour market exclusion. Methods: A longitudinal design was employed with data from a sample of 27,773 people interviewed twice ( Swedish Surveys of Living Conditions performed by Statistics Sweden) , including subjects ( n=12,556) at interview I, without chronic illness or adverse socioeconomic conditions . Results: The odds ratios for labour market exclusion, unemployment, and financial difficulties among people who had acquired LLSI at interview II varied between 1.4 and 4.0 for the outcomes. The elevated OR decreased after testing for the mediating effect of social context and the labour market position for financial difficulties but remained significantly elevated. Conclusions: The results suggest that LLSI increases the risk of adverse financial conditions, unemployment, and of not being economically active.

Key Words: financial difficulties • labour market exclusion • limiting longstanding illness • social consequences • social context.

Scandinavian Journal of Public Health, Vol. 29, No. 1, 63-70 (2001)
DOI: 10.1177/14034948010290011201


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