title: Ageing in the age of debt: household debt and mental wellbeing among people aged 50 years and older
Creators: name: Hiilamo, Aapo
Publisher: name: London School of Economics and Political Science (LSE)
Year: 2022

description: This thesis is concerned with the relationship between household debt and the mental wellbeing of people aged 50 years and older in England, elsewhere in Europe, and the US. This topic is prompted by the substantial levels of household indebtedness seen today in western countries, which have increased more rapidly than average incomes. Concurrently, the over-50 population has grown substantially, making it likely that there will be more older adults holding some form of debt in the future. For these reasons, the mental wellbeing implications of debt among older adults should be taken seriously. However, in current research, household debts are rarely considered to be socioeconomic determinants of the mental health of ageing populations. This thesis investigates the links between debt and mental wellbeing in three distinct but connected papers. The three papers all focus on people aged 50 years and older, all analyse mental wellbeing outcomes, and all use forms of household debt as main predictors. But each paper provides additional and novel evidence from different viewpoints. The thesis took a quantitative approach and used regression and sample weighting methods throughout. The first paper analyses the English Longitudinal Study of Ageing (ELSA). The paper explores the extent to which different household mortgage and non-mortgage debt measures predict depressive symptoms and quality of life scores in England. Non-mortgage debt, particularly when substantial considering the available assets of the household, has a robust link to both mental wellbeing outcomes. Mortgage debt is linked to lower quality of life, whereas no association is observed between this debt type and depressive symptoms. Similar associations, albeit smaller in magnitude, are observed in longitudinal settings; people had lower mental wellbeing after they acquired non-mortgage debts and better mental wellbeing after they got rid of their debts. The second paper uses the same dataset and focused on non-mortgage debt. The paper investigates the moderation of an individual level contextual factor – employment status – in the link between debt and mental wellbeing. This paper looks at moderation from population inference and intervention-focused perspectives. Population inference analysis shows that, while people in England with debts have lower mental wellbeing 4 (more depressive symptoms and lower quality of life) in all employment status categories, the mental pain linked to debts is stronger for people who are jobless (retired or not working). In the analysis, from an intervention perspective, observational data is analysed within the framework of a target trial. This type of analysis suggests that an intervention of getting rid of debts may reduce depressive symptoms only among people who are jobless. Getting rid of debts may improve the quality of life of all subgroups examined. The third paper analyses three harmonized longitudinal surveys, consisting of adults aged 50 and older from 21 European countries and the US. It investigates whether the link between non-mortgage debt and depression is observed across time and space, and whether this association is moderated by country-level factors. People with household non-mortgage debt have higher odds of depression – net of differences in other socioeconomic variables – in all countries. But this association is particularly strong in countries with poor personal discharge legislation and low levels of indebtedness, both of which indicate stronger social stigma related to debt. Within countries, there is also some weak indication that debts become more depressing in poor economic times, measured by the country-level unemployment rate. In almost all countries, the link between debt and depression is also observed when comparing people’s odds of depression in times when they were in debt to the times when they were debt-free. Altogether, these results stress that household debt is an important while nuanced socioeconomic determinant of poor mental wellbeing among adults aged 50 and older. Policy measures, such as integrated debt and mental health services, are needed to alleviate the mental health burden in older adults with non-mortgage debts, particularly among people in disadvantageous labour market situations and with few available assets. Subsequent intervention studies that aim to assess the mental health effects of debt relief may benefit from targeting people who are out of the labour market.