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Title: Is financial hardship associated with reduced health in disability? the case of spinal cord injury in Switzerland
Authors: Fekete, C
Siegrist, J
Reinhardt JD 
Brinkhof, MWG
Issue Date: 2014
Publisher: Public Library of Science
Source: PLoS one, 2014, v. 9, no. 2, e90130, p. 1-7 How to cite?
Journal: PLoS one 
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.
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0090130
Rights: © 2014 Fekete et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The following publication Fekete, C., Siegrist, J., Reinhardt, J. D., & Brinkhof, M. W. G. (2014). Is financial hardship associated with reduced health in disability? the case of spinal cord injury in Switzerland. PLoS ONE, 9(2), e90130, 1-7 is available at
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