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Sick of our loans: Student borrowing and the mental health of young adults in the United States

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... Estimates suggest that the average debtor leaves school with more than $30,000 in student debt (Reed & Cochrane, 2012;Student Borrower Protection Center, 2020). Given these trends in rising education costs, researchers have recently begun examining the social and health consequences for indebted students, including how debt is associated with engagement in college activities (Quadlin & Rudel, 2015), and the relationship between debt and mental health among university undergraduates (Cooke et al., 2004;Walsemann et al., 2015). A key emphasis of this research is that student loan debt is a stratifying mechanism for students' time use, the foundation of campus life, and their mental health. ...
... Utilizing large-scale quantitative surveys of students to assess whether a correlation exists between student debt and a range of health indicators (for review see Nissen et al., 2019), studies of educational debt on mental wellbeing typically indicate that students with higher levels of financial concern tend to have worse mental health scores (Richardson et al., 2017), assessed via standardized measures like the Generalized Anxiety Disorder questionnaire (GAD-7;Spitzer et al., 2006) or Perceived Stress Scale (PSS; Cohen et al., 1983), and poorer psychological functioning (Walsemann et al., 2015). In evaluating this relationship, a consistent finding across many studies is that perceptions of debt may be more consequential for mental health than actual levels of debt (Nissen et al., 2019). ...
... Stradling (2001), for example, found that students who perceived their anticipated graduate debt as 'excessive' were more likely to be anxious or depressed than students who viewed their anticipated debt as 'manageable'. Furthermore, among college-enrolled students, those classified as "high debt worry" report feeling more "tense, anxious, and nervous" (Cooke et al., 2004) and have more difficulty getting sleep (also Richardson et al., 2017;Walsemann et al., 2015). Beyond negative impacts to borrower's health, student perceptions and loan borrowing experiences have been associated with credit card debt, decreased capacity to plan financially, and extended years to homeownership (Cho et al., 2015;Fox et al., 2017;Henager & Wilmarth, 2018). ...
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Educational debt is an economic stressor that is harmful to mental health and disproportionately experienced by African American and Latinx youth. In this paper, we use a daily diary design to explore the link between mental health, context specific factors like “college stress” and time use, and educational debt stress, or stress incurred from thinking about educational debt and college affordability. This paper utilizes data from a sample of predominately African American and Latinx college students who provided over 1000 unique time observations. Results show that debt-induced stress is predictive of greater self-reported hostility, guilt, sadness, fatigue, and general negative emotion. Moreover, the relationship may be partly mediated by “college stress” reflecting course loads and post-graduation job expectations. For enrolled students then, educational debt may influence mental health directly through concerns over affordability, or indirectly by shaping facets of college life. The window that our granular data provides into college experiences suggest that the consequences of student debt are manifest and immediate. Further, the documented day-to-day mental health burden for minority students may contribute to downstream processes such as matriculation.
... The limited literature that does exist almost unanimously concludes that there exists a negative relationship between student loan debt and an individual's health after leaving higher education. These results include student loan debt being related to lower psychological functioning (Walsemann, Gee, & Gentile, 2015), less sleep duration for Black individuals (Walsemann, Ailshire, & Gee, 2016), more healthcare hardship (Despard et al., 2016), and less mastery and self-esteem among older adults (Dwyer, McCloud, & Hodson, 2011). All this points to a negative relationship between student loan debt and health, although it might be moderated by factors such as socio-economic background (Dwyer et al., 2011;Walsemann, Gee, & Gentile, 2015), the amount of debt (Despard et al., 2016), and ethnicity (Walsemann, Ailshire, & Gee, 2016 More research is however needed on this topic to confirm the aforementioned conclusions. ...
... These results include student loan debt being related to lower psychological functioning (Walsemann, Gee, & Gentile, 2015), less sleep duration for Black individuals (Walsemann, Ailshire, & Gee, 2016), more healthcare hardship (Despard et al., 2016), and less mastery and self-esteem among older adults (Dwyer, McCloud, & Hodson, 2011). All this points to a negative relationship between student loan debt and health, although it might be moderated by factors such as socio-economic background (Dwyer et al., 2011;Walsemann, Gee, & Gentile, 2015), the amount of debt (Despard et al., 2016), and ethnicity (Walsemann, Ailshire, & Gee, 2016 More research is however needed on this topic to confirm the aforementioned conclusions. This research will need to ensure that student loan debt can be disaggregated from other types of debt to assess the impact of student loan debt on short-and long-term health. ...
... ). Furthermore, there is ample evidence that student loan debt is associated with poorer health among students (e.g.Cooke, Barkham, Audin, Bradley, & Davy, 2004;Morra, Regehr, & Ginsburg, 2008;Ross, Cleland, & Macleod, 2006;Walsemann, Gee, & Gentile, 2015). ...
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Around the world, student loan debt is rising. Growing numbers of students rely on student loans to pay for their higher education and their levels of borrowing are increasing compared with previous decades. In countries like England it is anticipated that the majority of graduates will be repaying their loans for most of their working lives. For many, having student loan debt is no longer a short-term status and it is becoming the new normal. There is now value in exploring how student loan debt influences individuals’ choices, behaviour and life events once they have left higher education. Yet, the academic literature on the impact of student loan debt on decisions made after leaving higher education and later in life is scarce. The few studies available, mostly based in the US, tend to show that individuals with student loan debt make different career choices, delay buying a home, have worse mental health, and are less well-off financially throughout their lifetime as well as being less prepared for retirement. Student loan debt amongst women is also negatively related to family formation. The possible critical impact of student loan debt on the future of our societies and economies calls for further research to fill the gaps in this limited extant literature. This includes moving beyond its US-focus, its dependence on secondary datasets, and its narrow focus within a small number of disciplines. Future research should aim to improve and expand methodological research designs, in particular by using qualitative methods, analysing longitudinal datasets, improving sampling, and trying to show causality. Questions asked in these studies should encompass such issues as the evaluation of possible delays in decision-making, the difference between completers and non-completers, the importance of attitude to debt, and the impact of different student loan repayment plans.
... 7 These gendered patterns of student borrowing highlight the need for gender-based analysis on the consequences of student loans. Although there is evidence that student loans are associated with worse mental health of young adults, [8][9][10] it remains unknown whether this association differs by gender, or whether student loans influence other health outcomes of young men and women. ...
... 23 To the best of our knowledge, the few existing studies on student loans and mental health have not assessed whether the impact of student loans on mental health or other health outcomes differs between men and women. [8][9][10] Building on prior research, the current study advances the literature in three ways. First, we offer a gender-based analysis to understand gender variations in the health consequences of student loans. ...
... The NLSY97 has indeed been widely used in existing research related to student loans, mental health, and substance use. 2,8,14,32,[42][43][44][45][46][47] The NLSY97 contains 131,201 person-years from 8,984 respondents across rounds 1-17. We limit our sample to 24,589 person-years from 5,828 respondents who lived in the United States and reported college enrollment since their last interview (including enrollment in 2-year colleges, 4year colleges, or graduate schools). ...
Article
Objective: Student loan debt has become a growing crisis. Considering that women are more likely than men to take on student loans and more likely to take on larger amounts, we examine whether the effects of student loans on young adults' mental health and substance use differ by gender. Participants: We used the National Longitudinal Survey of Youth 1997 (NLSY97) data collected from 1997 to 2015. The NLSY97 consists of a nationally representative sample of American youths born between 1980 and 1984. Participants included 2,607 men and 3,004 women who reported college enrollment. Methods: We analyzed data using hybrid regression models. Results: Student loans have more negative effects on young men than young women, in terms of mental health problems, smoking, and heavy drinking. Particularly, young men tend to increase substance use in response to cumulative loan amounts. Conclusions: Borrowing patterns and the health consequences of student loans are gendered.
... Based on Keyes' (2002Keyes' ( , 2003 mental health continuum, an individual's mental health may be associated with other social, psychological, or cognitive-functioning-related factors (Garmezy, 1993;Luthar, 1991;Werner, 2000). Financial situation variables such as debt burden, income, and wealth have been associated with the mental health of young adults (Cooke et al., 2004;Sweet et al., 2013;Tay et al., 2017;Walsemann et al., 2015). Studies by Cooke et al. (2004) and Sweet et al. (2013) found debt burden to be negatively associated with mental health outcomes, studies by Tay et al. (2017) and Walsemann et al. (2015) found that family resources, problem-solving abilities, and income moderated the association between debt and subjective wellbeing of individuals. ...
... Financial situation variables such as debt burden, income, and wealth have been associated with the mental health of young adults (Cooke et al., 2004;Sweet et al., 2013;Tay et al., 2017;Walsemann et al., 2015). Studies by Cooke et al. (2004) and Sweet et al. (2013) found debt burden to be negatively associated with mental health outcomes, studies by Tay et al. (2017) and Walsemann et al. (2015) found that family resources, problem-solving abilities, and income moderated the association between debt and subjective wellbeing of individuals. ...
... Additionally, student loan debt in the previous period was also associated with a decrease in flourishing over the current period. This negative association between student loan debt and flourishing is consistent with findings from previous studies that found student loan debt was negatively associated with life satisfaction across time (Kim & Chatterjee, 2019) and was detrimental to young adults' mental health (Walsemann et al., 2015). Similarly, in another study, Archuleta et al. (2013) found that student loan debt was associated with financial anxiety and distress. ...
Article
The purpose of this study is to examine the debt burdens, perceived capabilities, and mental health of young adults. Panel data constructed from the 2009 to 2013 waves of the Panel Study of Income Dynamics (PSID) and its Transition to Adulthood (TA) supplement are used in this study. The multinomial logistic regression analysis findings showed that the amount of revolving debt was negatively associated with young adults’ mental health. On the other hand, perceived abilities in acting responsibly, in solving problems, and in managing money were positively associated with the mental health of young adults. The fixed effects regression analysis results indicate that the amounts of credit card and student loan debt from the previous period were negatively associated with an increase in the mental health continuum scores of young adults over time. A discussion of the implications of this study’s key findings for scholars, policymakers, and practitioners is included.
... Debt is associated with lower course grades and GPA (Destin & Svoboda, 2018;Stoddard et al., 2018), and a higher risk of drop-out (Dowd & Coury, 2006;Dwyer et al., 2012;McKinney & Burridge, 2015;Millea et al., 2018). Compounding academic setbacks, student debt is linked to poor emotional health and well-being (Britt et al., 2016;Lim et al., 2014;Walsemann et al., 2015;Zhang & Kemp, 2009), lower life-satisfaction both during and after school (Solis & Ferguson, 2017), and higher risk of emotional or psychiatric dysfunction (Kim & Chatterjee, 2019). ...
... Over two thirds of college students are in debt by their fourth year (Lim et al., 2014), the consequences of which alter decisions about starting a family, owning a home, or pursuing a new career (Froidevaux et al., 2020;Gutter & Copur, 2011). For students in debt, additional barriers to educational goals may emerge due to depleted emotional resilience and motivation, leading to unsatisfactory performance and higher risk of drop-out Destin & Svoboda, 2018;Kim, 2007;Walsemann et al., 2015). The unfamiliar psychological burden of debt, compounded by additional novel and unpredictable challenges during the school-to-college transition, threatens to reinforce perceptions of low control in competitive college learning environments (Borden et al., 2008;Cooke et al., 2004;Gutter & Copur, 2011;Perry et al., 2001). ...
... Suomalaisilla aineistoilla on myös osoitettu, että vanhempien ylivelkaantuminen linkittyy myöhemmin lasten suurempaan riskiin saada toimeentulotukea[27].Pääasiassa tutkimustieto nuorten omista veloista ja mielenterveydestä perustuu tutkimuksiin, joissa keskitytään yhdysvaltalaisiin tai brittiopiskelijoihin. Yhdysvalloissa ja Britanniassa opiskelijat ottavat merkittäviä opintolainoja opintojensa kustantamiseen. Lukuisat poikittaistutkimukset ja muutamat pitkittäistutkimukset ovat osoittaneet, että opiskelijoiden velat tai velkahuolet ennustavat mielenterveysoireita tai päihteiden ongelmakäyttöön[28][29][30][31]. Esimerkiksi Yhdysvalloissa havaittiin, että opintolainan dollarimäärä ennusti selvästi heikompaa psyykkistä hyvinvointia pitkittäisanalyysissä[31]. Näiden tutkimustulosten yleistämisessä Suomen kontekstiin on kuitenkin oltava varovainen, koska Yhdysvalloissa lukukausimaksut ovat suuri taloudellinen satsaus nuorille, kun taas Suomessa lukukausimaksuja ei ole.Kuvio 3. Niiden henkilöiden osuus ko. ...
... Lukuisat poikittaistutkimukset ja muutamat pitkittäistutkimukset ovat osoittaneet, että opiskelijoiden velat tai velkahuolet ennustavat mielenterveysoireita tai päihteiden ongelmakäyttöön[28][29][30][31]. Esimerkiksi Yhdysvalloissa havaittiin, että opintolainan dollarimäärä ennusti selvästi heikompaa psyykkistä hyvinvointia pitkittäisanalyysissä[31]. Näiden tutkimustulosten yleistämisessä Suomen kontekstiin on kuitenkin oltava varovainen, koska Yhdysvalloissa lukukausimaksut ovat suuri taloudellinen satsaus nuorille, kun taas Suomessa lukukausimaksuja ei ole.Kuvio 3. Niiden henkilöiden osuus ko. ...
... While most countries have financial aids systems or government-sponsored student loan schemes, there is considerable variation in the size of the repayment and recovery ratios across schemes (Shen & Ziderman, 2009). In addition, research shows that the use of student loans is associated with lower psychological functioning (Walsemann et al., 2015). ...
... In addition, the physical distancing rules caused a strong decline in social contact with friends, which can reinforce the risk of depressive symptoms, as these social contacts have been identified as an important resource in coping with stress in students (Liu, Zhang, et al., 2020). Our study also confirms the relationship between financial stress and depressive symptoms as profusely demonstrated in general and student populations (Walsemann et al., 2015). This demands attention to the repercussions of COVID-19 and the associated policy measures on students' financial situation in the mid to long term, particularly in countries with a pronounced imbalance between the costs of higher education and the capacity of students to shoulder increasing debt burdens (Goodnight et al., 2015). ...
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Higher-education students face substantial risks for developing depressive symptoms during the COVID-19 pandemic or experiencing exacerbated pre-existing depressive symptoms. This study uses data from the COVID-19 International Student Well-Being Study, which collected data through a non-representative convenience sample in 125 higher-education institutions (HEI) across 26 high- and middle-income countries (N: 20,103) during the first wave of the COVID-19 pandemic. It describes the prevalence of depressive symptoms in higher-education students. We find substantial cross-national variation in depressive symptoms, with lowest mean levels established in the Nordic countries and France, while highest mean levels of depressive symptoms were found in Turkey, South Africa, Spain and the USA. Elevated risk for depressive symptoms was found in female students, students with fewer social support resources and in a more disadvantaged socioeconomic position, and students with a migrant background. COVID-19 related stressors, such as reduced social contact, increased financial insecurity, and academic stress explained a relatively larger proportion of the variance in depressive symptoms compared to non-COVID-19 related stressors. This finding shows that not the pandemic itself, but rather the secondary effects of the pandemic relate to students' mental health. Our results enable HEIs to be better equipped to target groups that are particularly at risk during a pandemic.
... (Rodelo Valle & Garay Núñez, 2020) Gráfica 1 Funcionamiento psicológico medio predicho por la cantidad de créditos universitarios y el valor de la red familiar. Fuente: (Walsemann et al., 2015) Asimismo indicar que, en países anglosajones como Reino Unido, y en especial USA, donde el coste de las universidades requiere la petición de créditos o becas que dependen del desempeño que tenga el alumno, este criterio juega un papel destacado en la salud mental de los estudiantes. Se ha establecido relación entre la cantidad de dinero que se pidió prestado en un crédito universitario y el funcionamiento psicológico de dichos individuos entre los 25 y 31 años, observando que había una correlación inversa entre la cantidad de dinero pedida y el desempeño psicológico. ...
... Se ha establecido relación entre la cantidad de dinero que se pidió prestado en un crédito universitario y el funcionamiento psicológico de dichos individuos entre los 25 y 31 años, observando que había una correlación inversa entre la cantidad de dinero pedida y el desempeño psicológico. (Walsemann et al., 2015) Como se aprecia la situación de dificultad emocional, de riesgo per se, es más prevalente de lo que se podría pensar en un primer momento, de ahí la importancia de una respuesta clara a nivel institucional dentro de la propia universidad, venciendo el miedo a la discriminación y a las repercusiones laborales posteriores. (Macaskill, 2013) La intervención más ofrecida por la mayoría de las instituciones es el "counselling", y aunque tiene buenos resultados, debido a la cantidad de alumnado que puede demandarlo y a los recursos limitados con los que cuentan las instituciones académicas resulta todavía insuficiente para dar respuesta a estas nuevas necesidades desarrolladas por el alumnado en pleno siglo XXI. ...
Article
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El estigma y los recurrentes prejuicios en torno a la salud mental continúan coexistiendo en la sociedad globalizada del conocimiento y de la comunicación en pleno S.XXI. No olvidemos que la población general suele ser “opaca” ante cualquier problema psíquico y/o psicológico. Se acepta, en el contexto tecnológico actual y más en esta etapa pandémica, todo lo referente a los problemas físicos pero no tanto aquellos referentes a salud mental. De ahí, que la idea-fuerza del presente trabajo se centra en analizar el posible impacto de una salud mental positiva en el grupo de estudiantes universitarios de la rama sociosanitaria. Entendemos que la capacitación y/o formación de estos futuros profesionales ha fomentado un mayor estudio “per se” en cuanto a la necesidad de identificar rasgos vocacionales o de motivación intrínseca para el desempeño profesional, y por ello se ha comprobado en la revisión bibliográfica realizada que experimentan una prevalencia mayor de enfermedades mentales que otros estudiantes universitarios o que la población general. Además también se ha valorado que los estudiantes de Grado que quieren cursar estas carreras, están más predispuestos a padecer depresión, ansiedad o problemas con el alcohol, y que estas circunstancias tienden a empeorar conforme avanzan en su formación de acuerdo a los 50 artículos analizados. Una cuestión de evolución nada desdeñable por las especiales exigencias que implica tales Grados en la historia de vida de cada estudiante. Por ello, tal situación generalizada de excesiva responsabilidad asociada a su competencia profesionalizadora de toma de decisiones, genera una serie de demandas y necesidades específicas para las instituciones de Educación Superior, que no siempre son adecuadas en su respuesta universitaria. De manera que el conocimiento de dicho fenómeno es vital y no solo porque afecta al posible rendimiento académico del estudiante universitario de ciencias de la salud, sino porque también coarta la producción de conocimiento y contamina su futuro socioprofesional en los términos que plantea la OMS como calidad de vida total.
... Student loans lead to a reduced ability to accumulate wealth (Rothstein and Rouse 2011), limit the likelihood of homeownership (Cooper and Christina Wang 2014), and bias occupational choices toward jobs that are more financially rewarding but not those best suited to the individual (Rothstein and Rouse 2011). Even relatively small student loans have been shown to contribute to psychological stress (Elliott and Lewis 2015), a lower likelihood of flourishing and understanding one's purpose in life, less physical and social well-being (Cho et al. 2015), and poorer psychological functioning-especially in early adulthood (Walsemann et al. 2015). ...
... Our findings regarding the negative effect of taking out a student loan on life satisfaction corroborate previous research. Specifically, it has been shown that the cumulative amount of student loans borrowed over the course of schooling, together with lengthening repayment periods and higher levels of debt, associated with an increased probability of delinquency (Brown et al. 2014), affect psychological functioning (Walsemann et al. 2015), contributing to increased anxiety, problems with sleep, and a lack of social connectedness (Cooke et al. 2004). Our study adds that even the sole action of taking on a student loan may negatively affect psychological well-being by significantly decreasing life satisfaction, while repayment of such a debt does not contribute to increased life satisfaction. ...
Article
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This study evaluated the short-term links between different forms of household debt – credit card debt, student debt, debt from relatives, mortgage debt, car debt, and debt arrears – and life satisfaction. To this end, a longitudinal dataset for the US population from the Panel Study of Income Dynamics (PSID) was used and the propensity score difference-in-differences approach was applied. Credit card debt and student loans negatively impacted life satisfaction in the short term (up to two years). Mortgages and external financing for a car, however, were found to increase life satisfaction. The effects associated with the beginning and repayment of a loan turned out to not be symmetrical – the end of any type of loan contract was not related to life satisfaction. In the case of involuntary debt (i.e., mortgage arrears), a significant negative impact on life satisfaction was noted when problems emerged, while a positive effect was found when the debts were paid off.
... За рубежом исследования причин и последствий приобретения долга молодежью, а также социальных установок студентов к долгу, их структуры, динамики и связи с поведением имеют достаточно долгую историю: Lea, Deavis (1995) [1], Boddington, Kemp (1999) [2], Scott, Lewis (2001) [3], Callender et al. (2005) [4], Haultain et al. (2010) [5], из более современных работ можно отметить Norvilitis (2014) [6], Walsemann et. al. (2015) [7], Agnew, Harrison (2015) [8] и Almenberg et al. (2018) [9]. Возрос интерес отечественных психологов и социологов к проблеме отношения к займам, однако, в основном эти работы выполнены на взрослых респондентах [например, 10, 11]. ...
... Принципиальная разница в изучении долговой толерантности отечественными и зарубежными исследователями заключается в особенностях выборки и опыте заимствования, связанными с возможностями оплаты обучения студентами. Исследования, проведенные на американских [7], канадских [18], британских [1,8] и новозеландских [5,8], китайских [19] студентах -это исследования студентов, имеющих реальные образовательные ссуды и, соответственно, опыт заимствования, дающие возможность говорить о реальном долговом поведении. В России программа предоставления образовательных кредитов не работает, она была возобновлена после двухлетнего перерыва только в августе 2019 года на основании Соглашения о господдержке образовательного кредитования, подписанного Минобрнауки России и Сбербанком [20]. ...
... Several outcomes could emerge when a household finances college education through debt (Gayardon et al. 2018). Research has shown that student-loan debt could influence outcomes such as homeownership (Letkiewicz and Heckman 2018;Mountain et al. 2020), career choices (Sieg and Wang 2018;Schmeiser et al. 2016;Rothstein and Rouse 2011), postgraduate education (Zhang 2013), marriage choices (Sieg and Wang 2018;Gicheva 2016), health (Walsemann et al. 2015), financial distress, anxiety, and hardship (Bricker and Thompson 2016;Despard et al. 2016;Archuleta et al. 2013), stock ownership (Korankye and Guillemette 2020), and financial well-being and life satisfaction (Kim and Chatterjee 2019;Henager and Wilmarth 2018;Xiao et al. 2009). ...
... Hence, although a student loan can help a household enhance its human capital acumen, the debt itself serves as a constraint to the satisfaction of the household. Walsemann et al. (2015) point out that, although student loans can make it possible for a household to acquire human capital, the need for repayment can induce stress and worries among borrowers. The level of stress may be compounded by the fact that, in the United States, studentloan debt may not be forgivable when a person files for bankruptcy. ...
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This study finds a negative effect of holding student-loan debt on the life satisfaction of household heads using longitudinal data from the 2011 to 2017 U.S. Panel Study of Income Dynamics and a fixed-effects modeling approach. Although debt is taken to improve future utility, it provides disutility to the head of household until it is paid off. Thus, financial planners and educators should remind their clients about the consequences of holding student-loan debt in the short term, not just the future benefits.
... This indicates that people who feel deferred loans are important also tend to feel frustrated more often. This supports a study conducted by Walesmann et al. in 2015, which found that higher yearly and cumulative student loans correlate to worse psychological outcomes even after accounting for differences between students such as income, familial wealth, and educational attainment [91]. This also aligns with the results of Jones et al. [66], which shows a link between financial stress and a decline in mental health. ...
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COVID-19, the disease caused by the novel coronavirus (SARS-CoV-2), first emerged in Wuhan, China late in December 2019. Not long after, the virus spread worldwide and was declared a pandemic by the World Health Organization in March 2020. This caused many changes around the world and in the United States, including an educational shift towards online learning. In this paper, we seek to understand how the COVID-19 pandemic and the increase in online learning impact college students’ emotional wellbeing. We use several machine learning and statistical models to analyze data collected by the Faculty of Public Administration at the University of Ljubljana, Slovenia in conjunction with an international consortium of universities, other higher education institutions, and students’ associations. Our results indicate that features related to students’ academic life have the largest impact on their emotional wellbeing. Other important factors include students’ satisfaction with their university’s and government’s handling of the pandemic as well as students’ financial security.
... Financial pressure is one of the biggest factors jeopardizing college completion (Public Agenda, 2011). Longitudinal data suggest that student debt continues to negatively impact mental health in post-college life (Walsemann et al., 2015). ...
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In light of rising college student debt, many states now offer multiple options for students to earn college credit while still in high school. Concurrent enrollment programs, which allow qualified high school teachers to teach college credit-bearing classes in the high school, are one such option. Because concurrent enrollment classes teach college-level material at college-level rigor, they offer an ideal way to compare the secondary and tertiary learning environments across identical academic expectations. This study sought to compare the university mathematics environment with its concurrent enrollment counterpart. The WIHIC was found to be valid and reliable for the university population. The comparison of 242 students in university classrooms with 260 students in concurrent enrollment classrooms revealed a statistical difference, with the concurrent enrollment setting scoring higher in Involvement, Teacher Support, and Student Cohesion and the university setting scoring higher in Task Orientation. This implies that earning college credit in a secondary setting is a viable, and possibly even preferable, alternative to earning it in a university setting. We examine the discrepancy in scores—particularly the large discrepancy in Task Orientation—and discuss the benefit of the flipped classroom as one path to improving the university learning environment.
... Walsemann, Gee, and Gentile 2015;Kim and Chatterjee 2019) , evidence is generally mixed (McCloud and Bann 2019) .Richardson et al. (2017) find that debt can have concurrent negative mental health effects during a student's time in college, while others have found the effects to occur only after student life(Sato et al. 2020;Anong and Henager 2021).Cooke et al. (2004), andRichardson, Elliott, and Roberts ...
... Consistent with prior research, indicating debt to be a salient risk factor for depression and anxiety [e.g., 9,10,13,18], our findings highlight how clinical depression and anxiety are common among individuals with problems in managing their debt than those not struggling to control their debt. These strong associations remained even after accounting for income and receiving government benefits, supporting prior research indicating debt to be an important risk factor for poor mental health in its own right [e.g., 6,7,28]. It was interesting that the likelihood of having clinically significant anxiety symptoms was lower for those reporting "cannot manage at all" compared to "very serious problems", and that there was no statistically significant association between "cannot manage at all" and mental health help-seeking. ...
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Objectives This study examined the association between perceived manageability of debt and risk of depression, anxiety, and mental health help-seeking among a nationally representative sample of adults living in the United Kingdom (UK). Methods Data was derived from the COVID-19 Psychological Research Consortium (C19PRC) Study Wave 6 (August/September 2021) which examined the psychological, social, and economic effects of the COVID-19 pandemic on the UK adult population. Bivariate and logistic regression analyses were conducted to determine the association between different levels of perceived debt manageability (i.e., “easily manageable”, “some problems”, “quite serious problems”, “very serious problems”, “cannot manage at all”) and mental health related outcomes. Results Almost a quarter of the sample (24%, n = 494) reported debt management problems, and debt manageability associated with higher levels of anxiety, depression, and mental health help-seeking. After adjusting for demographic variables (e.g. income, receipt of benefits), logistic regression analysis demonstrated a dose-response association between increasing levels of debt manageability problems and mental health outcomes. Specifically, adjusted odds ratios for anxiety ranged from 2.28 (‘some problems’) to 11.18 (‘very serious problems’), for depression ranged from 2.80 (‘some problems’) to 16.21 (‘cannot manage at all’), and for mental health help-seeking ranged from 1.69 (‘some problems’) to 3.18 (‘quite serious problems’, ‘very serious problems’). Conclusion This study highlights that debt manageability problems represent a robust predictor of depression, anxiety, and mental-health help seeking.
... Expenditures incurred by university students for their education have also been known to have an effect on their mental health [56], but this may have intensified during the pandemic raising concerns about students falling into the 'vicious cycle' where financial difficulties beget mental health problems which in turn exacerbate students' financial difficulties [57]. Amongst our participants too, concerns about repayment of education loans, fees, accommodation costs made some students question their decision to enrol in university during the pandemic which seemed to have impacted their mental well-being. ...
Article
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The worldwide spread of the coronavirus disease 2019 (COVID-19) pandemic in early 2020 affected all major sectors, including higher education. The measures to contain the spread of this deadly disease led to the closure of colleges and universities across the globe, disrupting the lives of millions of students and subjecting them to a new world of online learning. These sudden disturbances coupled with the demands of a new learning system and the experiences of living through a pandemic have placed additional strains on the mental health of university students. Research on university students’ mental health, conducted during the pandemic, have found high levels of stress, anxiety and depression among students. In this qualitative study, we aimed to understand how pandemic experiences have affected student well-being by conducting in-depth interviews with 34 undergraduate students enrolled in a UK university. All interviews were conducted through Microsoft Teams and recorded with prior permission. Transcripts of recorded interviews were thematically analysed which identified two broad themes: (i) University students’ mental health and well-being experiences during the pandemic; (ii) factors that influenced students’ mental health and well-being. These factors were further distributed across six sub-themes: (a) isolation; (b) health and well-being; (c) bereavement; (d) academic concerns; (e) financial worries and; (f) support, coping, and resilience. Our study identifies the importance of mental health support to university students during pandemics and calls for measures to improve access to support services through these crisis points by universities. Findings can also inform students’ mental health and risk assessments in the aftermath of the pandemic.
... It would also increase the risk of over-indebtedness that may result in psychological ill-being (e.g. Ahlstr€ om & Edstr€ om, 2014; Meltzer et al., 2013;Walsemann et al., 2015). ...
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In the Nordic countries with growing markets for consumer credit, a concern is that consumption desires in conjunction with easily accessible credit make financially constrained young adults vulnerable to problem debt and over-indebtedness. In addressing this concern empirically, we investigate whether retail offers of instalment payments of discounted cash prices tempt young adults to finance purchases of more expensive premium smartphones than they would purchase by cash payment. Descriptions of smartphones ranging from budget to latest premium models are in an online experiment presented to 152 Swedish young adults between 18 and 25 years. We employ a within-group design requiring the participants in counterbalanced order to choose a preferred smartphone twice, either if the default choice is paying the regular cash price or two-year monthly instalments with a 20% discount on the cash price. Although a majority chose the same smartphone twice seemingly not influenced by the retail offer, this was not the case for about one third of the young adults who despite a negative attitude to borrowing choose instalment payments of more expensive premium smartphones, and more than half of them at a price exceeding the regular cash price they choose to pay for a cheaper smartphone. Instalment payments as well as rental contracts are penetrating many consumer markets in which young adults are large segments. These new forms of accessible credit should be particularly attractive to those who are financially constrained with potentially negative consequences for their solvency. Our results suggest that regulation policies may need to be considered.
... While much of the literature in this area tends to explain student stress and other potential threats to students' mental health and wellbeing by recourse to individual-level psychological attributes, a small number of scholars have employed a wider analytical lens and explored the impact of social, economic and institutional factors. Writing with respect to the US, Walsemann et al (2015) have argued that the taking on of loans to finance HE courses can have an adverse effect on students' mental wellbeing while, in Australia, Larcombe et al (2016) contend that caring responsibilities and hours available for study both impact on students' experiences of psychological distress. Bristow et al (2020) make similar arguments on the basis of their English research, arguing that students have been placed in new positions of vulnerability through 'the dominance of a moral economy within the university that emphasises neoliberalism and competition' (p 93) and the structural inequalities that have been thrown into sharp relief by efforts to widen participation. ...
Book
Amid debates about the future of both higher education and Europeanisation, this book is the first full-length exploration of how Europe’s 35 million students are understood by key social actors across different nations. The various chapters compare and contrast conceptualisations in six nations, held by policymakers, higher education staff, media and students themselves. With an emphasis on students’ lived experiences, the authors provide new perspectives about how students are understood, and the extent to which European higher education is homogenising. They explore various prominent constructions of students – including as citizens, enthusiastic learners, future workers and objects of criticism.
... Walsemann, Gee, and Gentile 2015;Kim and Chatterjee 2019) , evidence is generally mixed (McCloud and Bann 2019) .Richardson et al. (2017) find that debt can have concurrent negative mental health effects during a student's time in college, while others have found the effects to occur only after student life(Sato et al. 2020;Anong and Henager 2021).Cooke et al. (2004), andRichardson, Elliott, and Roberts ...
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Do financial capacity and financing concerns affect the frequency of students’ feeling depressed? Data from a sample of Philippine college and university students between 2015 and 2018 show that students from income brackets immediately above the poorest ones are less prone to feeling depressed although we do not find similar results from other higher income brackets in our sample. This suggests that partial needs-based financial assistance can alleviate depressive feelings among students. We also find that the perceived financial burden of college financing is positively associated with such feelings of depression. This implicitly recommends that mental health support should be more integrated in the University’s health services.
... A survey in China found that 11% of Chinese parents paid for their children's credit card debt while they were still in their twenties, and students are supported by their parents during their college years (Norvilitis and Mao, 2013). However, most American students pay for their education through work or government loans and repay these expenses themselves (Baum et al., 2013;Walsemann et al., 2015). In China, students have little exposure to work before attending university, and university planning place too much emphasis on teaching, with few training programs mentioning work experience, and internships only taking place in the final year of graduation. ...
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Background The number of students enrolled in higher education in China accounts for more than one-fifth of the world, and universities, as a community of faculty, staff and scholars, currently do not have a scale that specifically assesses the well-being of the population in the environment of Chinese universities. However, the University of Pittsburgh has developed a comprehensive well-being scale, referred to as the Pitt Wellness Scale, specifically to measure people’s well-being in a university environment. Aims Investigate the psychometric properties of the Pitt Wellness Scale in Chinese university environmental samples. Methods The original scale was culturally adapted and modified through expert consultation, a random sample of 1870 current faculty, staff, and students were selected for the questionnaire survey. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to investigate the potential factor structure of the Chinese Revision of the Pitt Wellness Scale and to measure its reliability and validity. Finally, the factors that affect people’s well-being in the Chinese university environment were explored. Results The Chinese Revision of the Pitt Wellness Scale retained 30 items, and the EFA supports a five-factor structure, which differed from the results of the original scale, and the CFA results showed that the model fitted well. The discriminant validity of the modified Chinese scale was excellent. The overall Omega coefficient of the scale was 0.958, and the reliability of the retest after 4 weeks was 0.821. Conclusion The Chinese Revision of the Pitt Wellness Scale possesses satisfactory psychometric properties, and it can be considered an instrument for assessing personal well-being in Chinese university environment.
... 7 In addition to the enhanced risk associated in young adulthood, college students are exposed to unique stressors that place them at risk for mental illness. 8 Some unique factors that shape mental health risk for college students include student debt 9 ; uncertainties about job prospects, 10 academic pressures, 11 "culture shock," especially for first-generation students 12 and separation from the family unit, which can be especially challenging for students from particular cultures. 13 Thus, college students represent a crucial population for screening, prevention, early intervention, and implementation of effective treatments. ...
Article
Objective: This study examined symptoms of anxiety, depression and suicidality in a national sample of college students. Participants: Using national survey data from the Healthy Minds Study (HMS), a random sample from 184 U.S. campuses from fall 2016 to spring 2019 was analyzed (N = 119,875). Methods: Prevalence rates were examined with the Generalized Anxiety Disorder 7-Item scale, Patient Health Questionnaire-9 and suicidality questions. Relationships between anxiety, depression and suicidality were assessed through Spearman's correlations, the Kruskal-Wallis H test and logistic regressions. Results: Findings revealed that screening only for depression would pick up 23% of suicidal ideation, increasing to 35% when also screening for anxiety. Those with anxiety and no to minimal depression had the second highest likelihood of suicide attempt, following those with anxiety and depression. The symptom "feeling afraid something awful might happen" doubled the odds of suicidal ideation. Conclusions: College campuses may benefit from assessing particular anxiety symptoms in relation to suicide.
... Emerging adult students (ages 18-25) navigate a particularly high-risk developmental period associated with mental health disorder onset (Jones, 2013;Conley et al., 2014). However, entering college at any age is a critical and often stressful point in an individual's life as they begin a new career and may accrue large amounts of debt, and thus, older students are also at risk for heightened stress (Acharya et al., 2018;Walsemann et al., 2015). At the same time, many college students report mental health concerns. ...
Article
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Background College students endorse high rates of mental health problems. While many colleges offer on-campus services, many students who could benefit from mental health services do not receive care. Indeed, nearly half of students who screen positive for depression, for example, do not receive treatment. Digital mental health programs, such as those delivered via mobile apps, may help expand access to mental health care and resources. This mixed-methods study aims to examine the uptake and effectiveness of an implementation of IntelliCare for College Students, a self-guided app-based mental health platform, on two university campuses. Methods Data on counseling center utilization was collected prior to the implementation of the app (pre-implementation phase) and while the app was available on campus (implementation phase). Data on app usage was collected throughout the implementation phase. A subset of participants (n = 20), along with counseling center staff members (n = 10), completed feedback interviews. Results Overall, uptake of the app platform was low. A total of 117 participants downloaded the app and registered their study ID during the implementation phase. Approximately 24% (28/117) of participants used the app only once. The number of days between the first and last day of app use ranged from 0 to 299, with a mean of 35.01 days and a median of 14 days. A relatively small portion of the sample (26.5%; 31/117) downloaded one or more of the IntelliCare interactive apps. In examining counseling center utilization, there were no significant changes in intake appointments, individual therapy sessions, or crisis appointments observed from the pre-implementation phase to the implementation phase of the study. Feedback interviews highlighted the significant level of disruption caused by the COVID-19 pandemic and shift to remote learning, including challenges disseminating information to students and a preference to spend less time with digital devices outside of class time. Conclusions Findings from this study indicate that there is an ongoing need to identify ways to reach college students and support student mental health and wellness for the remainder of the COVID-19 pandemic and beyond.
... Although declining marginal utility illustrates how well-being does not always rise at high income levels, it consistently declines at lower income levels. Debt repayment reduces discretionary income, and higher levels of debt are associated with greater financial worry during college and lower wellbeing after graduating from college (Walsemann et al., 2015). The majority of U.S. graduates believe their college education was worth the cost except among those with more than $50,000 in debt (Gallup, Inc., 2015). ...
Article
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Research on well-being has exploded in recent years, with over 55,000 relevant publications annually, making it difficult for psychologists—including key communicators such as textbook authors—to stay current with this field. Moreover, well-being is a daily concern among policymakers and members of the general public. It is relevant to the lives of students—illustrating the diverse methods used in the behavioral sciences, presenting highly-replicated findings, and demonstrating the diversity of individuals and cultures. Therefore, five experts present eight major findings that teachers and authors should seriously consider in their coverage of this field. These topics range from processes such as adaptation, to influences such as income, to the benefits of well-being, to cultural and societal diversity in well-being and its causes. We also examined how much these topics were covered in fifteen of the most popular introductory psychology textbooks. Although some topics such as social relationships and well-being were discussed in nearly all textbooks, others were less frequently covered including the validity of self-reported well-being, the effects of spending on happiness, and the impact of culture and society on well-being. We aim to ensure more complete coverage of this important area in psychology courses.
... Balancing academic and future career priorities is challenging, and the accompanying stress could lead to senioritis as students prioritize job searching or graduate school applications over academic assignments, withdraw into periods of inactivity, or leave college altogether because they feel overwhelmed and want to avoid making difficult decisions (Overton-Healy, 2010). Consider also that 64% of college students take out loans to pay for college, 70% of students who take out loans report stress about personal finances, and looming loan repayment obligations after graduation may be especially stressful for students who have not lined up gainful employment (Guo et al., 2011;McDaniel et al., 2015;Walsemann et al., 2015). Added to the academic demands of a college senior's course load, stress, anxiety, burnout, and depression can all contribute to the behaviors noted in descriptions of senioritis (Hunt et al., 2012). ...
Article
Senioritis is characterized by tendencies such as arriving late or skipping class, decreased motivation, or behaving irresponsibly by investing little effort in schoolwork. Research on senioritis primarily focuses on high school seniors, so the present study explored the phenomenon at the college level by investigating perceptions of senioritis in college students. Results indicated that students believe senioritis exists at the college level and that supportive relationships with faculty members and advisors play a significant role in how senioritis is perceived. This study confirms the relevance of studying college-level senioritis and suggests future research to define and further explore the phenomenon.
... It may be that the other effects of recessionsincreases in precarious forms of work, financial hardship, and incapacity to deal with debtcontribute to a larger extent than employment to mental distress trends in this age group. 37,38 Increases in mental distress in recent years may therefore be consequential to: 1) the longer-term effects of being out of work in the years after the 2008 GR on financial security and family transitions, 2) worsening trends in the work conditions of employed young adults, or 3) changes in other life domains such as sleep quality and use of technological devices and social media proposed by others. 3,39 Congruent with evidence on this topic, we found that short-term and long-term out-of-work experiences were each associated with a higher risk of mental distress between 1993-2019, with stronger associations observed among men. ...
Article
Few have examined how employment is linked to trends in mental health among young adults across economic contexts in more recent years. To better understand the burden of non-employment and mental distress in this age group, this study examines the association of short-term (<1 year) and long-term (1+ year) out-of-work status with mental health across three recessions among young men and women ages 18–34. We report sex-stratified estimates of frequent mental distress (FMD), out-of-work status, and their association through adjusted prevalence ratios across 27 cycles of the U.S. Behavioral Risk Factor Surveillance System (1993–2019). We found that FMD increased by 112% in men and 120% in women between 1993 and 2019, with 55% (men) and 44% (women) of this increase occurring between 2016 and 2019. Short-term (PR men = 1.53, 95%CI 1.46–1.61; PR women = 1.34, 95%CI 1.29–1.40) and long-term (PR men = 1.61, 95%CI 1.51–1.71; PR women = 1.28, 95%CI 1.22–1.34) out-of-work status were each associated with a higher risk of FMD during this period. The magnitude of associations between long-term out-of-work status and FMD significantly varied across cycles, and was strongest after the 1991 recession in men and the 2008 recession in women. Whereas employment represents an important determinant of mental health among young adults, particularly during economic downturns, it did not suffice to explain the rise in mental distress in this age group in more recent years.
... Finally, while we focus on unsecured debt in this study because it is considered more financially stressful than other forms of debt (Drentea & Lavrakas, 2000;Sun & Houle, 2020), future research might consider the association between other forms of debt and health, such as home mortgage or student loan debt. For example, recent research suggests that many college-going young adults are having difficulty repaying their student loans well into their 30's and 40's (Houle & Addo, 2019), which may have consequences for health later in life (Walsemann et al., 2015). ...
Article
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Background Unsecured debt — debt not tied to an asset — is a financial stressor that undermines health, but prior research has not investigated relationships between group-based trajectories of unsecured debt and pain and disability at midlife. Methods US respondents of the National Longitudinal Study of Youth-1979 cohort reported unsecured debt and income between ages 28–40. We used these measures to identify group-based trajectories of unsecured debt and unsecured debt-to-income ratio. We then used trajectory membership to predict three pain and disability-related health outcomes at age 50, adjusting for lagged health and other covariates. Results Group-based trajectory models divided the sample of 7850 respondents into 6 unsecured debt trajectories and 5 unsecured debt-to-income trajectories. In fully adjusted unsecured debt models, compared to people with constant low debt, those who paid down debt over time, carried constant debt, experienced debt cycling, or accumulated debt later in life were more likely to report pain interference with activities or joint pain or stiffness at age 50 (pain interference ORs ranging from 1.33 to 1.76; joint pain or stiffness ORs ranging from 1.27 to 1.45). In fully adjusted unsecured debt-to-income models, compared to those with constant low debt, those with constant high debt or accumulating debt later in life were more likely to report pain interference or joint pain or stiffness (pain interference ORs ranging from 1.30 to 1.91; joint pain or stiffness ORs ranging from 1.19 to 1.33). Conclusion The amount, timing, and duration of unsecured debt accumulation and repayment have important health implications and may exacerbate midlife health inequalities.
... The reported associations of current and lagged credit card and medical debt were similar to those found for student loan debt. Kim and Chatterjee considered their results consistent with previous studies of debt, life satisfaction, and psychological problems citing Adams et al. (2016), Drentea and Lavrakas (2000), Sweet et al. (2013), and Walsemann et al. (2015) among others. Watson et al. (2015) investigated life satisfaction and depressed mood among college students in a Western Australian university. ...
Article
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The last decade of research on college student financial wellness was driven by the onset of the “student loan debt crisis.” Prior to the focus on student loans, credit card use and marketing was the primary area of interest for those studying young adult finances on campuses. This paper consolidates the findings reported in twenty papers related to college student finances that were published in the Journal of Family and Economic Issues between 2010 and 2019. The work is organized into individual financial behaviors and its antecedents, followed by a summary of studies that study well-being indicators. The reviewed studies address financial behaviors as products of individual and personal characteristics, family relationships and formal socialization processes, and how these factors influence general well-being outcome. Though the approaches vary widely across published studies, each addressed at least one outcome within the socialization model. Credit card and student loan financial behaviors are common factors in determining well-being, their resulting impact on financial or general subjective well-being are mixed at best. The area of research is relatively new and directions for future research are outlined. Studies of emerging adults over time, replication of previous work, consistency in approach to measuring key constructs, and commitment to theoretically based approaches to research will all help to clarify our understanding of college students’ transition to financial independence.
... The alternate trend in the literature depicts students as suffering victims of debt, suggesting that student debt may predispose individuals to a variety of psychological difficulties. Student debt has been found to be accompanied by stress and anxiety (Doran et al., 2016b), and associated with poorer psychological functioning and worse global mental health (Cooke et al., 2004;Walsemann et al., 2015). Evidence from a longitudinal study suggests a causal relationship between financial difficulties resulting from student debt and increased rates of depression, stress, anxiety, and alcohol dependence (Richardson et al., 2017). ...
Article
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While public commentators herald the arrival of the Canadian “student debt crisis,” psychological research into postsecondary student debt proliferates. This study explored the ways in which indebted students themselves understand the meanings and implications of student debt in their own lives, by means of semistructured interviews with nine indebted university students. A hermeneutic phenomenological approach to analysis yielded six themes: indebted by necessity; haunted by distressing thoughts and feelings about debts; living under the pressure to repay debts; living a constrained life; feeling alienated from others; and uncertainty about the meaning of university education. Findings suggest that student debt is characterized by the experience of feeling unable to “live one’s life,” and of looking toward a fragile future after university. By grounding the psychological experience of debt in the socially embedded, historical realities of students’ everyday lives, this work suggests implications for critical psychological understandings of financial subjectivation.
... While these previous studies focused on objective financial outcomes, others have focused on perceived or subjective indicators, that is, the self-reported perspectives of graduates, and found that student loan debt is associated with emotional stress and concerns about the ability to repay the debt (Walsemann et al. 2015). Velez et al. (2019) found that four years after graduating, undergraduate debt was related to borrowers' earnings, job choice, decisions to marry and have children, and net worth. ...
Article
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This study sought to determine whether the levels of financial satisfaction reported by college undergraduates and graduates differ in relation to whether they funded their college education by working or borrowing or a combination of the two. Data for this study came from a survey sample of full-time freshmen that formed the basis of a longitudinal study conducted at a large public university. Funding sources examined were grouped into those who worked only, those who borrowed only, those who worked and borrowed, and those who used grants, scholarships, or other sources of money to fund their college education. Compared to those who had student loans, those who had financed college with grants, scholarships, or other money (usually from family and/or friends) were more likely to report greater financial satisfaction than those who had used student loans to pay for college. There was evidence that this was only true during college rather than after college. The results obtained suggest that merely possessing a student loan may not necessarily decrease the level of financial satisfaction as many suspect, especially considering other funding alternatives such as working during college. While there was no significant impact of these funding strategies on financial satisfaction either during or after college, there was evidence for possible thresholds at which overall student loan balances may begin to erode financial satisfaction. The results obtained suggest that student loans may not decrease the level of financial satisfaction as much as many have suspected when compared with working to pay for college, as long as the amount of the student loan is not excessive, and is not accompanied by other types of debt (which also reduced financial satisfaction).
... Economic factors can be a stressor, for example, where a full-time student is having to work due lack of parental financial contribution to the maintenance loan. The rise in tuition fees (covered by a student loan viewed as debt) results in partial increases in undergraduates' mental health difficulties (Richardson et al., 2015), and debt links to poorer psychological functioning and students considering withdrawing (Cooke et al., 2004;Walsemann et al., 2015). ...
Article
Using the UK as an example, students attending higher education providers (HEPs) increasingly suffer mental ill-health due to new stress factors. Relationships between stress, frequently co-occurring chronic medically unexplained symptoms (MUS) and mental health are explored as the basis for proposing The BodyMind Approach® (TBMA) as an innovative intervention, addressing the body and mind experience of MUS. Excessive stress can lead to/exacerbate, mental health difficulties and/or MUS (such as fibromyalgia, chronic fatigue/pain for which tests and scans are normal). MUS mostly affects women, non-native speakers and young people, all high numbers at HEPs. Students resist mental health services, and half in need do not disclose or seek help. TBMA, as an evidence-based, research-informed intervention, tested in the health service, is more accessible when framed as learning to self-manage symptom distress. Policymakers might consider this intervention to help improve student mental health as part of an institution-wide approach.
... Bemel et al. (2016) and their study of undergraduates at a U.S. university found that fiscal stress impacts many elements of mental health including concentration, ability to make decisions, general happiness and perceptions of usefulness. Walsemann et al. (2015) also find that poorer financial conditions of students and recent graduates leads to poorer mental health outcomes, but they note that care must be taken not to make overly general statements about student debt and health. Concurrent with Huang (2015), risk attitudes towards debt and perceptions of future income earning potential plays a significant role. ...
Article
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How the growth in student debt is impacting the well-being of the larger community is explored using U.S. county level data. Using tax return data from the Internal Revenue Service (IRS) we find that higher levels of student debt tends to be associated with lower levels of community well-being. Specifically, lower rates of home ownership, higher rental market stress, lower rates of entrepreneurship and poorer health behaviors. While the decision to take on student debt is an individual decision, local communities are uniquely positioned to help students make decisions around taking on debt and repayment options.
... Furthermore, in recent years, several studies linked student loan debt with poorer health among students (e.g. Cooke, Barkham, Audin, Bradley, & Davy, 2004;Morra, Regehr, & Ginsburg, 2008;Ross, Cleland, & Macleod, 2006;Walsemann, Gee, & Gentile, 2015). All these studies that reported such a link found that 'student loan debt is positively associated with incidence of financial distress' (de Gayardon, 2018, p. 34), such as financial struggle (Baum & O'Malley, 2003;Dugan & Kafka, 2014) having experienced bank overdrafts, bankruptcy and food insecurity (Despard et al., 2016;Gicheva & Thompson, 2015) and so on. ...
Article
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In this paper, we examine how alienation plays out in conditions of advanced neoliberalisation in education. We discuss two examples which exemplify the depth and extent of alienation. First the attacks on critical thinking in education that have been spearheaded by the ‘School without [political] parties’ [‘Escola sem Partido’] project in Brazil. Second, the mental health crisis that is rampant among staff and students in the UK higher education. Drawing on Freire, we explore how ‘the organization of alienation’ can fuel acts of resistance and praxis which can help us reclaim education and society from the forces of the market. The examples we draw on in relation to Brazil and the UK have not yet become mainstream strategies, especially internationally, that can sustain a resistance movement in education, but they form successful local, in some cases national even, strategies that seem to be able to open new possibilities which can eventually help us find creative and effective ways to make the organisation of alienation the project for Being More that Freire envisaged.
... Objective financial indicators, such as size of debt and tuition fees, and problems paying bills have been shown to be associated with poorer health outcomes among students in higher education (Carney et al., 2005;Richardson et al., 2015;Walsemann et al., 2015), and low income has been related to self-harm, suicidal ideation and suicide attempts in this group (Toprak et al., 2011). Subjective feelings of financial stress and concerns about financial circumstances have also been linked to mental health problems and mental illness; to more aches, pains and reduced physical functioning; to sleep problems; and to worse general health among students (Cooke et al., 2004;Farrer et al., 2016;Jessop et al., 2005;Richardson et al., 2017;Stallman, 2010). ...
Article
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To examine financial circumstances among Norwegian higher education students and investigate associations between financial difficulties and health, academic outcomes and self-destructive behaviours, we used data from a recent national health survey from 2018 for higher education in Norway (the SHoT study). 50,054 full-time students (69.1% women; 30.9% men) aged 18–35 years participated and reported work status, income and experience of financial difficulties, self-reported mental health problems, deliberate self-harm and suicide attempts, somatic health complaints and exam failures in higher education. Students often experiencing financial difficulties (n = 3933, 7.9%) reported more mental health problems (HSCL-25; M = 2.1 vs 1.6), depression (24% vs 7.2%), anxiety (20.8% vs 6.7%), deliberate self-harm (12.2% vs 4.9%), attempted suicide (3.1% vs 0.5%), somatic health complaints (SSS8; M = 13.1 vs 7.4), having ever failed exams (45.5% vs 28.4%) and higher average number of failed exams (M = 1.1 vs 0.6) compared to peers not experiencing financial difficulties. These associations were robust to adjustments for age, gender, relationship status, immigrant background and study program. Strategies to alleviate problems associated with financial difficulties may be to improve the existing financial support to students, strengthen student mental health services, and expand services for financial counselling and guidance.
... Financial strain contributes to differential morbidity and mortality rates, in part, because the induced stress of debt increases risk of obesity, substance abuse, depression, suicide, and poor self-related health (Richardson et al. 2013;Turunen and Hiilamo 2014). The majority of the studies we have identified (mostly cross-sectional) linked debt to perceived stress, depression, and poor self-rated health (e.g., Reynolds 2012, 2015;Gathergood 2012;Knapp and Dean 2018), with a growing number of studies focused on later cohorts who face proportionately higher debt burdens from unsecured debt and college loans (Dwyer et al. 2016;Kim and Chatterjee 2019;Sweet et al. 2013;Walsemann et al. 2015). ...
Article
Analyses of the Health and Retirement Study (HRS) between 1992 and 2014 compare the relationship between different levels and forms of debt and heart attack risk trajectories across four cohorts. Although all cohorts experienced growing household debt, including the increase of both secured and unsecured debt, they nevertheless encountered different economic opportunity structures and crises at sensitive times in their life courses, with implications for heart attack risk trajectories. Results from frailty hazards models reveal that unsecured debt is associated with increased risk of heart attack across all cohorts. Higher levels of housing debt, however, predict higher rates of heart attack among only the earlier cohorts. Heart attack risk trajectories for Baby Boomers with high levels of housing debt are lower than those of same-aged peers with no housing debt. Thus, the relationship between debt and heart attack varies by level and form of debt across cohorts but distinguishes Baby Boomer cohorts based on their diverse exposures to volatile housing market conditions over the sensitive household formation period of the life course.
Article
Objective: Determine relationships between college students' student loan presence and self-rated physical and mental health, major medical problems, mental health conditions, physical, dental, and mental health care visits and delays, and medication use and reductions. Participants: A total of 3,248 undergraduates at two regional public U.S. universities, surveyed Spring 2017. Methods: OLS and Logistic regression. Results: Loan presence was related to significantly worse self-rated physical and mental health and more major medical problems, but not to mental health conditions, or physical or mental health medication use. Respondents with loans were less likely to visit the dentist and more likely to report delaying medical, dental, and mental health care, and reducing medication use to save money. Conclusions: Results provide evidence of health and health care use divides among college students by loan presence.
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Objetivo: Identificar en qué medida la salud mental y bienestar subjetivo son predichas por el endeudamiento por motivos de estudio en estudiantes universitarios de la ciudad de Temuco, Chile. Método: Una muestra no probabilística de 151 estudiantes universitarios de quinto año o superior de su respectiva carrera universitaria respondió a medidas de salud mental (DASS-21), de bienestar subjetivo (satisfacción con la vida y felicidad subjetiva), y del nivel de endeudamiento asumido para financiar sus estudios universitarios. Los análisis incluyeron regresiones lineales múltiples jerárquicas donde se incluyeron como variables independientes la variable género en un primer paso y el endeudamiento por créditos universitarios en el segundo paso. En cada regresión se incluyó un factor de salud mental y de bienestar subjetivo como variable dependiente. Resultados: Resultados indican que el endeudamiento por motivos de estudio predice significativamente satisfacción con la vida (F(2, 148) = 5,95, p = 0,003, R2 Adjusted = 0,06; β = -0,16, p = 0,049), pero no predice felicidad subjetiva (p = n.s.) (factores de bienestar subjetivo), sintomatología depresiva (p = n.s.), ansiosa (p = n.s.), ni estrés (p = n.s.) (factores de salud mental). Conclusión: Resultados del estudio sugieren que los estudiantes universitarios pudieran percibir el endeudamiento estudiantil como una inversión hacia el futuro lo que pudiera operar como un factor protector de su salud mental y bienestar subjetivo.
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This study used the 2015 National Financial Capability Study to investigate the relationships among financial capability, financial education, and student loan debt outcomes. Specifically, this study examines four student loan outcomes: delinquency, stress, preparation, and satisfaction among borrowers who obtained loans for themselves. Three forms of financial capability (objective financial knowledge, subjective financial knowledge, and perceived financial capability) and two forms of financial education (formal school/workplace education and informal parental education) were used as potential predictors in the study. The Probit regression results showed that expectedly, several financial capability and financial education factors were positively associated with desirable financial outcomes such as loan calculation and loan satisfaction, and negatively associated with undesirable outcomes such as loan stress and loan delinquency. However, this study also showed several unexpected results. For example, objective financial knowledge was negatively associated with loan calculation and loan satisfaction, and subjective knowledge and formal financial education were positively associated with loan delinquency.
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Introduction Student loan debt has become common for young adults in the U.S. and is correlated with poor physical and mental health. It is unclear how the accumulation or repayment of student debt is associated with longer-term cardiovascular risks and chronic inflammation. Methods Nationally representative data collected between 1994 and 2018 from >4,000 participants of a U.S. cohort study were analyzed in 2021 to assess the associations among change in student debt between young adulthood and early mid-life, 30-year Framingham cardiovascular disease risk scores, and C-reactive protein levels. Results Ordinary least squares regression revealed higher cardiovascular disease and C-reactive protein risks among those in households who became indebted or were consistently in debt between young adulthood and early mid-life than among those in households who were either never in debt or repaid their loans. This pattern persisted after adjustments for degree completion, socioeconomic measures, and other sources of debt. Conclusions These findings provide a benchmark for widening health inequalities among a cohort bearing more student debt than any other in U.S. history. As student debt accumulates, within-cohort disparities in cardiovascular disease and related morbidities may undermine the health benefits of postsecondary education.
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Widening participation in creative arts higher education has international, national, and localised manifestations. This chapter explores the global context of widening participation by considering the policy model of neoliberalism. From a global perspective, widening participation in higher education generally has been linked to economic prosperity by supplying a workforce with high-level skills and knowledge. The neoliberal paradigm conceptualises higher education as benefitting the individual and contributing to their personal prosperity while simultaneously benefitting the national economy. Therefore, global policies are directed towards widening participation in particular ways. Measures to widen participation have increasingly focused on individuals, responsible for funding their education as customers and positioned as having choice and opportunity. As customers need to make informed choices, world rankings of universities have become a significant driver in higher education and also a mechanism of elitism, with implications for students who do not attend leading universities or who study subjects not perceived as contributing to economic growth, such as the creative arts. Students’ global mobility has strengthened the case for harmonisation of higher education systems yet priorities and policies regarding widening participation largely remain tied to national and localised considerations, with slowly growing efforts towards international analysis.
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At first sight, tuition fee seems a simple factor requiring student contribution but looking closely one might discover it is a hugely influental factor with an effect on the whole educational process. Tuituion fee influences the work between the student and the academic and the teaching profession itself as well. In the present study, we examine the effects of the compulsory student obligation being present in English higher education since 1998 in the light of the higher education processes observed in Germany. The author examines the phenomena that have developed in England as a result of tuition fees, relying on the concepts of sociology of professions. The analysis shows that tuition fees not only impose a financial burden on enrolling students but are also accompanied by higher expectations of students, a change in the role of the academics and a transformation and deterioration of the relationships between different actors in higher education. The changes observed in English higher education can provide important lessons for all countries where the privatization of higher education is taking place, with the introduction of a significant amount of student contribution being initiated.
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Using the 2017 wave of the transition to adulthood dataset, this study examined the association between the achievement of key milestone markers of adulthood and the well‐being of emerging adults between ages 18 and 28. Results indicate that relationship status, financial behavior, and perceived capability were positively associated with the well‐being of emerging adults. The results also indicate that financial responsibility, mediated by cohabiting relationship status, was negatively associated with relationship satisfaction and life satisfaction of emerging adults. All relationship categories were positively associated with well‐being when compared with the reference group of emerging adults who were single and not in a relationship. The study also found that being African Americans or other racial‐ethnic minority groups was negatively associated with life satisfaction, thus indicating a greater need for programs and policies to bridge the gap in perceived well‐being that currently exists between Non‐Hispanic Whites and other racial‐ethnic minority groups. Educational attainment was positively associated with the perceived well‐being of emerging adults. Implications of the key findings of this study are included for financial planners, scholars, and policymakers.
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While poor financial circumstances have been associated with an increased likelihood of depression, the role of personal debt in determining individual mental health is not fully understood. This paper investigates the existence of a causal relationship between individual debt and depression across 5 waves of panel data from the National Income Dynamics Study (NIDS). This paper adds to the existing literature on the relationship between consumer debt and mental health by: (i) exploring the causal relationship between debt and mental health, (ii) conducting the research between debt and mental health in a non-western economy, and (iii) considering the effect of various categories of debt on mental health e.g. mortgage debt, student debt, formal debt and informal debt. By using logistic fixed effects analysis, and exploiting the panel, the analysis controls for unobserved heterogeneity in the causal relationship between debt and depression. The paper finds that (I) Individuals who acquire informal debt have an increase in the odds of being depressed in both the current and future period. On the other hand, individuals who are depressed have an increase in the odds of being depressed. Therefore, informal debt appears to exhibit a bi-causal relationship. (II) Individuals with secure or mortgage debt exhibit a decrease in the odds of being depressed in the future, and (III) there is evidence that acquiring formal debt and being depressed decreases the odds by which an individual is exhibits symptoms of depression in the future. This means that for unproductive debt categories debt appears to exhibit a negative effect on mental health and thus a decrease in lifetime utility. However, for productive debt categories such as secure debt, there is a positive effect on future mental health which may be argued to be an improvement in lifetime utility.
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This paper summarizes recent research into the cost of higher education, and specifically the effects of growing student debt loads. It explores the utility of debt related to access to degree programs, entry into the job market, and economic impact in later life. It is not an economic analysis of higher education financing, but a consideration of the costs and benefits of education financing today. The central ethical consideration of “who benefits” applied to the current state of play in higher education financing leads to the questions: With constantly rising debt loads for individual students and the general population, is higher education still worth it? What are some of the issues that school debt creates and what impact do they have on diverse student and graduate populations? Finally, what are some potential areas for further research that can positively affect the cost vs. benefit of higher education for students and the state, while respecting prevailing social, economic, and political realities? The research shows while going into debt for a college degree is still “worth it” for the average student, as debt rises the payback of obtaining a degree is delayed. Debt loads have a negative disparate effect on vulnerable populations and a negative impact to the states as debt load drives some students away from careers that could benefit populations. Finally, there is a need for improved financial literacy and an opportunity to research and implement less costly financing options for students pursuing higher education.
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Female college students report higher rates of stress than their male peers. Ineffective stress management contributes to a variety of concerning health outcomes. A number of factors have been shown to promote resilience to stress, such as experiencing positive social support. Few studies have examined if gender-specific social support impacts resilience. The present study investigates if gender-specific social support uniquely contributes to resilience among nontraditional college female students. Participants (N = 57) aged 21 to 54 completed an online survey assessing resilience and perceived social support from females and males. Participants with higher levels of perceived female social support reported higher levels of resilience than those with lower levels of perceived female social support. Perceived male social support was not significantly related to resilience when examined in conjunction with perceived female social support. These findings suggest that perceived female social support may uniquely contribute to resilience in nontraditional female students.
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As the onus of paying for higher education shifted from the state onto students and their families, student indebtedness grew across a wide range of households in the United States in the 2000s, especially among Black and Hispanic households. Holding student debt is a financial risk that may leave households more vulnerable to economic shocks. We study the relationship between household student loan burden and the likelihood of financial stress during the Great Recession using the unique 2007 to 2009 panel of the Survey of Consumer Finances. We find a robust positive relationship across four dimensions of student loan burden and holding constant household characteristics and previous financial stress. We find that Black and Hispanic households with higher student debt burdens experienced higher odds of financial stress relative to White households, even once accounting for prior financial stress. Our results demonstrate the importance of considering the household risk incurred in the US system of financed attainment, especially during the inevitable downturns of a capitalist economy.
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Objective This study examined the statistical association between net tuition and changes in degree aspirations among community college students. In addition, the study explored the moderating influence of unmet financial need. Method Analyses relied on data from the most recent iteration of the Beginning Postsecondary Students Longitudinal Study. Estimates were derived from a series of robust multinomial models controlling for student, institutional, and state-level covariates. Results Net tuition was consistently associated with decreased risks of experiencing a “cool out,” regardless of model specification. Yet, this main effect of net tuition was moderated by unmet need, such that net tuition increased cool out risks among students with greater unmet need. Conclusions The results of this study suggest that net reductions in tuition alone may not fully reduce or eliminate barriers to college access and student success. Future financial aid policies should focus on the full cost of college attendance.
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Many social workers are exposed to trauma directly and indirectly through their academic coursework and practice settings. Research shows that social workers who practice self-care early in their careers are better able and more likely to effectively manage these experiences. In the long term, self-care can reduce staff turnover rates and burnout, and therefore increase the quality of client care. Bachelor of Social Work and Master of Social Work programs have an ethical responsibility to integrate self-care into the curriculum as a professional competency at the micro, mezzo, and macro levels of practice to help cultivate, develop, and retain practitioners long term. This article presents strategies for implementing self-care skill building into social work curricula and field education.
Chapter
Every year across the globe, thousands of students begin the quest towards becoming a medical doctor and donning a long white coat. Global research indicates that after beginning medical education, medical students' mental health and well-being dramatically declines. The loss of well-being continues into the residency and practice of medicine. The aim of this chapter is to broadly examine the pressures unique to medical students within the context of medical education training, higher education, and the general population. A call for medical education to adopt innovative policy, plans, and administrative and curricular changes designed to foster a culture conducive to the long-term positive mental health and well-being of medical students during training and into the internship and long-term practice of medicine concludes the chapter.
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Introduction: Increasing levels of student loan debt are a concern within many health professions, including physical therapy. This purpose of this study was to determine the levels and potential repayment of student loan debt for graduates of public and private physical therapist educational programs and to determine the relationship between debt management education, student loan debt, and credit card debt in Doctor of Physical Therapy (DPT) students just prior to graduation. Methods: Seven hundred thirty-three final year DPT students scheduled to graduate in spring or summer of 2019 completed a survey asking participants their level of student loan and credit card debt; their concerns regarding student loan debt; and if their educational program included curricular information on debt management. Results: Ninety-one percent of participants had some level of student loan debt. For participants with student loan debt, the average total student debt balance at the time of graduation was $103,482 for those attending a public institution and $138,361 for those attending a private institution; with the average amount of student loans taken out just for attending a DPT program being $83,087 for those attending a public institution and $112,207 for those attending a private institution. Participants who received debt management education within their DPT program had, on average, $3,520 less student loan debt for attending their DPT program and $570 less credit card debt than those who did not receive this education. For participants with student loans, 81% were concerned about loan repayment and 90.3% were concerned about the ability to make future major purchases, such as a house or car. Discussion & Conclusions: Utilizing participants' average estimated starting salary and a 15% debt to income guideline, 75.1% of participants with student loan debt would not meet 10-year loan repayment guidelines, 38.7% would not meet fixed 25-year loan repayment plan guidelines, and 21.4% would not meet 25-year graduated loan repayment plan guidelines. There was no significant difference in debt levels between students who did and did not receive debt management education within their DPT educational programs.
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Recent research shows personal financial debt is an important socioeconomic determinant of health, but the mechanisms through which it operates are not well understood. This article uses data from a mixed-methods study to explore how changes in spending and behavior that result from debt have salient health consequences in a cross-sectional sample of Boston area adults ( n = 286). Findings show that a large majority of respondents had skipped medical care, housing payments, or consumer purchases at least once because of their debt. Controlling for multiple sociodemographic characteristics, each of these measures of debt-related behavior change was associated with worse self-rated health, and higher depressive symptoms, anxiety, and perceived stress. In models including all three measures, skipped medical care was associated with worse health across all outcomes, while skipped consumer purchases were associated with higher perceived stress and depression. These findings suggest that altered spending and care-seeking behaviors are potential pathways through which financial debt can negatively affect health and suggest areas in need of additional research.
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A large literature documents a strong and consistent educational gradient in health: more-educated persons enjoy lower rates of morbidity and mortality. This literature has generally focused on the amount of schooling one completes but has yet to comprehensively examine other facets of education, such as educational quality or school segregation. More importantly, the literature has generally conceptualized education at the level of individual persons and has yet to fully study the structural dimensions of education and the production of educational inequities. The goal of this article is to identify several areas of educational inequity beyond personal educational attainment. These include (a) population differences in the strength of the educational gradient in health, (b) educational quality, (c) school segregation, and (d) the role of place of education among immigrants. We also discuss some emerging issues, such as student debt and pathways to education. Accordingly, there is much work to be done to further our knowledge regarding the relationship between education and health.
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The present paper provides an analysis of the relationship between attitudes toward debt and mental health among university undergraduates. Data were collected from the same cohort of students across their three years of university, with responses from 2146, 1360 and 1391 first, second and third year students, respectively. Mental health was measured using the General Population version of the Clinical Outcomes in Routine Evaluation (GP-CORE). Attitudes toward debt were measured using items that tapped current financial concerns and worry about debt on leaving university. Results showed that students become more concerned about their finances as they progress through university, that there was no relationship between anticipated debt and mental health and that attitudes toward debt were related to mental health levels. Students who were identified as having high financial concerns possessed significantly worse CORE-GP scores than students with low financial concern in all three years of university. In all three years students with high financial concerns felt more ‘tense, anxious or nervous’, more ‘criticised by other people’ and found it more ‘difficult getting to sleep or staying asleep’ than students with low financial concerns. There was also evidence that students with high worry about their debt anticipated leaving university with higher amounts of debt than low debt worry students. These findings are discussed in relation to the pattern of increased student debt in UK higher education.
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The 1990s saw a considerable fall in young adult homeownership rates in Britain. There is a concern that the future might hold further falls as a result of reforms to financing higher education. Using estimates from a housing tenure choice model, this paper conducts micro-simulation analyses to assess how this change could affect young adult homeownership transitions. The simulations reveal that increased student debt levels and the new repayment profile and their interaction with lender-imposed borrowing restrictions delay a first-time homeownership transition. The extent of the delay primarily depends upon the expected earnings profile, but lender criteria and general rises/falls in real house prices are also important. The analysis suggests that there will be much greater variation in the timing of house purchase between different groups of future graduates, brought about by increased graduate earnings heterogeneity, homeownership affordability schemes targeted toward specific types of households, and parental financial assistance.
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Objective: Drawing from cumulative inequality theory, this research examines how accumulated financial strain affects women's self-rated health in middle and later life. Method: Using data from the National Longitudinal Survey of Mature Women (1967-2003), we employ random-coefficient growth curve models to examine whether recurring financial strain influences women's health, above and beyond several measures of objective social status. Predicted probabilities of poor health were estimated by the frequency of financial strain. Results: Financial strain is associated with rapid declines in women's health during middle and later life, especially for those women who reported recurrent strain. Changes in household income and household wealth were also associated with women's health but did not eliminate the effects due to accumulated financial strain. Discussion: Accumulated financial strain has long-term effects on women's health during middle and later life. The findings demonstrate the importance of measuring life course exposure to stressors in studies of health trajectories.
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The "winners" in today's winner-take-all labor markets are differ-entiated by advanced levels of educational attainment, especially higher degrees. This article applies a sociological model of cumu-lative dis/advantage to the baby-boom cohort to examine whether life course timing differences in educational attainment help explain wage differentials by midlife. It finds that advantaged social origins lead to early postsecondary completion of degrees, which, in turn, yield higher wages. A pathway of cumulative disadvantage is also evident, where those least advantaged exit schooling early in life, do not return as adults, and earn low wages. In a middle path, advantaged social origins promote adult school attainment primarily for those without degrees but generally without the wage boosts associated with attainment earlier in life.
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We compared health outcomes for adults with the General Equivalency Diploma (GED) and regular high school diploma to determine whether GED recipients are equivalent to regular graduates despite research that documents their disadvantages in other outcomes. We used 1997 to 2009 National Health Interview Survey cross-sectional data on high school dropouts, graduates, and GED recipients aged 30 to 65 years (n = 76,705). Five general health indicators and 20 health conditions were analyzed using logistic models. GED recipients had a significantly higher prevalence of every health outcome compared with high school graduates (odds ratios = 1.3-2.7). The GED-high school differences attenuated but remained evident after controlling for health insurance, economic status, and health behaviors. For most conditions, the 95% confidence interval for GED earners overlapped with that for high school dropouts. The high school equivalency diploma was associated with nonequivalent health: adults with a GED had health comparable to that of high school dropouts, not graduates. GED recipients were at increased risk for many health conditions, and their health should be viewed as distinct from regular graduates. The findings have implications for health and educational policies.
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Heavy debt not only has economic consequences, but has also been related to severe psychological and physical distress. The present study investigates the relationship between perceived financial strain and mental health, and individual-level variables that moderate this relationship. Specifically it was expected that employment, access to the latent benefits of work, and self-efficacy would buffer the relationship between perceived financial strain and mental health. In a 2009 study conducted in Austria, among 106 people on the verge of bankruptcy, perceived financial strain appeared as the strongest predictor of distress. This effect was moderated by two out of five latent benefits of work and self-efficacy, but employment status failed to have a significant effect. The findings show the importance of subjective economic stress for the prediction of mental health among people in serious financial strain and indicate significant moderators of this relationship.
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We assessed whether it would be feasible to replace the standard measure of net worth with simpler measures of wealth in population-based studies examining associations between wealth and health. We used data from the 2004 Survey of Consumer Finances (respondents aged 25-64 years) and the 2004 Health and Retirement Survey (respondents aged 50 years or older) to construct logistic regression models relating wealth to health status and smoking. For our wealth measure, we used the standard measure of net worth as well as 9 simpler measures of wealth, and we compared results among the 10 models. In both data sets and for both health indicators, models using simpler wealth measures generated conclusions about the association between wealth and health that were similar to the conclusions generated by models using net worth. The magnitude and significance of the odds ratios were similar for the covariates in multivariate models, and the model-fit statistics for models using these simpler measures were similar to those for models using net worth. Our findings suggest that simpler measures of wealth may be acceptable in population-based studies of health.
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Although research investigating ethnic differences in mental health has increased in recent years, we know relatively little about how mental health trajectories vary across ethnic groups. Do these differences occur at certain ages but not others? We investigate ethnic variation in trajectories of depressive symptoms, and we examine the extent to which disadvantages in family background, high school experiences, and adult characteristics explain these diferences. Employing random-coefficient modeling using the National Longitudinal Survey of Youth, we find that blacks and Hispanics experience higher symptom levels in early adulthood in comparison to whites, but equivalent levels by middle age. Ethnic differences remained in early adulthood after including all covariates, but those differences were eliminated by middle age for Hispanics after controlling for demographics only, and for blacks after accounting for the age-varying relationship between income and depressive symptoms. These results highlight the importance of integrating a life course perspective when investigating ethnic variations in mental health.
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We compared the screening accuracy of a short, five-item version of the Mental Health Inventory (MHI-5) with that of the 18-item MHI, the 30-item version of the General Health Questionnaire (GHQ-30), and a 28-item Somatic Symptom Inventory (SSI-28). Subjects were newly enrolled members of a health maintenance organization (HMO), and the criterion diagnoses were those found through use of the Diagnostic Interview Schedule (DIS) in a stratified sample of respondents to an initial, mailed GHQ. To compare questionnaires, we used receiver operating characteristic analysis, comparing areas under curves through the method of Hanley and McNeil. The MHI-5 was as good as the MHI-18 and the GHQ-30, and better than the SSI-28, for detecting most significant DIS disorders, including major depression, affective disorders generally, and anxiety disorders. Areas under curve for the MHI-5 ranged from 0.739 (for anxiety disorders) to 0.892 (for major depression). Single items from the MHI also performed well. In this population, short screening questionnaires, and even single items, may detect the majority of people with DIS disorders while incurring acceptably low false-positive rates. Perhaps such extremely short questionnaires could more commonly reach use in actual practice than the longer versions have so far, permitting earlier assessment and more appropriate treatment of psychiatrically troubled patients in primary care settings.
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This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1167 adults 65 years and older collected as part of the 'Aging, Stress and Health Study". Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover, the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern offindings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the burden of an unrelenting stressor in a critically important life domain.
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The association between poor mental health and poverty is well known but its mechanism is not fully understood. This study tests the hypothesis that the association between low income and mental disorder is mediated by debt and its attendant financial hardship. The study is a cross-sectional nationally representative survey of private households in England, Scotland and Wales, which assessed 8580 participants aged 16-74 years living in general households. Psychosis, neurosis, alcohol abuse and drug abuse were identified by the Clinical Interview Schedule--Revised, the Schedule for Assessment in Neuropsychiatry (SCAN), the Alcohol Use Disorder Identification Test (AUDIT) and other measures. Detailed questions were asked about income, debt and financial hardship. Those with low income were more likely to have mental disorder [odds ratio (OR) 2.09, 95% confidence interval (CI) 1.68-2.59] but this relationship was attenuated after adjustment for debt (OR 1.58, 95% CI 1.25-1.97) and vanished when other sociodemographic variables were also controlled (OR 1.07, 95% CI 0.77-1.48). Of those with mental disorder, 23% were in debt (compared with 8% of those without disorder), and 10% had had a utility disconnected (compared with 3%). The more debts people had, the more likely they were to have some form of mental disorder, even after adjustment for income and other sociodemographic variables. People with six or more separate debts had a six-fold increase in mental disorder after adjustment for income (OR 6.0, 95% CI 3.5-10.3). Both low income and debt are associated with mental illness, but the effect of income appears to be mediated largely by debt.
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Using the Panel Study of Income Dynamics, this paper examines the relationship between non-collateralized debt (NCD) and health behaviors. The results reveal that households whose members tend to lead less healthy lifestyles are more likely to hold NCD. There are three possible underlying hypotheses that may explain these relationships: (a) common factors, such as preferences, shaping both debt and poorer health behaviors; (b) poorer health and health behaviors causing debt; and (c) debt causing poorer health behaviors. Our findings are not consistent with a causal relationship between health behaviors and NCD. It is likely that other factors, such as time preferences, risk aversion and self-control may underlie the observed correlation. Copyright Springer Science+Business Media, LLC 2007
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Student loans schemes are in operation in more than seventy countries around the world. Most loans schemes benefit from sizeable built-in government subsidies and, in addition, are subject to repayment default and administrative costs that are not passed on to student borrowers. We probe two issues in this paper, for 44 loans schemes in 39 countries: how much of the original loan is an individual student required to repay (the "repayment ratio") and what percentage of the total costs of loans schemes can the lending body expect to receive back in repayments (the "recovery ratio")? The analysis shows considerable variation in the size of the repayment and recovery ratios across schemes. Moreover, many loans schemes exhibit sizeable built-in subsidies accruing to student borrowers – in over 40 percent of the schemes examined, the repayment ratio is 40 percent or less. Overall loans recovery is considerably lower. Policy implications of these findings are discussed together with a consideration of steps that may be taken to improve the financial outcome of loans schemes.
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In the early 2000s, a highly selective university introduced a "no-loans" policy under which the loan component of financial aid awards was replaced with grants. We use this natural experiment to identify the causal effect of student debt on employment outcomes. In the standard life-cycle model, young people make optimal educational investment decisions if they are able to finance these investments by borrowing against future earnings; the presence of debt has only income effects on future decisions. We find that debt causes graduates to choose substantially higher-salary jobs and reduces the probability that students choose low-paid "public interest" jobs. We also find some evidence that debt affects students' academic decisions during college. Our estimates suggest that recent college graduates are not life-cycle agents. Two potential explanations are that young workers are credit constrained or that they are averse to holding debt. We find suggestive evidence that debt reduces students' donations to the institution in the years after they graduate and increases the likelihood that a graduate will default on a pledge made during her senior year; we argue this result is more likely consistent with credit constraints than with debt aversion.
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Background Major depression occurs more frequently among people of lower socioeconomic status (SES) and among females. Although the focus of considerable investigation, the development of SES and sex differences in depression remains to be fully explained. In this study, we test the hypotheses that low childhood SES predicts an increased risk of adult depression and contributes to a higher risk of depression among females. Methods Participants were 1132 adult offspring of mothers enrolled in the Providence, Rhode Island site of the US National Collaborative Perinatal Project between 1959 and 1966. Childhood SES, indexed by parental occupation, was assessed at the time of participants' birth and seventh year. A lifetime history and age at onset of major depressive episode were ascertained via structured interviews according to diagnostic criteria. Survival analyses were used to model the likelihood of first depression onset as a function of childhood SES. Results Participants from lower SES backgrounds had nearly a twofold increase in risk for major depression compared to those from the highest SES background independent of childhood sociodemographic factors, family history of mental illness, and adult SES. Analyses of sex differences in the effect of childhood SES on adult depression provided modest support for the hypothesis that childhood SES contributes to adult sex differences in depression. Conclusions Low SES in childhood is related to a higher risk of major depression in adults. Social inequalities in depression likely originate early in life. Further research is needed to identify the pathways linking childhood conditions to SES differences in the incidence of major depression.
Conference Paper
This paper focuses on financial strain across the life course as a condition underlying health inequalities observed in later life. The analysis is based on data from 1,167 adults 65 years and older collected as part of the 'Aging, Stress and Health Study." Relying on retrospective data about hardship experienced over the life course, we find that long-term financial hardship is reflected in a range of health outcomes at late life, even after controlling for the effects of current financial circumstances. Moreover the sheer persistence of hardship matters more than its episodic occurrence or timing, so that the health effects of early hardship may be obviated if followed by no further hardship. This pattern of findings is consistent with the notion of allostatic load, the cumulative damage done to health and well-being under the but-den of an unrelenting stressor in a critically important life domain.
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While powerful gender inequalities remain in American society, women have made substantial gains and now largely surpass men in one crucial arena: education. Women now outperform men academically at all levels of school, and are more likely to obtain college degrees and enroll in graduate school. What accounts for this enormous reversal in the gender education gap? In The Rise of Women: The Growing Gender Gap in Education and What It Means for American Schools, Thomas DiPrete and Claudia Buchmann provide a detailed and accessible account of women's educational advantage and suggest new strategies to improve schooling outcomes for both boys and girls.The Rise of Women opens with a masterful overview of the broader societal changes that accompanied the change in gender trends in higher education. The rise of egalitarian gender norms and a growing demand for college-educated workers allowed more women to enroll in colleges and universities nationwide. As this shift occurred, women quickly reversed the historical male advantage in education. By 2010, young women in their mid-twenties surpassed their male counterparts in earning college degrees by more than eight percentage points. The authors, however, reveal an important exception: While women have achieved parity in fields such as medicine and the law, they lag far behind men in engineering and physical science degrees. To explain these trends, The Rise of Women charts the performance of boys and girls over the course of their schooling. At each stage in the education process, they consider the gender-specific impact of factors such as families, schools, peers, race and class. Important differences emerge as early as kindergarten, where girls show higher levels of essential learning skills such as persistence and self-control. Girls also derive more intrinsic gratification from performing well on a day-to-day basis, a crucial advantage in the learning process. By contrast, boys must often navigate a conflict between their emerging masculine identity and a strong attachment to school. Families and peers play a crucial role at this juncture. The authors show the gender gap in educational attainment between children in the same families tends to be lower when the father is present and more highly educated. A strong academic climate, both among friends and at home, also tends to erode stereotypes that disconnect academic prowess and a healthy, masculine identity. Similarly, high schools with strong science curricula reduce the power of gender stereotypes concerning science and technology and encourage girls to major in scientific fields. As the value of a highly skilled workforce continues to grow, The Rise of Women argues that understanding the source and extent of the gender gap in higher education is essential to improving our schools and the economy. With its rigorous data and clear recommendations, this volume illuminates new ground for future education policies and research.
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Data collected from two major universities (one in the Midwest and one in the Southeast) in the United States were used to analyze student persistence behavior and perceptions of debt. Results from four separate logistic regression analyses suggested that financial factors play a significant role in student persistence behavior as well as in student perceptions of debt. Controlling for demographic characteristics, as well as a number of key student factors, student loan debt, credit card use behavior, and the presence of other debts, had a significant impact on whether students reported ever reducing credit hours for financial reasons, whether students ever dropped out for financial reasons, and the extent to which students reported difficulty persisting due to the psychological burden of student loan debt and consumer debt. Findings suggest that some persistence issues may be alleviated through targeted education programs.
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Numerous studies document lower levels of depression among adults with higher education, but little is known about the way in which the association varies over the life course. Do depression levels diverge or converge across educational strata with age? This study investigates how the association between education and depression changes with age and tests the extent to which these changes are accounted for by physical health problems, widowed status, employment status, coping resources, household income, and financial strain. Data for this investigation come from the Work, Family, and Well-Being Study, 1990, a nationally representative sample of 2,031 adults aged 18 to 90 interviewed by telephone. Findings indicate that the association between depression and education strengthens with increasing age. Physical health problems among adults with lower education account for most of the diverging gap in depression. These results show that an integration of insights from the stress paradigm and the life course perspective can lead to a fuller understanding of socioeconomic inequality and its influence on psychological functioning.
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Objectives: Millions of U.S. adults are recipients of the high school equivalency (GED) diploma. Virtually nothing is known about the health of this large group, although literature suggests GED recipients are considerably worse off than high school graduates in numerous economic and social outcomes. We analyze general health among working-age adults with a high school diploma, GED recipients, and high school dropouts. Methods: Ordered and binary logistic models of self-rated health and activity limitations were estimated using data from the 1997-2009 National Health Interview Surveys (N=76,703). Results: GED recipients have significantly and substantially worse health than high school graduates, among both sexes. In fact, the GED recipients' health is generally comparable to that of high school dropouts. Health behaviors and economic factors explain a large proportion of the difference but the gap remains significant. Conclusions: In terms of health, adults with a terminal GED are not equivalent to high school graduates. GED recipients report considerably worse general health and activity limitations. The disadvantage is only partly due to the worse economic outcomes and health behaviors; a significant difference remains unexplained and may be due to other, unobserved pathways, or to selection mechanisms.
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The goal of "college-for-all" in the United States has been pursued in an environment of rising tuition, stagnant grant aid and already strapped family budgets with the gap filled by college loans. College students are thus facing increasing levels of debt as they seek to develop their human capital and improve their career options. Debt is a useful resource for making needed investments. It is unique as a resource, however, because it must be repaid and can thus also increase vulnerabilities and limit options. We find that lower levels of educational debt do support college completion. However, additional educational debt beyond about $10,000 actually reduces the likelihood of college completion compared to lower levels of debt as the burden of repayment looms. Graduation likelihoods for students from the bottom 75% of the income distribution at public universities are especially influenced by debt. The article considers how the macro-level changes in financing societal functions influence the individual-level risks and vulnerabilities of life in a debt-based society.
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Household financial debt in America has risen dramatically in recent years. While there is evidence that debt is associated with adverse psychological health, its relationship with other health outcomes is relatively unknown. We investigate the associations of multiple indices of financial debt with psychological and general health outcomes among 8400 young adult respondents from the National Longitudinal Study of Adolescent Health (Add Health). Our findings show that reporting high financial debt relative to available assets is associated with higher perceived stress and depression, worse self-reported general health, and higher diastolic blood pressure. These associations remain significant when controlling for prior socioeconomic status, psychological and physical health, and other demographic factors. The results suggest that debt is an important socioeconomic determinant of health that should be explored further in social epidemiology research.
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In this paper, we examine the antecedents and consequences of timing in the transition from high school to college. Using the National Education Longitudinal Study of 1988 (NELS:88), we find that 16 percent of high school graduates postpone enrollment by seven months or more after completing high school. Delayers tend to have some common characteristics: they come from families with few socioeconomic resources, they have performed poorly on standardized tests, they have dropped out of school, and they have exited high school with a GED. We find that even after controlling for these academic and socioeconomic characteristics, students who delay postsecondary enrollment have lower odds of bachelor degree completion. Additionally, we find that delayers are more likely than on-time enrollees to attend less than four-year institutions and to transition to other roles such as spouses or parents before entering college. Controlling for institutional context and life course contingencies, however, does not completely explain the negative relationship between delayed enrollment and degree completion.
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This report presents annual data on the amount of financial assistance--grants, loans, and work-study--available to students to help pay for postsecondary education. The College Board began this data series in 1983 to track the value of financial aid over time from federal, state, and institutional sources. The report also contains information on federal education tax credits and unsubsidized loans to students. Students received more than $105 billion in financial aid for undergraduate and graduate study in 2002-2003, an increase of 12% after adjusting for inflation. Grant aid grew by 10% in real terms, while education loan volume rose by 14%. Grant aid per full-time equivalent (FTE) grew 9% in constant dollars, compared to a 13% increase in loans per FTE. Part of the increase is an increase in enrollment, but aid itself has increased. Aid from every source has more than doubled in constant dollars over the decade. Federal aid increased 120% in real terms, compared to 107% for state grants and 122% for institutional grant aid. In 2002-2003, loans constituted 54% of total aid; grants, 40%; work, 1%; and education tax credits, 5%. The federal government provides more than $70 billion in student aid during 2002-2003. Of this loans represented 69%, down from 78% in 1997-1998, but higher than the 64% a decade ago. More detailed information is presented about federal direct loan programs, parent loans, nonfederal loans, Pell grants, state programs, and institutional aid. The affordability gap and the distinction between need-based and nonneed-based aid are discussed. Four appendixes present supplemental data in table form. (Contains 15 tables and 12 figures.) (SLD)
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This study applies a family process model to the linkage between early economic disadvantage and later enrollment in higher education. Using two waves of data on low-income youth, the authors found that the attitudes and behaviors of their parents, mostly mothers, mediate the impact of disadvantage on enrollment. Economically disadvantaged parents are less optimistic about their adolescents' educational chances and, in turn, engage less in the proactive parenting that promotes enrollment. The authors also found that parents' perceived efficacy buffers against the more negative consequences of disadvantage that can influence their adolescents' educational trajectories. Group comparisons reveal few differences by gender or ethnicity.
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In the early 2000s, a highly selective university introduced a “no-loans” policy under which the loan component of financial aid awards was replaced with grants. We use this natural experiment to identify the causal effect of student debt on employment outcomes. In the standard life-cycle model, young people make optimal educational investment decisions if they are able to finance these investments by borrowing against future earnings; the presence of debt has only income effects on investment decisions. We find that debt causes graduates to choose substantially higher-salary jobs and reduces the probability that students choose low-paid “public interest” jobs. We also find some evidence that debt affects students' academic decisions during college. Our estimates suggest that recent college graduates are not life-cycle agents. Two potential explanations are that young workers are credit constrained or that they are averse to holding debt. We find suggestive evidence that debt reduces students' donations to the institution in the years after they graduate and increases the likelihood that a graduate will default on a pledge made during her senior year; we argue this result is more likely consistent with credit constraints than with debt aversion.
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This paper surveys the recent literature on the causal relationship between education and earnings. I focus on four areas of work: theoretical and econometric advances in modelling the causal effect of education in the presence of heterogeneous returns to schooling; recent studies that use institutional aspects of the education system to form instrumental variables estimates of the return to schooling; recent studies of the earnings and schooling of twins; and recent attempts to explicitly model sources of heterogeneity in the returns to education. Consistent with earlier surveys of the literature, I conclude that the average (or average marginal) return to education is not much below the estimate that emerges from a standard human capital earnings function fit by OLS. Evidence from the latest studies of identical twins suggests a small upward “ability” bias — on the order of 10%. A consistent finding among studies using instrumental variables based on institutional changes in the education system is that the estimated returns to schooling are 20–40% above the corresponding OLS estimates. Part of the explanation for this finding may be that marginal returns to schooling for certain subgroups — particularly relatively disadvantaged groups with low education outcomes — are higher than the average marginal returns to education in the population as a whole.
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In this paper we explore the association between debt and psychological well-being amongst heads of households using the British Household Panel Survey. Our principle finding is that those household heads who have outstanding (non-mortgage) credit, and who have higher amounts of such debt, are significantly less likely to report complete psychological well-being. The average increase in the psychological distress is greater when outstanding credit is measured at the individual, as opposed to household, level. No such significant association is found in the case of mortgage debt. Our results highlight the psychological cost associated with the consumer credit culture in Britain.
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This study examines the impact of indebtedness on depressive symptomatology, anxiety, and anger. We use data from a two-wave panel study of adults in Miami-Dade County. The analytic sample consists of 1,463 mostly older respondents with valid data on all study measures, including education, income, occupational status, wealth, and debt. We find that indebtedness is common and is associated with more symptoms of depression, anxiety, and anger. It is weakly associated with other aspects of socioeconomic status (SES), and thus not redundant with them. In fact, in this sample, debtor status is more consistently associated with mental health than any other single traditional indicator of SES, its effect does not vary across income or other aspects of SES, and fears of never paying off debt account for its negative impact on mental health. These findings affirm health scholars' calls for more complete measures of SES.
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Foreclosure rates have risen rapidly since 2005, reaching historically high levels. The purpose of this study was to examine the health implications of the current housing crisis. We conducted a cross-sectional online consumer panel survey including residents of California, Arizona, Nevada, and Florida (n = 798) to determine the feasibility of contacting distressed homeowners via the Internet and to assess mental and physical health among respondents across the spectrum from those having no housing strain to those in loan default or home foreclosure. Homeowners in default or foreclosure exhibited poorer mental health and more physical symptoms than renters, homeowners with moderate strain, and homeowners with no strainöfollowing a gradient that was consistent across multiple health indicators. Internet panel sampling was an efficient method of contacting distressed homeowners. Record-high foreclosure rates may have broad implications for nursing and public health. Homeowners in default or foreclosure represent an identifiable high-risk group that may benefit from coordinated, affordable health and social services.
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Forty decades of sociological stress research offer five major findings. First, when stressors (negative events, chronic strains, and traumas) are measured comprehensively, their damaging impacts on physical and mental health are substantial. Second, differential exposure to stressful experiences is a primary way that gender, racial-ethnic, marital status, and social class inequalities in physical and mental health are produced. Third, minority group members are additionally harmed by discrimination stress. Fourth, stressors proliferate over the life course and across generations, widening health gaps between advantaged and disadvantaged group members. Fifth, the impacts of stressors on health and well-being are reduced when persons have high levels of mastery, self-esteem, and/or social support. With respect to policy, to help individuals cope with adversity, tried and true coping and support interventions should be more widely disseminated and employed. To address health inequalities, the structural conditions that put people at risk of stressors should be a focus of programs and policies at macro and meso levels of intervention. Programs and policies also should target children who are at lifetime risk of ill health and distress due to exposure to poverty and stressful family circumstances.
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Multiple imputation by chained equations is a flexible and practical approach to handling missing data. We describe the principles of the method and show how to impute categorical and quantitative variables, including skewed variables. We give guidance on how to specify the imputation model and how many imputations are needed. We describe the practical analysis of multiply imputed data, including model building and model checking. We stress the limitations of the method and discuss the possible pitfalls. We illustrate the ideas using a data set in mental health, giving Stata code fragments.
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The problem of high monthly repayment obligations for educational debt has long plagued students, particularly graduate and professional students, who desired lower-paying public interest careers. Congress has recently responded very positively. In the College Cost Reduction and Access Act of 2007, Congress has made it possible for high-debt, lower-income graduates to manage debt repayment through an "income-based repayment" plan. In addition, Congress has created a new program through which public servants -- including all government workers and all employees of all non-profit organizations that are tax-exempt under Section 501(c) (3) of the Internal Revenue Code --are entitled to have a substantial portion of their educational debt forgiven after making modest repayments during ten years of full-time employment. Together, these two new programs will enable student borrowers to choose their careers without being unduly influenced by their debt burdens and will enable governments and non-profit organizations to retain talented professionals who would otherwise be forced to resign after two or three years and seek higher-paying jobs so that they could repay their student loans. This article describes how the new law will apply to graduates serving in public interest jobs (including those who have already graduated and those who will graduate before the law goes fully into effect). A major purpose of the article is to help students and high-debt/low-income graduates understand how the new law may help them in theire career and financial planning. This article also discusses additional reforms that Congress should adopt to complete its significant accomplishments in this area.
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Mental health disparities refer to the disproportionate amount of psychopathology found among persons of disadvantageous social standing, such as persons of low socioeconomic status (SES). Although social and self selection cannot entirely be ruled out as explanations for these differences, the accumulation of evidence supports a social causation interpretation for a large portion of this association for many disorders. The stress process model is applied to understand how social inequities become mental health disparities. Data from the Los Angeles Depression Study, originated by Leo Reeder are used to illustrate the key idea that explicit causal models are essential to the development of programmatic interventions to alleviate mental health disparities, as distinct from interventions to improve mental health in general. In light of recent work on neighborhood stratification and mental health, I advocate the modification of the social contexts of the stress process.
Article
Increasing social inequalities in health in the United States and elsewhere, coupled with growing inequalities in income and wealth, have refocused attention on social class as a key determinant of population health. Routine analysis using conceptually coherent and consistent measures of socioeconomic position in US public health research and surveillance, however, remains rare. This review discusses concepts and methodologies concerning, and guidelines for measuring, social class and other aspects of socioeconomic position (e.g. income, poverty, deprivation, wealth, education). These data should be collected at the individual, household, and neighborhood level, to characterize both childhood and adult socioeconomic position; fluctuations in economic resources during these time periods also merit consideration. Guidelines for linking census-based socioeconomic measures and health data are presented, as are recommendations for analyses involving social class, race/ethnicity, and gender. Suggestions for research on socioeconomic measures are provided, to aid monitoring steps toward social equity in health.
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This article examines how financial strain and social relations may independently and jointly influence psychological distress among older people in four nations. Data from four Western Pacific nations (N = 3,277) are used to test additive and multiplicative models of the relationships between financial strain, social relations, and psychological distress. Financial strain is associated with higher levels of psychological distress in three of the four nations. Interactive models of the effects of financial strain and social relations on distress were uncovered in three of the four nations, but the type of social relation influencing the strain-distress relationship varied. Subjective-health and IADLs were significant predictors of psychological distress in all four nations. Findings suggest that although financial strain is quite likely to lead to psychological distress among elders, this can be mitigated, at least in part, by social relationships. Modernization was not associated with higher psychological distress.
Article
What is the association between debt and anxiety? Is the relationship between age and anxiety in part due to financial debt? Recently there has been a renewed interest for the reconceptualization and measurement of socioeconomic status that moves beyond the standard education, occupation, and income. This paper uses credit card debt and stress regarding debt to examine the relationship among age, debt, and anxiety. Using data from a 1997 representative sample of more than 1,000 adults in Ohio, results show that anxiety does increase with the ratio of credit card debt to income, and with being in default; but credit card debt accounts for little of the age-anxiety association. Stress regarding overall debt does explain some of the age effect. In addition, stress also explains some of the effect of the credit card debt to income ratio, and all of the effect of default on anxiety.