Überschuldung und gesundheit - Sozialmedizinische Erkenntnisse für die Versorgungsforschung

Introduction: The number of over-indebted households in Germany is currently estimated to be 3.13 million. Social exclusion, restrictions on living conditions and on equal participation in society can be the consequence of destitution in expenditure and can have adverse effects on health. To examine for the first time from the social medical point of view the state of health of over-indebted persons in Germany, the ASG-study (Armut, Schulden und Gesundheit, i.e. poverty, debt and health) was initiated. Methods: In cooperation with all 53 debt and insolvency counselling services of Rhineland-Palatinate a cross-sectional study of over-indebted persons was conducted between 2006 and 2007 by means of a single, anonymous interview in written form. Results: Altogether 666 persons (51.1 % women) aged between 18 and 79 years took part; this was a participation rate of 35.5 %. 79.1 % of the interviewed persons claimed to suffer from at least one illness, with mental diseases in first place, followed by joint and spine diseases, both being reported by approximately 40% of the participants. Only 20.6% of the participants did not agree at all with the statement "I am ill because of being heavily indebted". One third of the participants listed illness, accident or addiction as the main reason for being in debt. Conclusion: The state of health of over-indebted persons is markedly subnormal. The evidence suggests that two mechanisms interact here: over-indebtedness leads to illness and illness leads to over-indebtedness. An interdisciplinary approach is needed to reduce the burden of debt and ill-health by debt counselling and medical counselling, in order to do justice to the circumstances of the persons concerned and to find ways out of the debt situation. Health-related preventive programs for over-indebted persons must be developed to improve the state of health of the persons concerned and to give them an opportunity to get out of debt on their own.