Academic Journal
Escaping in-work poverty and mental health: A longitudinal study of Swedish workers.
| Title: | Escaping in-work poverty and mental health: A longitudinal study of Swedish workers. |
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| Authors: | Kim W; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Demography Unit, Department of Sociology, Stockholm University, Stockholm, Sweden. Electronic address: wooseong.kim@ki.se., Baron S; Barry Commoner Centre for Health and the Environment, Queens College, City University of New York, Queens, NY, USA., Almroth M; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden., Johansson G; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden., Bodin T; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden., Hick R; School of Social Sciences, Cardiff University, South Glamorgan, Wales, Cardiff, United Kingdom., Badarin K; Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; School of Sport, Nutrition and Allied Health Professions (SNAHP), Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom. |
| Source: | Social science & medicine (1982) [Soc Sci Med] 2026 Sep; Vol. 405, pp. 119556. Date of Electronic Publication: 2026 Jul 03. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: Pergamon Country of Publication: England NLM ID: 8303205 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1873-5347 (Electronic) Linking ISSN: 02779536 NLM ISO Abbreviation: Soc Sci Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford ; New York : Pergamon, c1982- |
| MeSH Terms: | Poverty*/psychology , Poverty*/statistics & numerical data , Mental Disorders*/epidemiology , Mental Health*/statistics & numerical data , Employment*/statistics & numerical data , Employment*/psychology, Sweden/epidemiology ; Humans ; Male ; Adult ; Longitudinal Studies ; Middle Aged ; Female ; Low Socioeconomic Status ; Young Adult ; Socioeconomic Disparities in Health |
| Abstract: | In-work poverty (IWP) affects individuals who are employed but have an equivalised disposable household income below 60% of the national median. While IWP is associated with poorer mental health, it remains unclear whether escaping IWP reduces mental health risk or whether adverse effects persist after upward mobility. This study examines whether escaping IWP reduces mental health risk in Sweden, and whether moving moderately versus substantially above the poverty line differentially affects outcomes. This cohort study included 93,962 Swedish workers aged 24-60 who were in IWP in 2012. Escaping IWP was defined as moving from IWP in 2012 to either "moderately above" (60-100% of the median) or "substantially above" (>100% of the median) the poverty line in 2013, with those remaining in IWP as the reference group. Outcomes were first-diagnosed mental health disorders and first SSRI prescriptions during 2014-2019. Sex-stratified Cox regression models estimated crude and adjusted hazard ratios (AHRs) with 95% confidence intervals. Moving moderately above the poverty line was not associated with a significantly lower risk of either outcome. Men who moved substantially above the poverty line had a significantly lower risk of diagnosed mental health disorders (AHR 0.65, 95% CI 0.50-0.84) and SSRI prescriptions (AHR 0.85, 95% CI 0.74-0.97). No significant associations were observed among women. Escaping IWP yields greater mental health benefits for men than women, and only substantial income gains were associated with improved outcomes. Policies should address not only IWP reduction but also the adequacy and stability of upward mobility pathways. (Copyright © 2026 The Authors. Published by Elsevier Ltd.. All rights reserved.) |
| Contributed Indexing: | Keywords: Employment; Health inequalities; Mental health disorders; Poverty; Selective serotonin reuptake inhibitors (SSRIs); Social determinants of health |
| Entry Date(s): | Date Created: 20260704 Date Completed: 20260826 Latest Revision: 20260826 |
| Update Code: | 20260827 |
| DOI: | 10.1016/j.socscimed.2026.119556 |
| PMID: | 42401095 |
| Database: | MEDLINE |
| ISSN: | 1873-5347 |
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| DOI: | 10.1016/j.socscimed.2026.119556 |