Escaping in-Work Poverty and Mental Health: A Longitudinal Study of Swedish Workers

Wooseong Kim , Institute of Environmental Medicine, Karolinska Institutet
Sherry Baron, Barry Commoner Centre for Health and the Environment, Queens College, City University of New York
Melody Almroth, Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet
Gun Johansson, Karolinska Institutet
Theo Bodin, Karolinska Institutet
Rod Hick, School of Social Sciences, Cardiff University
Kathryn Badarin, Karolinska Institutet

In-work poverty (IWP) affects workers whose equivalised disposable household income is below 60% of the national median. While IWP has been linked to poorer mental health, it remains unclear whether escaping IWP reduces the risk of mental ill-health or if the effects persist after upward mobility. We examine whether escaping IWP is associated with a lower risk of diagnosed mental health disorders, and whether the extent of income improvement, moving slightly or substantially above the poverty line, matters. This cohort study included 93,962 Swedish workers, aged 24–60 in 2013, who were in IWP in 2012. Escaping IWP was defined as moving to “slightly above” or “substantially above” the poverty line in 2013, with those remaining in IWP as the reference group. Outcomes were diagnosed mental health disorders and prescriptions of selective serotonin reuptake inhibitors (SSRIs). Sex-specific adjusted hazard ratios (AHRs) with 95% confidence intervals (CIs) were estimated using Cox regression for 2014–2019. Our findings show that moving slightly above the poverty line was not associated with a lower risk of mental health disorders or SSRI prescriptions. In contrast, men who moved substantially above the poverty line had a lower risk of diagnosed disorders (AHR 0.65, 95% CI 0.51–0.83) and SSRI prescriptions (AHR 0.85, 95% CI 0.74–0.97). No significant associations were found for women. Taken together, escaping IWP appears more beneficial for men’s mental health, with only substantial, not modest, income gains linked to improvement. Policies should address both poverty reduction and the adequacy of upward mobility opportunities.

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 Presented in Session P5. Health, Mortality, and Ageing 1