Is poverty a disease of the economy?

Poverty makes you sick, sickness makes you poor

WUNSTORF. Poverty makes you sick, illness makes you poor - that became clear at the debt counseling conference of the Diakonie Hannover-Land and the Medical Association of Lower Saxony (ÄKN) in Wunstorf, Lower Saxony. And this connection did not just take effect today, explained Professor Stephan Letzel from the University of Mainz in his lecture.

When typhus broke out in Upper Silesia in 1848, Rudolf Virchow was sent to assess the situation. In his report, he blamed the population's low social status, poor housing and one-sided diet (potatoes, sauerkraut and whey) and bad air for the epidemic.

"These people did not suspect that the spiritual and material impoverishment into which they had been allowed to sink were largely the causes of hunger and disease," wrote Virchow in his report.

"In short: poverty leads to typhus," said Letzel. This connection is still correct. He has proven this with figures in his study "Poverty, Debt and Health".

Many citizens are in debt

Certainly, many citizens are in debt. At the bank, online retailers, relatives who helped over a bottleneck with 200 euros. But not everyone who has to repay borrowed money is over-indebted.

But it's about over-indebtedness. Letzel understands this to mean the inability to service current and future obligations even when all costs are reduced to essential expenses from income and assets.

At the event, it was said at the event that clients who are deeply caught up in the connection between debt and illness come to Diakonie's debt counseling. In 2015, 6.7 million people in Germany were overindebted, according to the figures from the debt collection company Creditreform in the latest debtor report. The debt burden is greater in the north and west than in the south of the republic. Bremen is at the top of the federal states with a debtor quota of around 14 percent, Bremerhaven even has a debtor quota of more than 20 percent, and Bavaria just 7.12 percent.

At the same time, those affected slide into poverty. This is pointed out by the Paritätische Wohlfahrtsverband. People who earn less than 11,840 euros a year are at risk of poverty. According to the Federal Statistical Office, 68 percent of the debtors advised even had to get by on less than 900 euros a month. From this money they also had to pay off debts averaging around 23,000 euros.

No wonder that many over-indebted people can no longer afford the drug co-payments. Letzel found in his study that 65 percent of those surveyed could not buy prescribed medication and (by the end of 2012) 61 percent of them did not go to the doctor because of the practice fee.

More than 40 percent of them suffer from mental illnesses, around 38 percent from spinal diseases and 25 percent from high blood pressure. Among the current complaints, lower back pain was at the top, followed by sleep disorders and headaches, according to Letzel's results.

More cigarettes and alcohol

The poor also change their health behavior: "Because, for example, there is not enough money for the sports club, around 48 percent of the indebted do less sport and forego the healthier but more expensive diet. Instead, they smoke more, drink more alcohol and consume more tranquilizers. Letzel's figures show Finally, the bitter consequence: those who are poor live eleven years less.

Men with incomes below the poverty line die at an average of 70.1 years. Anyone who brings home more than 150 percent of the average income does not die on average until the age of 80.9.

The reverse also applies: Illness makes you poor. Behavioral therapist Professor Astrid Müller from Hannover Medical School proved this on the basis of patients suffering from shopping addiction. Around five percent of the population are affected. The addicts mainly buy online and often hoard unopened purchases. Shoes, clothing and food pile up in their homes.

Doctors and judges also affected

"Among my patients there are also MTAs who have their job under control but live on the verge of poverty because of their addiction," says Müller, "or doctors and judges. They buy the 5,000-euro dress, put it on once and buy a new one. " Unopened bills and reminders are piled up in their apartments.

You don't see the suffering of the sick, says Müller. Even general practitioners had their difficulties with this and did not dare to ask because the subject was so shameful. "Many doctors don't speak to their patients because they don't want to embarrass them." What they all have in common is a certain fearfulness, noted Müller, and the conviction that money means power and prestige. The short way to purchase on the Internet and the credit card do the rest. After all, addicts often only come to therapy when the house is mortgaged, the marriage is broken, the bank account is hopelessly overdrawn and the psyche is down.

The road to healing and financial consolidation is rocky. Six out of eight participants in Müller's therapy groups actually want to continue shopping, says the therapist. She does not rely on total abstinence for her patients in cognitive behavioral therapy, but on control, including through everyday tricks: "Throw away catalogs. Delete apps. Block the shopping channel. Take a detour around certain shops. Pay cash." She sums up: "We cannot completely cure shopping addiction. But we can learn to live with it in a healthier way."

Like Stephan Letzel, Müller also calls for those affected not to be stigmatized or treated with moral assessments. Letzel: "Poverty and debt are a problem for society as a whole."