A diagnosis of depression in connection with hospital treatment can have long-term consequences for personal finances. This is shown in a new registry-based study from the Department of Public Health, University of Southern Denmark, which follows nearly five million people in Denmark over time. The study includes only people who had contact with a hospital and therefore does not cover those treated solely by a general practitioner or private practitioners.
Income is around 10 per cent lower 10 years after diagnosis compared with people without depression, and the gap does not disappear. At the same time, the income loss for depression is greater than for several physical illnesses such as stroke and breast cancer.
The study compares depression, alcohol use disorder, stroke and breast cancer. Income falls after illness in all four groups, but the decline is greatest for mental disorders.
- We see that mental disorders affect not only health, but also people’s economic life course to a considerable extent, says Emily K. Johnson, Ph.D. Student at the Danish Centre for Health Economics, Department of Public Health, University of Southern Denmark.
She is first author of the study, which has been published in JAMA Health Forum.
- The income loss grows over time and can still be measured 10 years later. Even though mental disorders are more common in women, losses are generally greater for men, Emily K. Johnson explains.
While earlier studies have often focused on short-term sick leave, the new study shows that income loss persists and in many cases grows over time.
- It is not only about being away from work for a period. We see changes in the entire income trajectory, says Emily K. Johnson.
This may, among other things, reflect reduced ability to keep a job, change jobs or progress in a career.
Income loss is greatest among people in the middle of working life, when earnings would normally be increasing. At the same time, the loss grows over time for younger people.
- If you are affected early in your career, you may lose your footing in the labour market. That can be difficult to recover later, says Emily K. Johnson.
People outside the labour market are also hit particularly hard. For them, illness may make it even harder to enter employment.
The findings therefore suggest that illness can reinforce existing social inequality.
Income already begins to decline in the years before people receive a diagnosis of depression in hospital care. This suggests that the consequences begin before the illness is formally registered and treated.
The study includes people who had contact with a hospital, either as inpatients or outpatients, including psychiatric hospital care. People treated only by their general practitioner or by private psychologists or psychiatrists are not included.
- This suggests that the course of illness starts earlier and that the consequences for working life emerge gradually, Emily K. Johnson explains. Job loss, income loss and poor mental health can reinforce one another over time,
The study is based on Danish registry data and includes all non-retired residents aged 18 to 65 between 2000 and 2018. People with illness were compared with similar people without a diagnosis, matched on factors including age, sex, education and income, and baseline health.
Income was measured as disposable income, meaning post-tax income including wages, transfers and capital income.
According to the researchers, the findings can help improve decision-making in health and social policy.
- Priority setting should not be based only on how many people become ill, but also on how illness affects people’s working lives and finances, especially for those early in their careers, says Emily K. Johnson.
The study adds new knowledge by comparing mental and physical illnesses using the same method, making it possible to assess their relative consequences.
The study includes only people who had contact with a hospital and therefore does not cover everyone with depression. At the same time, it cannot establish cause and effect with certainty, especially in the case of mental disorders which are difficult to measure.
In addition, only people who survive the course of illness are included in the analyses of income over time.
What does the study investigate?
This study measures the income trajectories of people in Denmark with different mental and physical health hospital diagnoses, compared to the trajectories of peers without a diagnosis.
What is the most important finding?
All four diseases we studied saw income losses up to 10 years after diagnosis, but people with mental disorders were particularly affected, with income on average up to 17 per cent lower than in the control population.
How can the results be used?
The results can be used to better inform health policy priorities by taking into account not only rates of illness, but also how diseases affect people’s working lives and livelihoods.
Facts:
Depression:
After 3 years:
After 10 years:
Other illnesses, 10 years after diagnosis:
Alcohol use disorder:
Stroke:
Breast cancer:
Key points:
Method
Registry-based observational study of 4.9 million people in Denmark aged 18 to 65. People diagnosed in connection with hospital contact were matched with similar people without a diagnosis and followed for up to 10 years.
Funding
Independent Research Fund Denmark, the EU Marie Skłodowska-Curie Actions, and Helsefonden.
Read the study
Lasting Income Costs of Mental and Physical Illness, JAMA Health Forum, published 27 March 2026. Read the study: https://doi.org/10.1001/jamahealthforum.2026.0196
JAMA Health Forum
10.1001/jamahealthforum.2026.0196
Observational study
People
Lasting Income Costs of Mental and Physical Illness
27-Mar-2026