{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:32:26Z","timestamp":1791581546273,"version":"4.3.4"},"reference-count":51,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,2,1]],"date-time":"2025-02-01T00:00:00Z","timestamp":1738368000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["ES \/T003191\/1"],"award-info":[{"award-number":["ES \/T003191\/1"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Social Science &amp; Medicine"],"published-print":{"date-parts":[[2025,2]]},"DOI":"10.1016\/j.socscimed.2025.117678","type":"journal-article","created":{"date-parts":[[2025,1,11]],"date-time":"2025-01-11T02:27:53Z","timestamp":1736562473000},"page":"117678","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":11,"special_numbering":"C","title":["Sick of debt: How over-indebtedness is hampering health in rural Cambodia"],"prefix":"10.1016","volume":"367","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1885-6467","authenticated-orcid":false,"given":"Dalia","family":"Iskander","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3456-386X","authenticated-orcid":false,"given":"Fiorella","family":"Picchioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Zanello","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Guermond","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Brickell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"2","key":"10.1016\/j.socscimed.2025.117678_bib1","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1355\/sj24-2f","article-title":"Microfinance and post-conflict development in Cambodia and Timor-Leste","volume":"24","author":"Alld\u00e8n","year":"2009","journal-title":"Sojourn J. Soc. Issues Southeast Asia"},{"issue":"Suppl. ment_1","key":"10.1016\/j.socscimed.2025.117678_bib2","doi-asserted-by":"crossref","first-page":"i4","DOI":"10.1093\/heapol\/czz011","article-title":"Who benefits from healthcare spending in Cambodia? Evidence for a universal health coverage policy","volume":"34","author":"Asante","year":"2019","journal-title":"Health Pol. Plann."},{"key":"10.1016\/j.socscimed.2025.117678_bib3","series-title":"8th International Scientific Conference \u201cFuture World by 2050\u201d, Croatia","article-title":"Post-war reconstruction and development in Cambodia and the destructive role of microcredit","author":"Bateman","year":"2017"},{"key":"10.1016\/j.socscimed.2025.117678_bib4","series-title":"\u201cMicro\u201d Finance in Cambodia: Development, Challenges and Recommendations","author":"Bliss","year":"2022"},{"key":"10.1016\/j.socscimed.2025.117678_bib53","first-page":"1","article-title":"Wakeful Geographies, Wakeful Bodies: Day and Nighttime Rhythms of Indebted Life and Capitalist Enclosure in Cambodia","author":"Brickell","year":"2024","journal-title":"Ann. Assoc. Am. Geogr."},{"key":"10.1016\/j.socscimed.2025.117678_bib5","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.socscimed.2015.02.002","article-title":"Can debt affect your health? Cross country evidence on the debt-health Nexus","volume":"130","author":"Clayton","year":"2015","journal-title":"Soc. Sci. Med."},{"key":"10.1016\/j.socscimed.2025.117678_bib6","volume":"vol. 3","author":"Coates","year":"2007"},{"key":"10.1016\/j.socscimed.2025.117678_bib7","series-title":"Mental Well-Being Among the Poor: Do Health Equity Funds Protect Them from Stress and Financial Hardship? Population Council","author":"Comins","year":"2015"},{"key":"10.1016\/j.socscimed.2025.117678_bib8","series-title":"Financial Melancholia: Mental Health and Indebtedness","author":"Davies","year":"2015"},{"issue":"2","key":"10.1016\/j.socscimed.2025.117678_bib9","first-page":"231","article-title":"From commoning to debt: financialization, Microcredit, and the changing architecture of capital accumulation","volume":"113","author":"Federici","year":"2014","journal-title":"S. Atl. Q."},{"issue":"8","key":"10.1016\/j.socscimed.2025.117678_bib10","doi-asserted-by":"crossref","first-page":"906","DOI":"10.1093\/heapol\/czy073","article-title":"Equality in financial access to healthcare in Cambodia from 2004 to 2014","volume":"33","author":"Fernandes Antunes","year":"2018","journal-title":"Health Pol. Plann."},{"issue":"6","key":"10.1016\/j.socscimed.2025.117678_bib11","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1080\/03066150.2021.1923007","article-title":"Placing Cambodia's agrarian transition in an emerging Chinese food regime","volume":"49","author":"Green","year":"2022","journal-title":"J. Peasant Stud."},{"issue":"1","key":"10.1016\/j.socscimed.2025.117678_bib12","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1111\/anti.12413","article-title":"Precarious debt: microfinance subjects and intergenerational dependency in Cambodia","volume":"51","author":"Green","year":"2019","journal-title":"Antipode"},{"key":"10.1016\/j.socscimed.2025.117678_bib13","series-title":"Microfinance, Debt and Over-indebtedness: Juggling with Money","article-title":"The social meaning of over-indebtedness and creditworthiness in the context of poor rural South Indian households (Tamil Nadu)","author":"Gu\u00e9rin","year":"2013"},{"key":"10.1016\/j.socscimed.2025.117678_bib47","article-title":"Depleted by debt:\u201cGreen\u201d microfinance, over-indebtedness, and social reproduction in climate-vulnerable Cambodia","author":"Guermond","year":"2024","journal-title":"Antipode"},{"key":"10.1016\/j.socscimed.2025.117678_bib51","series-title":"The Climate Adaptation Trap: Microfinance and Over-Indebtedness in Rural Cambodia","author":"Guermond","year":"2022"},{"key":"10.1016\/j.socscimed.2025.117678_bib15","first-page":"431","article-title":"From Sapphires to Cassava: the Politics of debt in Northwestern Cambodia ACME","volume":"20","author":"Gyorvary","year":"2021","journal-title":"An International Journal for Critical Geographies"},{"key":"10.1016\/j.socscimed.2025.117678_bib16","series-title":"Social Resilience in the Neoliberal Era","author":"Hall","year":"2013"},{"issue":"1","key":"10.1016\/j.socscimed.2025.117678_bib17","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1080\/14725860220137345","article-title":"Talking about pictures: a case for photo elicitation","volume":"17","author":"Harper","year":"2002","journal-title":"Vis. Stud."},{"key":"10.1016\/j.socscimed.2025.117678_bib46","article-title":"\u2018Thinking Too Much\u2019: making visible the moral economy that sustains over-indebtedness in Rural Cambodia","author":"Iskander","year":"2023","journal-title":"Etnofoor"},{"issue":"6","key":"10.1016\/j.socscimed.2025.117678_bib18","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0010930","article-title":"Self-reported serious illnesses in rural Cambodia: a cross-sectional survey","volume":"5","author":"Ir","year":"2010","journal-title":"PLoS One"},{"key":"10.1016\/j.socscimed.2025.117678_bib48","series-title":"Trapped in the Service of Debt: How the Burdens of Repayment are Fuelling the Health Poverty Trap in Rural Cambodia","author":"Iskander","year":"2022"},{"key":"10.1016\/j.socscimed.2025.117678_bib19","doi-asserted-by":"crossref","DOI":"10.1155\/2011\/639814","article-title":"Pesticide use and self-reported symptoms of acute pesticide poisoning among aquatic farmers in Phnom Penh, Cambodia","author":"Jensen","year":"2011","journal-title":"J. Toxicol."},{"key":"10.1016\/j.socscimed.2025.117678_bib20","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2023.115792","article-title":"Assessing progress towards universal health coverage in Cambodia: evidence using survey data from 2009 to 2019","volume":"321","author":"Kaiser","year":"2023","journal-title":"Soc. Sci. Med."},{"key":"10.1016\/j.socscimed.2025.117678_bib21","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/issr.12227","article-title":"Expanding social health protection in Cambodia: an assessment of the current coverage potential and gaps, and social equity considerations","volume":"73","author":"Kolesar","year":"2020","journal-title":"Int. Soc. Secur Rev."},{"issue":"2","key":"10.1016\/j.socscimed.2025.117678_bib22","doi-asserted-by":"crossref","first-page":"295","DOI":"10.2190\/M11W-VWXE-KQM9-G97Q","article-title":"Embodying inequality: a review of concepts, measures, and methods for studying health consequences of discrimination","volume":"29","author":"Krieger","year":"1999","journal-title":"Int. J. Health Serv."},{"key":"10.1016\/j.socscimed.2025.117678_bib23","article-title":"Debt and health","author":"Lenton","year":"2008","journal-title":"Sheffield Economic Research Paper Series"},{"key":"10.1016\/j.socscimed.2025.117678_bib24","series-title":"Worked to Debt: Over-indebtedness in Cambodia's Garment Sector","year":"2020"},{"key":"10.1016\/j.socscimed.2025.117678_bib25","series-title":"Debt Threats: A Quantitative Study of Microloan Borrowers in Cambodia's Kampong Speu Province","year":"2023"},{"key":"10.1016\/j.socscimed.2025.117678_bib26","series-title":"Study on the Drivers of Over-indebtedness of Microfinance Borrowers in Cambodia: an In-Depth Investigation of Saturated Areas. Phnom Penh","author":"Liv","year":"2013"},{"issue":"4","key":"10.1016\/j.socscimed.2025.117678_bib27","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1016\/j.socscimed.2005.07.001","article-title":"What are the economic consequences for households of illness and of paying for health care in low- and middle-income country contexts?","volume":"62","author":"McIntyre","year":"2006","journal-title":"Soc. Sci. Med."},{"issue":"1","key":"10.1016\/j.socscimed.2025.117678_bib28","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s13690-017-0183-y","article-title":"Living on the edge: precariousness and why it matters for health","volume":"75","author":"McKee","year":"2017","journal-title":"Arch. Publ. Health"},{"key":"10.1016\/j.socscimed.2025.117678_bib29","series-title":"The Third Health Strategic Plan 2016-2020 (HSP3)","year":"2016"},{"issue":"4","key":"10.1016\/j.socscimed.2025.117678_bib30","first-page":"695","article-title":"Chemical regimes of living","volume":"13","author":"Murphy","year":"2008","journal-title":"Environ. Hist."},{"issue":"Suppl. 1","key":"10.1016\/j.socscimed.2025.117678_bib31","doi-asserted-by":"crossref","first-page":"S95","DOI":"10.1080\/13600818.2013.778237","article-title":"The definition and causes of microfinance over-indebtedness: a customer protection point of view","volume":"41","author":"Schicks","year":"2013","journal-title":"Oxf. Dev. Stud."},{"issue":"4\u20135","key":"10.1016\/j.socscimed.2025.117678_bib32","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1080\/09614524.2011.561294","article-title":"The impact of high food prices on food security in Cambodia","volume":"21","author":"Sophal","year":"2011","journal-title":"Dev. Pract."},{"key":"10.1016\/j.socscimed.2025.117678_bib33","article-title":"Land use and land cover change implications on agriculture and natural resource management of Koah Nheaek, Mondulkiri province, Cambodia","volume":"29","author":"Teck","year":"2023","journal-title":"Remote Sens. Appl.: Society and Environment"},{"key":"10.1016\/j.socscimed.2025.117678_bib34","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1249\/mss.0b013e31815a51b3","article-title":"Physical activity in the United States measured by accelerometer","volume":"40","author":"Troiano","year":"2008","journal-title":"Med. Sci. Sports Exerc."},{"issue":"11","key":"10.1016\/j.socscimed.2025.117678_bib35","doi-asserted-by":"crossref","first-page":"2317","DOI":"10.1038\/oby.2011.364","article-title":"Identification and validity of accelerometer cut-points for toddlers","volume":"20","author":"Trost","year":"2011","journal-title":"Obesity (Silver Spring). Nov"},{"key":"10.1016\/j.socscimed.2025.117678_bib36","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1186\/1471-2458-14-489","article-title":"Health effects of indebtedness: a systematic review","volume":"14","author":"Turunen","year":"2014","journal-title":"BMC Publ. Health"},{"key":"10.1016\/j.socscimed.2025.117678_bib37","series-title":"Cambodia: Nutrition Profile","year":"2021"},{"issue":"2","key":"10.1016\/j.socscimed.2025.117678_bib38","article-title":"Out-of-pocket health expenditure and debt in poor households: evidence from Cambodia","volume":"9","author":"Van Damme","year":"2004","journal-title":"Trop. Med. Int. Health"},{"key":"10.1016\/j.socscimed.2025.117678_bib39","series-title":"$70 Million ADB Loan to Strengthen Agricultural Value Chain, Food Safety in Cambodia","year":"2020"},{"key":"10.1016\/j.socscimed.2025.117678_bib40","series-title":"Cambodia Economic Update. Navigating Global Economic Headwinds","year":"2022"},{"key":"10.1016\/j.socscimed.2025.117678_bib41","series-title":"Cambodia Country Climate and Development Report (English)","year":"2023"},{"key":"10.1016\/j.socscimed.2025.117678_bib52","series-title":"Cambodia- From Spending More to Spending Beter","year":"2024"},{"key":"10.1016\/j.socscimed.2025.117678_bib42","series-title":"UNICEF and Council for Agricultural and Rural Development (CARD)","year":"2023"},{"key":"10.1016\/j.socscimed.2025.117678_bib43","series-title":"WHO Regional Office for the Western Pacific. The Kingdom of Cambodia Health System Review","year":"2015"},{"key":"10.1016\/j.socscimed.2025.117678_bib44","series-title":"Heat and Health","year":"2018"},{"key":"10.1016\/j.socscimed.2025.117678_bib49","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.deveng.2017.10.001","article-title":"Piloting the use of accelerometry devices to capture energy expenditure in agricultural and rural livelihoods: Protocols and findings from northern Ghana","volume":"2","author":"Zanello","year":"2017","journal-title":"Dev. Eng."},{"key":"10.1016\/j.socscimed.2025.117678_bib50","doi-asserted-by":"crossref","DOI":"10.1038\/s41597-020-0414-x","article-title":"Physical activity, time use, and food intakes of rural households in Ghana, India, and Nepal","volume":"7","author":"Zanello","year":"2020","journal-title":"Sci. Data"}],"container-title":["Social Science &amp; Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953625000073?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0277953625000073?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T10:33:45Z","timestamp":1777545225000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0277953625000073"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2]]},"references-count":51,"alternative-id":["S0277953625000073"],"URL":"https:\/\/doi.org\/10.1016\/j.socscimed.2025.117678","relation":{},"ISSN":["0277-9536"],"issn-type":[{"value":"0277-9536","type":"print"}],"subject":[],"published":{"date-parts":[[2025,2]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Sick of debt: How over-indebtedness is hampering health in rural Cambodia","name":"articletitle","label":"Article Title"},{"value":"Social Science & Medicine","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.socscimed.2025.117678","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Ltd.","name":"copyright","label":"Copyright"}],"article-number":"117678"}}