Abstract
OBJECTIVE--To ascertain whether, after controlling for several relevant background variables simultaneously, unemployment is related to mortality and to assess whether this relation is causal or whether unhealthy people are more likely to become unemployed. DESIGN--Prospective study of mortality in Finland during 1981-5 based on 1980 census data on 30-54 year old wage earner men and with particular attention to unemployment in the year before the census. SETTING--Research project at the University of Helsinki. SUBJECTS--All wage earner men in Finland aged 30-54 at the 1980 census. MAIN OUTCOME MEASURES--Causes of death during 1981-5 and duration of unemployment in the year before the census. Background variables controlled for were age, socioeconomic state, marital state, and health. The data were analysed by log linear regression models. RESULTS--During the study period 1981-5, which covered almost 2.7 million person years, there were 9810 deaths. After controlling for all background variables relative total mortality among unemployed versus employed men was 1.93 (95% confidence interval 1.82 to 2.05). The excess mortality was highest in accidental and violent causes of death (relative mortality 2.51; 95% confidence interval 2.28 to 2.76). For circulatory diseases the relative death rate was 1.54 (95% confidence interval 1.40 to 1.70), but among neoplasms only lung cancer was associated with excess mortality. Selection for unemployment based on age, socioeconomic state, and marital state was evident but no such selection was detected based on health. Effects of unemployment on mortality were more pronounced with increasing duration of unemployment. CONCLUSIONS--The relative excess mortality of unemployed men in Finland cannot fully be explained by demographic, social, and health variables preceding unemployment. Unemployment therefore seems to have an independent causal effect on male mortality. Further studies are needed to elucidate the mechanisms between unemployment and mortality.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brenner M. H. Mortality and the national economy. A review, and the experience of England and Wales, 1936--76. Lancet. 1979 Sep 15;2(8142):568–573. [PubMed] [Google Scholar]
- Iversen L., Andersen O., Andersen P. K., Christoffersen K., Keiding N. Unemployment and mortality in Denmark, 1970-80. Br Med J (Clin Res Ed) 1987 Oct 10;295(6603):879–884. doi: 10.1136/bmj.295.6603.879. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lahelma E. Unemployment, re-employment and mental well-being. A panel survey of industrial jobseekers in Finland. Scand J Soc Med Suppl. 1989;43:1–170. [PubMed] [Google Scholar]
- Moser K. A., Fox A. J., Jones D. R., Goldblatt P. O. Unemployment and mortality: further evidence from the OPCS Longitudinal Study 1971-81. Lancet. 1986 Feb 15;1(8477):365–367. doi: 10.1016/s0140-6736(86)92326-3. [DOI] [PubMed] [Google Scholar]
- Moser K. A., Fox A. J., Jones D. R. Unemployment and mortality in the OPCS Longitudinal Study. Lancet. 1984 Dec 8;2(8415):1324–1329. doi: 10.1016/s0140-6736(84)90832-8. [DOI] [PubMed] [Google Scholar]
- Moser K. A., Goldblatt P. O., Fox A. J., Jones D. R. Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples. Br Med J (Clin Res Ed) 1987 Jan 10;294(6564):86–90. doi: 10.1136/bmj.294.6564.86. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stern J. The relationship between unemployment, morbidity and mortality in Britain. Popul Stud (Camb) 1983 Mar;37(1):61–74. [PubMed] [Google Scholar]