Table 6.

Characteristics of studies included in review focusing children and adolescents, older adults and people with mental health problems, 2004–2014

Study	Setting	Study design	N Year Age	Socioeconomic determinants	Mental health outcomes	Associations/Effects	Strengths	Limitations
[118]	Regional sample of parents and children, Southern Finland	Cohort	1149 12 y 843 mothers 30–59y 573 fathers 28–66 y	Individual-level indicators Family perceived financial strain	Psychological Well-being Parental Mental health distress caseness (GHQ-12) Child mental health	Family economic hardship creates a risk for child mental health through economic pressures and problems in parental mental health, marital interaction, and parenting even in a welfare state.	Gives information on transgenerational effect of family economic pressure on child mental health. Child mental health was reported by both parents and children, which adds to the reliability. Temporal order of exposures, confounders, and the outcome under consideration affected all participants at the same time producing stronger causal conclusions	Reporter bias is expected since mothers and fathers reported on their own mental health and parenting. Other contexts determinants such as reductions in funding in day care and schools can act as confounders. Generalizing findings is limited to the uniqueness of the Finish welfare system with extensive governmental support to families.
[119]	Cross-national samples of adolescents, 31 countries worldwide	Repeated cross-sectional	164,623 (2005–2006) 168,284 (2009–2010) 11–15y	Inter-time Variables Macroeconomic indicators Unemployment Rates	Psychological Well-being Psychological health complaints (HBSC symptom checklist)	Ireland and Portugal were the only countries facing a rise In psychological health complaints (9–17 %) with increasing unemployment (21–148 %). Youth unemployment rates in 2010 increased the likelihood of psychological health complaints.	Uses nationally representative data on adolescents from 31 countries, surveyed over two time points, before and after recession	Data derives from 2006–2010 and the crisis started in 2008 so the long term effects of the recession could not be investigated. The sample is composed only by adolescents aging 11 to 15 years old.
[120]	National population sample of adolescent, Slovenia	Cross-sectional	1815 (2010) 15y	Individual-level indicators Family Affluence Scale, perceived material welfare, family type, occupational status of parents	Psychological Well-being Mental health (KIDSCREEN-10, SDQ), Life satisfaction Feelings of depression	The adolescents who perceived to be socioeconomically worse off had 4-times higher odds (p < 0.001) of a low life satisfaction, a greater chance of a low quality of life, and a higher SDQ score than those who perceived to be better off (p < 0.001).	Uses a national representative sample and several variables to measure socioeconomic status.	Includes only 15-year-olds who are enrolled in school and does not include dropouts, who might be among the most socioeconomically underprivileged. Its cross-sectional design removes the possibility of causal inference.
[121]	National population sample of adolescents, Portugal	Cross-sectional	4877 (2010) 10–18 y	Individual-level indicators Parental employment status	Psychological Well-being Health Related Quality of Life	Having at least one parent unemployed has a statistical significant negative impact on perceptions of adolescent health.	Gives important information about the transgenerational effect of employment status.	Its cross-sectional design removes the possibility of causal inference. The study was not designed specifically to address causal links between the variables and parental employment.
[122]	Cross-national samples of children and adolescents, Denmark and Sweden	Cross-sectional	4299 2–17 y (1996)	Individual-level indicators Parental employment status	Psychological Well-being Psychosomatic symptoms	Children in families with one or both parents without paid work had an increased prevalence of recurrent psychosomatic symptoms (OR = 1.52 to 3.20)	Gives important information about the transgenerational effect of employment status.	Underreporting bias is expected as children differ in their tendency to report symptoms to their parents. Also the parents’ reports on their children can depend on their own health. Its cross-sectional design removes the possibility of causal inference.
[123]	Regional sample of adolescents, Kosice, Slovakia	Cross-sectional	2836 14–22	Individual-level indicators Parental employment status	Psychological Well-being Self-rated health Long-term well-being Health complaints	Parental long-term unemployment (especially of fathers) is negatively associated with adolescents’ subjective health. Father’s long-term unemployment was a significant predictor of moderate self-rated health and low long-term well-being among girls and boys. Mother’s long-term unemployment was negatively associated with self-rated health of girlss and long-standing illness among boys.	Gives important information about the transgenerational effect of employment status.	Lack of specific detailed information about parental unemployment (maternity leave of mothers, retirement, or invalidity of parents were considered unemployment)
[124]	Regional sample of adolescents, emergency room, Ontario, Canada	Cohort	15,739 (2002–2011) 12–17 y	Inter-time Variables Pre and Post- recession period	Suicidal behaviours Hospital records of suicide-related behaviours	The suicide-related behaviours incidence rates decreased by 30 % in boys and girls from FYs 2002/03 to 2006/07, but stopped afterwards and subsequent admissions increased.	Large sample of adolescents and examines trends in the total suicide related behaviour during recession periods.	The hospital records do not identify suicidal intent. Data is not representative of the general population. Suicide-related behaviours are complex and other variables may act as confounders.
[125]	National population sample of adolescent, USA	Repeated cross-sectional	403,457 (1997–2009) mean age 16 y	Macroeconomic indicators State level job loss	Suicidal Behaviours Suicide ideation, attempts and plans	State level unemployment during the year preceding the survey increased girls’ probability of suicidal ideation and suicide plans, but did not affect the suicide-related behaviors of boys	Uses a national representative sample and Gives important information about economic circumstances effects on adolescents risk behaviours.	It is unable to identify the pathways through which unemployment rates affect adolescents’ suicide-related behaviors.
[126]	Regional sample of older adults, Canberra/Queanbeyan, Australia	Cohort	1973 (2005–2010) mean age 66.58 y (SD = 1.5)	Inter-time Variables Individual-level indicators Pre and Post- recession period Financial security Financial hardship	Common Mental Disorders Depression Anxiety (Goldberg Scales) Self-reported health	Economic slowdown related distress is linked to greater depression symptoms at both waves 2 (t(655) = −3.44,p = .001) and 3 (t(662) = −4.96, p < .001), and greater anxiety symptoms at both waves (wave 2 - t(655) = −3.62, p < .001; wave 3 - t(662) = −5.15, p < .001).	Temporal order of exposures, confounders, and the outcome under consideration affected all participants at the same time producing stronger causal conclusions.	The analysis was restricted to older adults at baseline. Consequently, the results and recommendations should not be applied to younger cohorts. Limited period of time, the long term effects of the recession could not be investigated.
[127]	National population sample of older adults, USA	Cohort	2261 (2005–2006) (2010–2011) >57 y	Individual-level indicators Home foreclosure	Common Mental Disorders Depressive symptoms (CES-D)	Increases in neighborhood-level foreclosure was associated with an increased rate in depression in older adults. Notices of default (OR = 1.75; 95 % CI = 1.14, 2.67) and properties returning to ownership by the bank (OR = 1.62; 95 % CI = 1.06, 2.47) were associated with depressive symptoms.	Establishes longitudinal associations between home foreclosure and depressive symptoms producing stronger causal conclusions.	The mechanisms linking increases in foreclosure to depressive symptoms are not explored. The sample is limited to a longitudinal cohort of older American adults.
[128]	Cross-national working population sample, European Union countries	Cross-sectional	20,368 (2006) 20,124 (2010) 18–64 y	Inter-time Variables Macroeconomic indicators ndividual-level indicators Pre and Post- recession period Employment Status Sate level unemployment	Psychological Well-being Mental health distress (MHI-5) Mental health disorders	Following the onset of the recession, individuals with mental health problems were more vulnerable to losing their jobs [OR = 1.12, 95 % CI: 1.03–1.34] (OR: 1.12, 95 % CI: 1.03, 1.34).	Uses nationally representative data on people with and without mental health problems from 27 countries in Europe surveyed over two time points, before and after recession.	The data was collected through brief, self-reported questionnaires. Limited period of time, the long term effects of the recession could not be investigated. Its cross-sectional design removes the possibility of causal inference.