Section G
Unemployment and health in the context of economic change

https://doi.org/10.1016/0277-9536(83)90005-9Get rights and content

Abstract

Evidence relating unemployment to health is found at every level of social science analysis from national population rates to individual psychophysiological stress response. At the population level of analysis, increase in the unemployment rate indicates recession and/or structural economic decline. At the individual level, unemployment is interpreted as a stressful life event. In both cases, inverse associations are found between measures of unemployment and indicators of health. We identify social science literatures associating health indicators with each of the following: economic growth, socioeconomic status, sociocultural change, economic instability, the status of being unemployed, social stress and work stress.

Outstanding research issues include the requirements to identify and measure the effects of conditional factors and control variables in multivariate analysis and to examine a broader range of both severity of unemployment and severity of health outcomes. A research agenda proposes studies at the macro, meso and micro levels of analysis. We urge such research for its potential contribution both to analytic social science and to economic and social policy.

References (110)

  • Kagan A.R. The evidence for a relationship between unemployment and ill health and lack of well being. Unpublished...
  • R. Liem et al.

    Health and social costs of unemployment: research and policy considerations

    Am. Psychol.

    (1982)
  • P. Warr

    Psychological aspects of employment and unemployment. Editorial

    Psychol. Med.

    (1982)
  • M.H. Brenner

    Industrialization and economic growth: estimates of their effects on the health of populations

  • M.H. Brenner

    Mortality and the national economy: a review, and the experience of England and Wales, 1936–1976

    The Lancet

    (1979)
  • S.H. Preston

    Mortality Patterns in National Populations

    (1976)
  • A.L. Cochrane et al.

    Health service ‘input’ and mortality ‘output’ in developed countries

    J. Epid. Communit. Hlth

    (1978)
  • E.M. Kitagawa

    On mortality

    Demography

    (1977)
  • A.S. St Leger et al.

    Factors associated with cardiac mortality in developed countries with particular reference to the consumption of wine

    The Lancet

    (1979)
  • M.J. Gardner et al.

    Patterns of mortality in middle and early old age in the county boroughs of England and Wales

    Br. J. prev. soc. Med.

    (1969)
  • M. Lerner et al.

    Mortality by socioeconomic status, 1959–1961 and 1969–1971

    Maryland State med. J.

    (December, 1978)
  • C.D. Jenkins

    Social stressors and excess mortality from hypertensive disease

    J. Hum. Stress

    (September, 1979)
  • C.D. Jenkins

    Zones of excess mortality in Massachusetts

    New Engl. J. Med.

    (1977)
  • M. Lerner

    Socioeconomic differentials in mortality in Baltimore, 1959–1961 and 1969–1971

    Proc. Am. Stat. Assn. Soc. Stat. Section

    (1980)
  • U.S. National Center for Health Statistics

    Selected Vital and Health Statistics in Poverty and Nonpoverty Areas of 19 Large Cities: United States

    (1969–1971)
    S.J. Ventura et al.

    Vital and Health Statistics

    (1975)
  • A. Antonovsky

    Social class, life expectancy and overall mortality

    Milbank Meml Fund Q.

    (1967)
  • L.F. Berkman

    Physical health and the social environment: a social epidemiological perspective

  • J.N. Morris

    Social inequalities undiminished

    The Lancet

    (1979)
  • U.S. Department of Health, Education and Welfare et al.

    Health Status of Minorities and Low-Income Groups

    (1979)
  • J.J. Feldman

    Health of the disadvantaged: an epidemiological overview

  • L. Egbuonu et al.

    Child health and social status

    Pediatrics

    (1982)
  • E.G. Stockwell et al.

    Research needed on socioeconomic differentials in U.S. mortality

    Pub. Hlth Rep.

    (1978)
  • M.G. Marmot

    Changing social-class distribution of heart disease

    Br. med. J.

    (1978)
  • L.E. Hinkle

    The effect of cultural change, social change and changes in interpersonal relationships in health

  • E. Durkheim

    Suicide

    (1951)
    (1897)
  • D.S. Thomas

    Social Aspects of the Business Cycle

    (1925)
  • E. Sydenstricker

    The declining death rate from tuberculosis

  • J.N. Morris et al.

    Health and social change. I. The recent history of rheumatic heart disease

    Med. Offr

    (1944)
  • M.H. Brenner

    Importance of the economy to the nation's health

  • M.H. Brenner

    Economic changes and heart disease mortality

    Am. J. publ. Hlth

    (1971)
  • W. Forbes et al.

    Scottish unemployment and the public health

  • M.H. Brenner

    Mortality and economic instability: detailed analysis for Britain, and comparative analyses for selected industrialized countries

    (1982)
  • A.R. Bunn

    Ischaemic heart disease mortality and the business cycle in Australia

    Am. J. publ. Hlth

    (1979)
  • R. Bunn et al.

    Economic change as a factor in heart disease

    New Doctor

    (1977)
  • M.H. Brenner

    Economic change and mortality by cause in selected European countries

    Paper prepared for WHO Workshop on Health Policy in Relation to Unemployment in the Community

    (1982)
  • U.S. Congress, Joint Economic Committee et al.

    Estimating the Social Costs of National Economic Policy: Implications for Mental and Physical Health and Criminal Aggression

    (1976)
  • M.H. Brenner et al.

    A multivariate model for the assessment of alcohol-related pathology: application to cirrhosis mortality rates

    (1982)
  • M.H. Brenner

    Fetal, infant and maternal mortality during periods of economic instability

    Int. J. Hlth Serv.

    (1973)
  • H.S.E. Gravelle et al.

    Mortality and unemployment: a critique of Brenner's time-series analysis

    The Lancet

    (1981)
  • M.H. Brenner

    Unemployment and health. Letter to the editor

    The Lancet

    (1981)
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