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The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain

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Abstract

Objectives

To estimate the impact of (particularly long-term) unemployment on the overall and mental health of the Spanish working-age population and to check whether the effects of unemployment on health have increased or been tempered as a consequence of the economic crisis.

Methods

We apply a matching technique to cross-sectional microdata from the Spanish Health Survey for the years 2006 and 2011–2012 to estimate the average treatment effect of unemployment on self-assessed health (SAH) in the last year, mental problems in the last year and on the mental health risk in the short term. We also use a differences-in-differences estimation method between the two periods to check if the impact of unemployment on health depends on the economic context.

Results

Unemployment has a significant negative impact on both SAH and mental health. This impact is particularly high for the long-term unemployed. With respect to the impact on mental health, negative effects significantly worsen with the economic crisis. For the full model, the changes in effects of long-term unemployment on mental problems and mental health risk are, respectively, 0.35 (CI 0.19–0.50) and 0.20 (CI 0.07–0.34).

Conclusions

Anxiety and stress about the future associated with unemployment could have a large impact on individuals’ health. It may be necessary to prevent health deterioration in vulnerable groups such as the unemployed, and also to monitor specific health risks that arise in recessions, such as psychological problems.

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References

  1. Brenner, M.H., Mooney, A.: Unemployment and Health in the context of economic change. Soc. Sci. Med. 17(16), 1125–1138 (1983)

    Article  CAS  PubMed  Google Scholar 

  2. Ruhm, C.J.: Macroeconomic Conditions, Health and Mortality. NBER Working Paper No. 11007 (2004)

  3. Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., McKee, M.: The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet 374, 315–323 (2009)

    Article  PubMed  Google Scholar 

  4. CSDH: Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final report of the Commission on Social Determinants of Health. World Health Organization, Geneva (2008)

  5. Ruhm, C.J.: Are recessions good for your health? Q. J. Econ. 115(2), 617–650 (2000)

    Article  Google Scholar 

  6. Gerdtham, U.G., Ruhm, C.J.: Deaths rise in good economic times: evidence from the OECD. Econ. Hum. Biol. 4(3), 298–316 (2006)

    Article  PubMed  Google Scholar 

  7. Egan, M.L., Mulligan, C.B., Philipson, T.J.: Adjusting Measures of Economic Output for Health: Is the Business Cycle Countercyclical? NBER Working Paper No. 19058 (2013)

  8. Neumayer, E.: Recessions lower (some) mortality rates: evidence from Germany. Soc. Sci. Med. 58(6), 1037–1047 (2004)

    Article  PubMed  Google Scholar 

  9. Buchmueller, T., Grignon, M., Jusot, F.: Unemployment and Mortality in France, 1982–2002. CHEPA Working Paper 07-04 (2007)

  10. Ross, C., Mirowsky, J.: Does employment affect health? J. Health Soc. Behav. 36, 230–243 (1995)

    Article  CAS  PubMed  Google Scholar 

  11. Dooley, D., Fielding, J., Levi, L.: Health and unemployment. Annu. Rev. Public Health 17, 949–965 (1996)

    Article  Google Scholar 

  12. Platt, S., Pavis, S., Akram, G.: Changing labour market conditions and health: a systematic literature review (1993–98). In: Research Unit in Health and Behavioural Change. University of Edinburgh Medical School, Edinburgh (1999)

  13. Kasl, S., Jones, B.: The impact of job loss and retirement on health. In: Berkman, L., Kawachi, I. (eds.) Social Epidemiology, pp. 118–136. Oxford University Press, Oxford (2000)

    Google Scholar 

  14. Darmon, N., Drewnowski, A.: Does social class predict diet quality? Am. J. Clin. Nutr. 87(5), 1107–1117 (2008)

    CAS  PubMed  Google Scholar 

  15. Mossakowski, K.N.: Is the duration of poverty and unemployment a risk factor for heavy drinking? Soc. Sci. Med. 67, 947–955 (2008)

    Article  PubMed  Google Scholar 

  16. Fagan, P., Shavers, V., Lawrence, D., Gibson, J.T., Ponder, P.: Cigarette smoking and quitting behaviors among unemployed adults in the United States. Nicotine Tob. Res. 9(2), 241–248 (2007)

    Article  PubMed  Google Scholar 

  17. Grayson, J.P.: Health, physical activity level, and employment status in Canada. Int. J. Health Serv. 23(4), 743–761 (1993)

    Article  CAS  PubMed  Google Scholar 

  18. World Bank: Averting A Human Crisis During the Global Downturn. World Bank, Washington (2009)

    Google Scholar 

  19. Dávila, C.D., González, B.: Crisis económica y salud. Gac. Sanit. 23, 261–265 (2009)

    Article  Google Scholar 

  20. Catalano, R., Dooley, D., Rook, K.: A test of reciprocal risk between undesirable economic and noneconomic life events. Am. J. Community Psychol. 15, 633–651 (1987)

    Article  CAS  PubMed  Google Scholar 

  21. Artazcoz, L., Benach, J., Borrell, C., Cortès, I.: Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am. J. Public Health 94(1), 82–88 (2004)

    Article  PubMed Central  PubMed  Google Scholar 

  22. Vinokur, A.D., Price, R.H., Caplan, R.D.: Hard times and hurtful partners: how financial strain affects depression and relationship satisfaction of unemployed persons and their spouses. J. Pers. Soc. Psychol. 71, 166–179 (1996)

    Article  CAS  PubMed  Google Scholar 

  23. Paul, K.I., Moser, K.: Unemployment impairs mental health: meta-analyses. J. Vocat. Behav. 74, 264–282 (2009)

    Article  Google Scholar 

  24. Goldman-Mellor, S.J., Saxton, K.B., Catalano, R.C.: Economic contraction and mental health. A review of the evidence, 1990–2009. Int. J. Ment. Health 39(2), 6–31 (2010)

    Article  Google Scholar 

  25. Pharr, J.R., Moonie, S., Bungum, T.J.: The impact of unemployment on mental and physical health, access to health care and health risk behaviors. ISRN Public Health (2012). doi:10.5402/2012/483432

    Google Scholar 

  26. Laufey, T., Corman, H., Noonan, K. et al.: Are Recessions Good for Your Health Behaviors? Impacts of the Economic Crisis in Iceland. NBER Working Paper 18233 (2012)

  27. Jenkinson, C.E., Dickens, A.P., Jones, K., Thompson-Coon, J., Taylor, R.S., Rogers, M., et al.: Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health 13, 773 (2013)

    Article  PubMed Central  PubMed  Google Scholar 

  28. Boone, J., van Ours, J.C.: Are recessions good for workplace safety? J. Health Econ. 25, 1069–1093 (2006)

    Article  PubMed  Google Scholar 

  29. Davies, R., Jones, P., Núñez, I.: The impact of the business cycle on occupational injuries in the UK. Soc. Sci. Med. 69, 178–182 (2009)

    Article  PubMed  Google Scholar 

  30. Corcoran, P., Arensman, E.: Suicide and employment status during Ireland’s Celtic Tiger economy. Eur. J. Public Health 21(2), 209–214 (2010)

    Article  PubMed  Google Scholar 

  31. Martikainen, P.T., Valkonen, T.: Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet 348, 909–912 (1996)

    Article  CAS  PubMed  Google Scholar 

  32. Ostamo, A., Lahelma, E., Lonnqvist, J.: Transitions of employment status among suicide attempters during a severe economic recession. Soc. Sci. Med. 52, 1741–1750 (2001)

    Article  CAS  PubMed  Google Scholar 

  33. Platt, S., Kreitman, N.: Long term trends in parasuicide and unemployment in Edinburgh, 1968–87. Soc. Psychiatry Psychiatr. Epidemiol. 25, 56–61 (1990)

    CAS  PubMed  Google Scholar 

  34. Preti, A., Miotto, P.: Suicide and unemployment in Italy, 1982–1994. J. Epidemiol. Community Health 53, 694–701 (1999)

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  35. Ahs, A.M., Westerling, R.: Mortality in relation to employment status during different levels of unemployment. Scand. J. Public Health 34, 159–167 (2006)

    Article  PubMed  Google Scholar 

  36. Bank of Spain: Economic Bulletin. http://www.bde.es/f/webbde/SES/Secciones/Publicaciones/InformesBoletinesRevistas/BoletinEconomico/13/May/Files/be1305e.pdf (2013). Accessed 30 April 2013

  37. Benavides, F.G., García, A.M., Sáez-Lloret, I., Librero, J.: Unemployment and health in Spain. The influence of socio-economic environment. Eur. J. Public Health 4(2), 103–107 (1994)

    Article  Google Scholar 

  38. Tapia-Granados, J.A.: Recessions and mortality in Spain: 1980–1997. Eur. J. Popul. 21, 393–422 (2005)

    Article  Google Scholar 

  39. Pascual, N., Rodríguez, I.: Effects of unemployment on self-assessed health and mental health: empirical evidence for Catalonia (2006–2012). Masters Project. Masters in Health Economics and Policy, Barcelona Graduate School of Economics (2013)

  40. Spanish Ministry of Health. National health survey 2006 (2007)

  41. Spanish Ministry of Health. National health survey 2011–2012 (2013)

  42. Böckerman, P., Ilmakunnas, P.: Unemployment and self-assessed health: evidence from panel data. Health Econ. 18, 161–179 (2009)

    Article  PubMed  Google Scholar 

  43. Rosenbaum, P.R., Rubin, D.B.: The central role of the propensity score in observational studies for causal effects. Biometrika 70(1), 41–55 (1983)

    Article  Google Scholar 

  44. Kunst, A.E., Bos, V., Lahelma, E., Bartley, M., Lissau, I., Regidor, E., Mielck, A., Cardano, M., Dalstra, J.A., Geurts, J., Helmert, U., Lennartsson, C., Ramm, J., Spadea, T., Stronegger, W.J., Mackenbach, J.P.: Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int. J. Epidemiol. 34(2), 295–305 (2005)

    Article  PubMed  Google Scholar 

  45. Hernández-Quevedo, C., Masseria, C., Mossialos, EA.: Analysing the Socioeconomic Determinants of Health in Europe: New Evidence from EU-SILC. Eurostat Working Paper (2010)

  46. Lucas, R.E., Clark, A.E., Georgellis, Y., Diener, E.: Unemployment alters the set point for life satisfaction. Psychol. Sci. 15, 8–13 (2004)

    Article  PubMed  Google Scholar 

  47. Goldberg, D.: Mental health priorities in a primary care setting. Ann. N. Y. Acad. Sci. 310, 65–68 (1978)

    Article  CAS  PubMed  Google Scholar 

  48. Turner, J.B.: Economic context and the health effects of unemployment. J. Health Soc. Behav. 36, 213–229 (1995)

    Article  CAS  PubMed  Google Scholar 

  49. Karlsdotter, K.: Análisis de la Influencia de las Desigualdades Socioeconómicas Regionales Sobre la Salud de Los Andaluces y Españoles en el Período 2004–2007. PhD Dissertation, University of Granada (2012)

  50. Novo, M.: Young and unemployed: does the trade cycle matter for the health. In: A Study of Young Men and Women During Times of Prosperity and Times of Recession. Umeå: Umeå Universitet (2000)

  51. Stewart, J.M.: The impact of health status on the duration of unemployment spells and the implications for studies of the impact of unemployment on health status. J. Health Econ. 20, 781–796 (2001)

    Article  CAS  PubMed  Google Scholar 

  52. STATA®. Stata 12 Software (2012)

  53. Karasek, R., Theorell, T.: Healthy work: stress, productivity, and the reconstruction of working life. Basic Books, New York (1990)

    Google Scholar 

  54. Gili, M., Roca, M., Basu, S., McKee, M., Stuckler, D.: The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010. Eur. J. Public Health 23, 103–108 (2013)

    Article  PubMed  Google Scholar 

  55. Urbanos, R., González, B.: Desempleo y salud: un análisis de la repercusión de la crisis económica sobre la salud de los españoles. Estudios de Economía Aplicada 31(2), 303–326 (2013)

    Google Scholar 

  56. Ayala, L., Rodríguez, M.: Health-related effects of welfare-to-work policies. Soc. Sci. Med. 93, 103–112 (2013)

    Article  PubMed  Google Scholar 

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Correspondence to Beatriz G. Lopez-Valcarcel.

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Urbanos-Garrido, R.M., Lopez-Valcarcel, B.G. The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain. Eur J Health Econ 16, 175–184 (2015). https://doi.org/10.1007/s10198-014-0563-y

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