Abstract
Purpose
To analyze the association between unemployment and suicide in Italy during the years 1990–2014, with a peculiar focus on the great recession (GR) and the role played by social protection as buffering mechanism against the negative effect on health outcomes.
Methods
Fixed effects panel regressions were used to assess the association between changes in unemployment rate and suicide rates. Additional models investigated the role of active labor market programs (ALMPs) as possible moderators of the association. Analyses were carried out for both males and females, stratified by age and region.
Results
The negative time-trend displayed by suicide rate in Italy until 2007 was slowed down by changes in unemployment at the beginning of the GR, when this trend reversed and the rate of suicide started increasing. Male workers aged 25–64 and women aged 55–64 years were affected by both “normal” unemployment rate fluctuations as well as severe economic crises. Women aged 35–44 were only influenced by the latter. Men benefit from ALMPs mainly in Central Italy, while women did not benefit significantly from ALMPs.
Conclusions
In Italy, economic downturns were associated with increased suicides mainly among men, while severe economic crises were associated with increased suicides among both men and women. ALMPs showed to be effective in moderating the association between unemployment and suicide among men aged 45–54 only in Central Italy. The overall small effectiveness of such programs may be due to lack of sufficient funding.
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References
Wessel D (2010) Did ‘Great Recession’ live up to the name? Wall Str J http://online.wsj.com/news/articles/SB10001424052702303591204575169693166352882. Accessed 30 April 2018
Blanchard O, Amighini A, Gavazzi F (2010) Macroeconomics. A European perspective. Financial Times, Upper Saddle River
World Health Organization (2011) Impact of economic crises on mental health. http://www.euro.who.int/en/what-we-do/healthtopics/noncommunicable-diseases/mental-health/publications/2011/ impact-of-economic-crises-on-mental-health. Accessed 30 April 2018
Stuckler D, Basu S, Suhrcke M et al (2009) The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet 374:315–323
Stuckler D, Basu S (2013) The body economic. Allen Lane, London
O’Brien M (2014) Italy’s triple-dip recession has wiped out all its growth since 2000. Washington Post. https://www.washingtonpost.com/news/wonk/wp/2014/08/07/italys-triple-dip-recession-has-wiped-out-all-its-growth-since-2000/. Accessed 21 February 2018
Fubini F (2014) Recessione Italia. Come usciamo dalla crisi più lunga della storia. Editori Laterza, Roma-Bari (in Italian)
De Vogli R (2013) Unemployment and suicides during the recession in Italy. BMJ 347:f4908
De Vogli R, Marmot M, Stuckler D (2013) Excess suicides and attempted suicides in Italy attributable to the great recession. J Epidemiol Commun Health 67(4):378–379. https://doi.org/10.1136/jech-2012-201607. Epub 2012 Aug 2
Mattei G, Ferrari S, Pingani L, Rigatelli M (2014) Short-term effects of the 2008 Great Recession on the health of the Italian population: an ecological study. Soc Psychiatry Psychiatr Epidemiol 49:851–858
König D, Fellinger M, Pruckner N, Hinterbuchinger B, Dorffner G, Gleiss A, Vyssoki S, Vyssoki B (2018) Availability and use of mental health services in European countries: influence on national suicide rates. J Affect Disord 15:239:66–71
Torbica A, Maggioni AP, Ghislandi S (2015) The economic crisis and acute myocardial infarction: new evidence using hospital-level data. PLoS One 10(11):e0142810. https://doi.org/10.1371/journal.pone.0142810
Gallus S, Tramacere I, Pacifici R et al (2011) Smoking in Italy 2008–2009: a rise in prevalence related to the economic crisis? Prev Med 52:182–183
Mattei G, De Vogli R, Ferrari S et al (2017) Impact of the economic crisis on health-related behaviors in Italy. Int J Soc Psychiatry 63:649–656
Zuccato E, Castiglioni S, Tettamanti et al (2011) Changes in illicit drug consumption patterns in 2009 detected by wastewater analysis. Drug Alcohol Depend 118:464–469
Bor J, Basu S, Coutts A et al (2013) Alcohol use during the great recession of 2008–2009. Alcohol 48(3):343–348. https://doi.org/10.1093/alcalc/agt002 (Epub 2013 Jan 29)
de Goeij MC, Suhrcke M, Toffolutti V et al (2015) How economic crises affect alcohol consumption and alcohol-related health problems: a realist systematic review. Soc Sci Med 131:131–146. https://doi.org/10.1016/j.socscimed.2015.02.025 (Epub 2015 Feb 18)
Dom G, Samochowiec J, Evans-Lacko S et al (2016) The impact of the 2008 economic crisis on substance use patterns in the countries of the European Union. Int J Environ Res Public Health 13:122 https://doi.org/10.3390/ijerph13010122
Margerison-Zilko C, Goldman-Mellor S, Falconi A et al (2016) Health impacts of the Great Recession: a critical review. Curr Epidemiol Rep. https://doi.org/10.1007/s40471-016-0068-6
Martin-Carrasco M, Evans-Lacko S, Dom G et al (2016) EPA guidance on mental health and economic crises in Europe. Eur Arch Psychiatry Clin Neurosci 266:89–124. https://doi.org/10.1007/s00406016-0681-x
Odone A, Landriscina T, Amerio A, Costa G (2018) The impact of the current economic crisis on mental health in Italy: evidence from two representative national surveys. Eur J Public Health 28(3):490–495. https://doi.org/10.1093/eurpub/ckx220
Uutela A (2010) Economic crises and mental health. Curr Opin Psychiatry 23(2):127–130
Swanson JW, Bonnie RJ, Appelbaum PS (2015) Getting serious about reducing suicide: more ‘How’ and Less ‘Why’. JAMA 314:2229–2230
Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33(3):395–405
Istituto per lo Sviluppo della Formazione Professionale dei Lavoratori (2016) Rapporto di monitoraggio sui servizi per il lavoro 2015 [Report on the monitoring of job service]. Roma, Isfol. Accessed 30 April 2018 (in Italian)
Ufficio Studi Confcommercio (2016) La spesa pubblica locale [Local public expenditure] http://www.confcommercio.it/documents/10180/9356497/La+spesa+pubblica+locale.pdf/e77fcdd6-5387-4d71-9546-825cf40cd026. Accessed 19 May 2018 (in Italian)
Visentini C, Mattei G, Gobba F et al (2017) Impact of the economic crisis on mental health: report of a multidisciplinary seminar held in Sassuolo (Modena), June 17th, 2016. Med Lav 108(3):237–238
Tassinari G, Modenese A, Mungai F et al (2018) Psychic discomfort in the workplace: report of a multidisciplinary conference occurred in Modena in 25 October 2017. Med Lav 109(3):236–238
Mattei G, Sacchi V, Alfieri A et al (2018) Stakeholders’ views on vocational rehabilitation programs: a call for collaboration with Occupational Health Physicians. Med Lav 109(3):201–209
Starace F, Mungai F, Sarti E, Addabbo T (2017) Self-reported unemployment status and recession: an analysis on the Italian population with and without mental health problems. PLoS One 12:7–10
Ceccherini-Nelli A, Piebe S (2011) Economic factors and suicide rates: associations over time in four countries. Soc Psychiatry Psychiatr Epidemiol 46(10):975–982
Toffolutti V, Suhrcke M (2014) Assessing the short term health impact of the great recession in the European Union: a cross-country panel analysis. Prev Med 64:54–62
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BP gratefully acknowledges the financial support from FAR 2017 provided by University of Modena and Reggio Emilia, Italy.
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Mattei, G., Pistoresi, B. & De Vogli, R. Impact of the economic crises on suicide in Italy: the moderating role of active labor market programs. Soc Psychiatry Psychiatr Epidemiol 54, 201–208 (2019). https://doi.org/10.1007/s00127-018-1625-8
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DOI: https://doi.org/10.1007/s00127-018-1625-8