Does contextual unemployment matter for health status across the life course? A longitudinal multilevel study exploring the link between neighbourhood unemployment and functional somatic symptoms

Gendered employment trajectories and later life health in liberal regime countries: A quantitative study in the United States, England, Switzerland and Chile

We explore the association between adulthood employment patterns and later life health among men and women in four liberal regime countries: two from Europe (England and Switzerland) and two from the Americas (United States and Chile). We carefully harmonized life-history data from the surveys SHARE (N = 1,143), HRS (N = 4,006), ELSA (N = 3,083), and EVDA (N = 802). The samples included individuals born between 1944 and 1954, with information on employment histories from age 15 to 65 and on 11 health outcomes in later life. In line with welfare regime and health literature, we find significant differences in health outcomes between countries, which are likely explained by differences in health systems. However, we extend previous literature by showing that positive health outcomes are consistently explained by standard employment histories, and poor health outcomes are consistently explained by non-standard employment histories. Importantly, men and women following the same employment pathway across countries are either similarly penalized or compensated in their health. This suggests that it is not gender per se that affects health in later life, but the employment trajectory experienced. Nonetheless, women are disproportionately more likely to experience non-standard employment and thus suffer a greater health disadvantage. Policy measures to mitigate negative health effects of non-standard employment trajectories may therefore pay attention to the specific reasons why women are more likely to experience non-standard trajectories.

How do labour market conditions explain the development of mental health over the life-course? a conceptual integration of the ecological model with life-course epidemiology in an integrative review of results from the Northern Swedish Cohort

BACKGROUND

The aim of this study was to contribute to the theoretical development within the field of labour market effects on mental health during life by integrating Bronfenbrenner's ecological model with mainly earlier theoretical work on life-course theory.

METHODS

An integrative review was performed of all 52 publications about labour market conditions in relation to mental health from the longitudinal Northern Swedish Cohort study. Inductive and deductive qualitative content analysis were performed in relation to Bronfenbrenner's ecological framework combined with life-course theories.

RESULTS

The following nine themes were identified: 1. Macroeconomic recession impairs mental health among young people. 2. The mental health effects on individuals of youth unemployment seem rather insensitive to recession. 3. Small but consistent negative effect of neighbourhood unemployment and other work-related disadvantaged on individuals' mental health over life. 4. Youth unemployment becomes embodied as scars of mental ill-health over life. 5. Weak labour market attachment impairs mental health over life. 6. Bidirectional relations between health and weak labour market attachment over life. 7. Macrolevel structures are of importance for how labour market position cause poor health. 8. Unequal gender relations at work impacts negatively on mental health. 9. The agency to improve health over life in dyadic relations. Unemployment in society permeates from the macrolevel into the exolevel, defined by Bronfenbrenner as for example the labour market of parents or partners or the neighbourhood into the settings closest to the individual (the micro- and mesolevel) and affects the relations between the work, family, and leisure spheres of the individual. Neighbourhood unemployment leads to poor health among those who live there, independent of their employment status. Individuals' exposure to unemployment and temporary employment leads to poorer mental health over the life-course. Temporal dimensions were identified and combined with Bronfenbrenner levels into a contextual life-course model CONCLUSION: Combining the ecosocial theory with life-course theories provides a framework for understanding the embodiment of work-related mental health over life. The labour market conditions surrounding the individual are of crucial importance for the embodiment of mental health over life, at the same time as individual agency can be health promoting. Mental health can be improved by societal efforts in regulations of the labour market.

Predictors of cognitive and emotional symptoms 12 months after first-ever mild stroke

Even mild strokes may affect the patients' everyday life by impairing cognitive and emotional functions. Our aim was to study predictors of such impairments one year after first-ever mild stroke. We included cognitively healthy patients ≤ 70 years with acute mild stroke. Vascular risk factors, sociodemographic factors and stroke classifications were recorded. At one-year post-stroke, different domains related to cognitive and emotional function were assessed with validated instruments. Logistic regression analyses were performed to identify predictors of cognitive and emotional outcome. Of 117 patient assessed at follow-up, only 21 patients (18%) scored within the reference range on all cognitive and emotional assessments. Younger age, multiple infarcts, and being outside working life at stroke onset were independent predictors of cognitive impairments (psychomotor speed, attention, executive and visuospatial function, memory). Female gender and a higher National Institutes of Health Stroke Scale (NIHSS) score at discharge were significantly associated with emotional impairments (anxiety, depressive symptoms, fatigue, apathy, emotional lability) after one year, but these associations were only seen in the unadjusted models. In conclusion, patients in working age may profit from a follow-up during the post-stroke period, with extra focus on cognitive and emotional functions.

Unemployment and mental health in a community population from a border city in Mexico

BACKGROUND

The constant changes in the global economy generate instability in the markets, favoring the closing of companies, dismissals of personnel, job losses. Unemployment has been associated with adverse psychological effects, serving as a predictor of poor mental health.

OBJECTIVE

The main goal was to analyze the relation between work status and mental health.

METHODS

A cross-sectional, quantitative study was carried out with a sample of community population, inhabitants of the urban area of a Mexican city. The sample consisted of 1351 participants, being 577 men (43%) and 774 women (57%) with an average age of 41.46 (SD = 17.00). The participants were selected by a quota sampling, in 13 representative points of Matamoros' city urban area. Home surveys were applied; the Spanish version of the Symptom Checklist 90 (SCL-90) was used for mental health assessment.

RESULTS

The model explaining the relation between work status and mental health (GFI) was significant (p < 0.01). Unemployment was related to higher scores in all sub-scales of psychopathologies evaluated by the SCL-90, in comparison with the rest of work status categories.

CONCLUSIONS

The unemployed, followed by housewives, presented indicators of poorer mental health, while the retired and those in strikes or lockouts showed the best mental health indexes.

Health status among NEET adolescents and young adults in the United States, 2016-2018

Adolescents and young adults not employed or in education/training (NEET) could be at higher risk of adverse health outcomes. Approximately 4.6 million Americans aged between 16 and 24 fall in this group. However, differences in health between NEET and non-NEET population remain unaddressed. This study examines the association of NEET status and poor/fair self-reported health status (SRH), among adolescents and young adults in the United States. Data for this study come from the 2016-2018 National Survey on Drug Use and Health (NSDUH). Our analytical sample consisted of 53,690 respondents. We used logistic regression models to investigate the association between NEET and health status in the United States, while controlling for potential covariates. Approximately 14% of our analytical sample was classified as NEET. NEET report poor/fair health status at higher rates than their counterparts who remained in school and/or had a job (11.30% vs. 5.62%). The NEET population was older, had a higher proportion of non-Hispanic Blacks, engaged in more smoking but in less alcohol drinking than non-NEET. In our initial model, NEET were more likely report poor/fair SRH than their non-NEET counterparts (OR = 2.14; p < 0.001). This difference remains strong when demographic and socioeconomic characteristics are accounted for in our empirical models (OR = 1.93, p < 0.001). In our fully specified model, which accounts for health behaviors, NEET continue to have higher odds of reporting poor/fair SRH (OR = 1.77, p < 0.001). Our analyses suggest that NEET populations report worse health than non-NEETs. The health of this population may improve if interventions to reinsert them into either education or employment are effectively deployed.

Location, Location, Location: The Role of Objective Neighborhood Characteristics for Perceptions of Control

INTRODUCTION

Control beliefs can protect against age-related declines in functioning. It is unclear whether neighborhood characteristics shape how much control people perceive over their life. This article studies associations of neighborhood characteristics with control beliefs of residents of a diverse metropolitan area (Berlin, Germany).

METHODS

We combine self-report data about perceptions of control obtained from participants in the Berlin Aging Study II (N = 507, 60-87 years, 51% women) with multisource geo-referenced indicators of neighborhood characteristics using linear regression models.

RESULTS

Findings indicate that objective neighborhood characteristics (i.e., unemployment rate) are indeed tied to perceptions of control, in particular, how much control participants feel others have over their lives. Including neighborhood characteristics in part doubled the amount of explained variance compared with a reference model covarying for demographic characteristics only (from R2 = 0.017 to R2 = 0.030 for internal control beliefs; R2 = 0.056 to R2 = 0.102 for external control beliefs in chance; R2 = 0.006 to R2 = 0.030 for external control beliefs in powerful others).

DISCUSSION/CONCLUSION

Findings highlight the importance of access to neighborhood resources for control beliefs across old age and can inform interventions to build up neighborhood characteristics which might be especially helpful in residential areas with high unemployment.

The interplay of gender, social context, and long-term unemployment effects on subjective health trajectories

Background

While a strong negative impact of unemployment on health has been established, the present research examined the lesser studied interplay of gender, social context and job loss on health trajectories.

Methods

Data from the German Socio-Economic Panel was used, which provided a representative sample of 6838 participants. Using latent growth modelling the effects of gender, social context (East vs. West Germans), unemployment (none, short-term or long-term), and their interactions were examined on health (single item measures of self-rated health and life satisfaction respectively).

Results

Social context in general significantly predicted the trajectories of self-rated health and life satisfaction. Most notably, data analysis revealed that West German women reported significantly lower baseline values of self-rated health following unemployment and did not recover to the levels of their East German counterparts. Only long-term, not short-term unemployment was related to lower baseline values of self-rated health, whereas, in relation to baseline values of life satisfaction, both types of unemployment had a similar negative effect.

Conclusions

In an economic crisis, individuals who already carry a higher burden, and not only those most directly affected economically, may show the greatest health effects.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10324-8.

Consumo de tabaco y condición de empleo en una región del eje cafetero colombiano

Objetivos Estimar la prevalencia del consumo de tabaco en una región del eje cafetero y su asociación con la condición de empleo. Métodos Este estudio fue del tipo corte transversal. Los participantes fueron hombres y mujeres mayores de 15 años residentes de los municipios de Risaralda que aceptaron ser encuestados sobre las características del consumo de tabaco en 2017. Resultados Se evaluaron 4 157 registros de personas y se obtuvo una prevalencia de consumo de tabaco en Risaralda del 11,5%. En subempleados hubo una asociación significativa por fumar (p<0,05) (OR=1,51 IC95%: 1,18-1,94) cuando se ajustó el consumo de cigarrillo por edad y sexo, mientras que en desempleados el odds ratio reportado fue mayor (OR=3,10 IC95%: 2,03-4,73).  Conclusiones Se encontró que el subempleo es un factor de riesgo para el consumo de tabaco que debe ser considerado en el desarrollo de políticas para el control de consumo de tabaco en la región en población vulnerable. La condición de empleo puede explicar las limitaciones de una política de control de consumo de tabaco en la población.

The interplay between national and parental unemployment in relation to adolescent life satisfaction in 27 countries: analyses of repeated cross-sectional school surveys

BACKGROUND

Previous research shows that parental unemployment is associated with low life satisfaction in adolescents. It is unclear whether this translates to an association between national unemployment and adolescent life satisfaction, and whether such a contextual association is entirely explained by parental unemployment, or if it changes as a function thereof. For adults, associations have been shown between unemployment and mental health, including that national unemployment can affect mental health and life satisfaction of both the employed and the unemployed, but to different degrees. The aim of this paper is to analyse how national unemployment levels are related to adolescent life satisfaction, across countries as well as over time within a country, and to what extent and in what ways such an association depends on whether the individual's own parents are unemployed or not.

METHODS

Repeated cross-sectional data on adolescents' (aged 11, 13 and 15 years, n = 386,402) life satisfaction and parental unemployment were collected in the Health Behaviour in School-aged Children (HBSC) survey, in 27 countries and 74 country-years, across 2001/02, 2005/06 and 2009/10 survey cycles. We linked this data to national harmonised unemployment rates provided by OECD and tested their associations using multilevel linear regression, including interaction terms between national and parental unemployment.

RESULTS

Higher national unemployment rates were related to lower adolescent life satisfaction, cross-sectionally between countries but not over time within countries. The verified association was significant for adolescents with and without unemployed parents, but stronger so in adolescents with unemployed fathers or both parents unemployed. Having an unemployed father, mother och both parents was in itself related to lower life satisfaction.

CONCLUSION

Living in a country with higher national unemployment seems to be related to lower adolescent life satisfaction, whether parents are unemployed or not, although stronger among adolescents where the father or both parents are unemployed. However, variation in unemployment over the years did not show an association with adolescent life satisfaction.

Regional employment and individual worklessness during the Great Recession and the health of the working-age population: Cross-national analysis of 16 European countries

Studies from single countries suggest that local labour market conditions, including rates of employment, tend to be associated with the health of the populations residing in those areas, even after adjustment for individual characteristics including employment status. The aim of this study is to strengthen the cross-national evidence base on the influence of regional employment levels and individual worklessness on health during the period of the Great Recession. We investigate whether higher regional employment levels are associated with better health over and above individual level employment. Individual level data (N = 23,078 aged 15–64 years) were taken from 16 countries (Austria, Belgium, Czech Republic, Denmark, Finland, France, Germany, Hungary, Ireland, Netherlands, Norway, Poland, Portugal, Spain, Sweden and United Kingdom) participating in the 2014 European Social Survey. Regional employment rates were extracted from Eurostat, corresponding with the start (2008) and end (2013) of the Great Recession. Health outcomes included self-reported heart or circulation problems, high blood pressure, diabetes, self-rated health, depression, obesity and allergies (as a falsification test). We calculated multilevel Poisson regression models, which included individuals nested within regions, controlling for potential confounding variables and country fixed effects. After adjustment for individual level socio-demographic factors, higher average regional employment rates (from 2008 to 2013) were associated with better health outcomes. Individual level worklessness was associated with worsened health outcomes, most strongly with poor self-rated health. In models including both individual worklessness and the average regional employment rate, regional employment remained associated with heart and circulation problems, depression and obesity. There was evidence of an interaction between individual worklessness and regional employment for poor self-rated health and depression. The findings suggest that across 16 European countries, for some key outcomes, higher levels of employment in the regional labour market may be beneficial for the health of the local population.

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Few cross-national studies have examined regional employment and health.

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High regional employment is related to reduced risk of poor health.

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Regional employment moderates the impact of individual worklessness on some outcomes.

From the dark end of the street to the bright side of the road: Automated redistricting of areas using physical barriers as dividers of social space

This study examines the properties of administrative areas compared to a new method of automated redistricting when measuring social differentiation and segregation. Using physical barriers, such as roads, railways, streams, areas of uninhabited nature, and the like as dividers of social space, this study explores alternative ways of thinking social belonging and social cohesion that are beyond standard measures of geography and utilize areas of smaller size and population count. The geographical data are linked to Danish register data of the total Danish population in 2015, N = 4,986,125 on key variables of income, months of completed education, and ethnicity. The overall findings in this study suggest that rethinking geography when localizing social enclaves and segregated communities yields better results than using the more illogical administrative areas. The visual inspection, entropy levels of homogeneity, and intraclass correlation suggest that smaller areas that are divided by physical objects serve as a better reservoir of social cohesion and therefore better measurement of social inequality.