Exercise,physical activity,and exertion over the business cycle

Shifts in time and income constraints over economic expansions and contractions would be expected to affect individuals' behaviors. We explore the impact of the business cycle on individuals' exercise, time use, and total physical exertion, utilizing information on 112,000 individual records from the 2003–2010 American Time Use Surveys. In doing so, we test a key causal link that has been hypothesized in the relation between unemployment and health, but not heretofore assessed. Using more precise measures of exercise (and other activities) than previous studies, we find that as work-time decreases during a recession, recreational exercise, TV-watching, sleeping, childcare, and housework increase. This, however, does not compensate for the decrease in work-related exertion due to job-loss, and total physical exertion declines. These effects are strongest among low-educated men, which is validating given that employment in the Great Recession has declined most within manufacturing, mining, and construction. We also find evidence of intra-household spillover effects, wherein individuals respond to shifts in spousal employment conditional on their own labor supply. The decrease in total physical activity during recessions is especially problematic for vulnerable populations concentrated in boom-and-bust industries, and may have longer-term effects on obesity and related health outcomes.     

Hearing loss and paid employment: Australian population survey findings

This paper provides an analysis of participation in paid employment for people with a hearing loss over the full span of adult ages. The paper is based on original analysis of the 2003 Australian survey of disability, aging and carers (SDAC). This analysis shows that hearing loss was associated with an increased rate of non-participation in employment of between 11.3% and 16.6%. Advancing age and the existence of co-morbidities contribute significantly to reduced participation in employment. A disproportionate impact is evident for women and for those having low education and communication difficulties. Controlling for co-morbidities, hearing loss was associated with a 2.1% increase of non-participation in employment, a proportional difference of 1.4 times the population. People with hearing loss were less likely to be found in highly skilled jobs and were over-represented among low income earners. The SDAC data set provides self-report findings on the experience of disability rather than hearing impairment. As such, these findings serve as a conservative estimate of the impact of hearing loss on accessing well-paid employment.     

Unemployment,employment precarity,and inflammation

Unemployment has been associated with poorer health, but few studies have examined the biological mechanisms that confer these health decrements. Further, no studies to date have examined differences across employment groups to consider whether employment (in whatever means) is preferential in terms of health. The present study utilised secondary data from Understanding Society: The Household Longitudinal Survey during the aftermath of the recent global recession. Two markers of peripheral inflammation: C-reactive protein (CRP) and fibrinogen were assessed across employment groups (unemployed; permanent, temporary, and self-employed), controlling for individual, socio-demographic and health variables to give greater context to our understanding of how employment status influences health. After controlling for relevant confounds, unemployment was associated with higher levels of fibrinogen but not CRP. Subsequent analyses of employment subgroup revealed the temporary employed have similar levels of fibrinogen to the unemployed, and may therefore be at a similar health disadvantage. The findings confirm that unemployment is associated with increases in one marker of peripheral inflammation, but that this health protection is not conferred to those in precarious employment.     

Being out of Work and Health among Younger Japanese Men: A Panel Data Analysis

This paper examines the effect of being out of work, which is in a broader category of unemployment, on the physical and mental health of younger Japanese men using panel data. A fixed effects model, widely used to control for unobserved individual heterogeneity in panel data analysis, was used for this analysis. Using the first through the fifth waves of the Japanese Life Course Panel Survey, the first wave of which was conducted with people aged 20–40 yrs in 2007, it is found that being out of work has no observable effect on self-assessed physical health. However, being out of work has a negative effect on mental health as measured by the five-item version of the Mental Health Inventory. It is difficult to clearly distinguish the direction of causality even after controlling for individual heterogeneity that is constant over time. An analysis was done with a sub-sample to mitigate a possible reverse causality. The results consistently show that being out of work has a negative effect on mental health.     

Returning the chronically unemployed with low back pain to employment.

Much of the research into return to work following rehabilitation for low back pain in the literature reflects work done in those employed. Unemployment is a consequence of chronic low back pain which has considerable health and economic consequences for the individual and society. This paper describes an occupationally orientated rehabilitation programme for long-term unemployed people (mean duration of unemployment 38.9 months). The aim of the project was to identify factors which predict return to work and progress towards employment. Eight six subjects underwent a pain management rehabilitation programme incorporating vocational focussing and advice, subjects were followed up at 6 months to determine work status. At follow-up 38.4% of subjects were employed and another 23% were in voluntary work, or education/training. There were no significant differences on presenting characteristics between those who returned to work and those who did not. Subjects were divided into those who made positive progress (work, education/training or voluntary work) and those who did not (remained unemployed, dropped out of the programme or lost to follow up). Those who failed to make positive progress were characterised by longer duration of unemployment and higher scores on somatic anxiety and depression. A predictive model was able to identify 80% of those who failed to make progress but prediction of those achieving a positive outcome was poor (44% correct prediction). The factors predicting return to work in unemployed people with low back pain differs from the employed, the need for employment skills training and a vocational focus to rehabilitation are highlighted.     

Mortality and the business cycle: Evidence from individual and aggregated data

There has been much interest recently in the relationship between economic conditions and mortality, with some studies showing that mortality is pro-cyclical, while others find the opposite. Some suggest that the aggregation level of analysis (e.g. individual vs. regional) matters. We use both individual and aggregated data on a sample of 20–64 year-old Swedish men from 1993 to 2007. Our results show that the association between the business cycle and mortality does not depend on the level of analysis: the sign and magnitude of the parameter estimates are similar at the individual level and the aggregate (county) level; both showing pro-cyclical mortality.     

Measuring Outcome in Psychogenic Nonepileptic Seizures: How Relevant Is Seizure Remission?

PURPOSE: To examine whether seizure remission is a comprehensive marker of outcome in psychogenic nonepileptic seizures (PNESs). METHODS: A postal questionnaire was returned by 147 patients with PNESs a mean of 4.2 years after diagnosis (mean age at follow-up, 38.1 years). The proportion of patients who were "unproductive" (receiving health-related state benefits) at follow-up was determined, with a comparison of markers of ongoing psychopathology (Global Severity Index, anxiety and depression scores of the Symptom Checklist 90, Somatization Index DSM of the SOMS-2) in three outcome groups: group 1, continuing seizures; group 2, seizures stopped but patients "unproductive;" and group 3, seizures stopped, patients "productive." RESULTS: Of the patients, 71.4% continued to have seizures, and 28.6% had achieved seizure remission; 60.0% of patients with continuing seizures and 42.7% of patients in remission were "unproductive" (difference, NS). Ongoing psychopathology was related to the factor "group membership" with higher values in groups 2 and 3 than in group 1 (GSI, p < 0.001; anxiety, p = 0.01; depression, p = 0.02; Somatization Index DSM, p < 0.001). Across all patients and in the subgroup with PNESs and additional epilepsy, differences were significant only between groups 2 and 3, not between groups 1 and 2. In patients with PNESs alone, differences were significant only between groups 1 and 2. CONCLUSIONS: Seizure remission is not a comprehensive measure of good medical or psychosocial outcome in PNESs. Nearly half the patients who become seizure free remain unproductive. Many of these patients continue to report symptoms of psychopathology. Seizure control should not be the only focus of treatment in clinical practice or outcome observation in research studies.     

Living conditions,inequalities in health,human rights and security: A European perspective in a global context

This paper examines the living conditions and inequalities affecting health, human rights and security in developed Western countries. Possible remedies based on experience in Sandwell Health District, West Midlands, are considered and analogies drawn with global initiatives.     

The impact of unemployment on school leavers’ perception of health. Mediating effect of financial situation and social contacts?

Summary Objectives: The main purpose of this paper is to explore whether unemployment influences adolescents’ subjective perception of health and whether perceived financial stress and social contacts can mediate the effect of employment status on health. We are also interested in the differences in financial situation and social contacts between unemployed secondary school leavers and their employed and studying counterparts. Methods: Data were obtained from 844 adolescents (mean age 19.6) from Slovakia. The effect of unemployment on several health indicators was measured and subsequently controlled for perceived financial strain of respondents and their social contacts. Results: The results showed highest financial strain among unemployed, whereas only small differences in social contacts were found between three groups. Negative influence of unemployment on perceived health of respondents was confirmed. Nevertheless, strong influence was found only on long-term well-being and mental health. Financial situation and social contacts contributed to the prediction of almost all health outcomes, and to some extent mediated the effect of unemployment. Conclusions: Although unemployment was found to have a negative impact on health of adolescents, sufficiency of social contacts and good financial situation seem to decrease this effect and protect the health of unemployed people. Submitted: 22 May 2006; Revised: 16 February 2007; Accepted: 27 February 2007