Unemployment and health impairments: Longitudinal analyses for the Federal Republic of Germany

In recent years many studies of unemployment and health haveshown that unemployed persons are in poorer health. However,one question remained unanswered: is the poorer health of theunemployed caused by unemployment Itself (causation hypotheses)or is it a result of selection processes, whereby people inpoor health are more likely to lose their job and less likelyto be re-employed (selection hypothesis)? Findings from a studybased on the longitudinal data of the German Socio-economicPanel (1984–1988, N=5, 516 persons, 18–64 years)are presented. All health indicators (health satisfaction, chronicillness, handicaps in fulfilling daily life tasks, disability)showed poorer outcomes for the unemployed persons, even aftercontrolling for the possible confounding effects of sodo-demographicvariables. Unemployed persons also consulted a physician morefrequently and were hospitalized more often. But longitudinalanalyses (of becoming unemployed and of re-employment) did notlend much support to the causation hypothesis. Instead, a constantlevel of health satisfaction for persons losing their job andfor the re-employed compared to their initial ratings supportedthe selection hypotheses. This means that in the Federal Republicof Germany persons in poorer health are more likely to losetheir jobs and persons in better health are more likely to bere-employed.     

The impact of anticipation of job loss on psychological distress and worksite blood pressure.

The impact of occupational stressful life events on psychological distress and blood pressure was examined among employees of a major New York City brokerage firm undergoing massive layoffs. One hundred thirty-nine employees of the firm, who had participated in a blood pressure screening in 1986, were rescreened during the period of layoffs within their company in 1989. About two-thirds of the 139 employees reported being "somewhat" or "very" anxious or upset in 1989 during the period of layoffs, and psychological distress was significantly elevated among those employees reporting possible or definite layoff or job change and/or difficulty in obtaining a comparable job. However, we found no increase in overall blood pressure level, and no effect of anticipation of job loss on 1989 blood pressure when controlling for 1986 blood pressure level, age, body mass index, work hours, and other demographic variables. On the other hand, employment in a department sold to another employer on the day of screening, as well as employment in a clerical job title, were both associated with significant increases in diastolic blood pressure of about 5 mm Hg.     

Seelische Gesundheit und Erwerbslosigkeit

Meta-analyses show stronger mental impairments for unemployed compared to employed persons (McKee-Ryan et al., 2005, Murphy und Athanasou, 1999, Paul und Moser, 2009a). There is evidence for two processes: firstly, health-related constraints complicate the professional (re-)entry due to selection effects. On the other hand, unemployment causes negative psychological symptoms (causation effects). The causative effects are stronger.     

Association of current employment status with oral health‐related behaviors: findings from the Finnish Health 2000 Survey

The aim of this study was to compare the oral health‐related behaviors of unemployed people with those of employed people and to assess whether they differ according to the length of unemployment. This study is part of the Health 2000 Survey in Finland. The cross‐sectional data were based on interviews and questionnaires. The present study comprised dentate participants, 30–63 yr of age (n = 4,670). Current employment status (employed vs. unemployed) and length of current unemployment (≤1, >1–2, >2–5, and >5 yr) were used as exposures. Binary logistic regression models were fitted separately for the oral health‐related behaviors, and latent class analysis (LCA) was used to form behavioral clusters. Current unemployment and being unemployed for longer than 5 yr were inversely associated with regular use of dental services. Current unemployment indicated non‐regular dental attendance, infrequent use of xylitol, daily smoking, and risky use of alcohol. Findings from the LCA supported the assumption that unemployed people could be considered as a risk group for poor oral health‐related behaviors.     

The Impact of the Macroeconomy on Health Insurance Coverage: Evidence from the Great Recession

This paper investigates the impact of the macroeconomy on the health insurance coverage of Americans using panel data from the Survey of Income and Program Participation for 2004–2010, a period that includes the Great Recession of 2007–2009. We find that a one percentage point increase in the state unemployment rate is associated with a 1.67 percentage point (2.12%) reduction in the probability that men have health insurance; this effect is strongest among college‐educated, white, and older (50–64 years old) men. For women and children, health insurance coverage is not significantly correlated with the unemployment rate, which may be the result of public health insurance acting as a social safety net. Compared with the previous recession, the health insurance coverage of men is more sensitive to the unemployment rate, which may be due to the nature of the Great Recession. Copyright © 2013 John Wiley & Sons, Ltd.     

Vocational Rehabilitation in Spinal Cord Injury: What Vocational Service Activities Are Associated with Employment Program Outcome?

Background:

Designing effective vocational programs for persons with spinal cord injury (SCI) is essential for improving return to work outcome following injury. The relationship between specific vocational services and positive employment outcome has not been empirically studied.

Objective:

To examine the association of specific vocational service activities as predictors of employment.

Method:

Secondary analysis of a randomized, controlled trial of evidence-based supported employment (EBSE) with 12-month follow-up data among 81 Veteran participants with SCI.

Results:

Primary activities recorded were vocational counseling (23.9%) and vocational case management (23.8%). As expected, job development and employment supports were the most time-consuming activities per appointment. Though the amount of time spent in weekly appointments did not differ by employment outcome, participants obtaining competitive employment averaged significantly more individual activities per appointment. Further, for these participants, job development or placement and employment follow-along or supports were more likely to occur and vocational counseling was less likely to occur. Community-based employment services, including job development or placement and employment follow-along or supports as part of a supported employment model, were associated with competitive employment outcomes. Office-based vocational counseling services, which are common to general models of vocational rehabilitation, were associated with a lack of employment.

Conclusions:

Vocational services that actively engage Veterans with SCI in job seeking and acquisition and that provide on-the-job support are more likely to lead to employment than general vocational counseling that involves only job preparation.     

Does the legalization of medical marijuana increase completed suicide?

Introduction: Suicide is among the 10 most common causes of death in the United States. Researchers have identified a number of factors associated with completed suicide, including marijuana use, and increased land elevation. Colorado is an ideal state to test the strength of these associations. The state has a completed suicide rate well above the national average and over the past 15 years has permitted first the medical and, as 2014, the recreational use of marijuana. Objectives: To determine if there is a correlation between medical marijuana use, as assessed by the number of medical marijuana registrants and completed suicides per county in Colorado. Methods: The number of medical marijuana registrants was used as a proxy for marijuana use. Analysis variables included total medical marijuana registrants, medical marijuana dispensaries per county, total suicide deaths, mechanism of suicide death, gender, total suicide hospitalizations, total unemployment, and county-level information such as mean elevation and whether the county was urban or rural. Analysis was performed with mixed model Poisson regression using generalized linear modeling techniques. Results: We found no consistent association between the number of marijuana registrants and completed suicide after controlling for multiple known risk factors for completed suicide. Conclusion: The legalization of medical marijuana may not have an adverse impact on suicide rates. Given the concern for the increased use of marijuana after its legalization, our negative findings provide some reassurance. However, this conclusion needs to be examined in light of the limitations of our study and may not be generalizable to those with existing severe mental illness. This finding may have significant public health implications for the presumable increase in marijuana use that may follow legalization.     

Out of sight but not out of mind: Home countries' macroeconomic volatilities and immigrants' mental health

We provide the first empirical evidence that better economic performances by immigrants' countries of origin, as measured by lower consumer price index (CPI) or higher gross domestic product, improve immigrants' mental health. We use an econometrically‐robust approach that exploits exogenous changes in macroeconomic conditions across immigrants' home countries over time and controls for immigrants' observable and unobservable characteristics. The CPI effect is statistically significant and sizeable. Furthermore, the CPI effect diminishes as the time since emigrating increases. By contrast, home countries' unemployment rates and exchange rate fluctuations have no impact on immigrants' mental health.