Unemployment-related lifestyle changes and health disturbances in adolescents and children in the western countries

According to official statistics 11 million under 25's, thereof 5-6 million under 20's in the 12 OECD member states are unemployed at any given time. In depth studies show that this figure is at least 40-50% higher. In many countries a systematic under-reporting exists in the registration of unemployed. Surveys used to show more relevant figures. Unemployment hits mainly adolescents, school leavers, young adults (unskilled male and female) immigrants and then, indirectly, those who are in need of familial and social support, i.e. the frail, sick, disabled children and old people. In many cities in Europe 40-50% of 18-25 year olds are unemployed and figures as high as 90% have been reported (inner cities). Unemployment is endangering the socio-economic status of people, in spite of short-time unemployment benefits and is creating inequalities in health and serious social misfits. Loss of job or the mere prospect of becoming jobless have, in follow-up studies on an individual level, been found to cause elevated blood pressure and serum cholesterol, increased concentration of blood catecholamine and elimination of noradrenaline, an increase in the frequency of stress and psychosomatic diseases. After regaining employment, these values have normalized. Unemployment is therefore considered by many as a real source of stress. Chronic stress is now considered as a major contributor to cardiovascular diseases, ulcers, asthma and some other diseases. According to several well designed and controlled studies on the individual level in the developed countries, the majority of young people do not learn to cope with unemployment. It fosters isolation, loss of self-esteem, frustration and hopelessness. Many of the unemployed school leavers differ markedly from others in their health habits, and are more prone to a destructive lifestyle such as drug, tobacco and alcohol abuse. They even respond less to health promotion, family planning, hygienic and nutritional programmes. Once employed or re-employed, a dramatic improvement has been seen to occur. Children and members of families of the unemployed are the silent sufferers--they are never registered. Valid surveys show that they do suffer from various somatic and psychosomatic disorders. They take a less active part in various health education promotion programmes and have a much higher admission rate to hospitals than children of employed families. Without doubt, unemployment is a direct or indirect cause of their suffering. According to several well defined prospective, controlled studies on an individual level from the U.S.A., Sweden and the U.K., a significantly higher prevalence of mental disorders has been found in the unemployed compared to the employed population. It was also found that there are higher admission rates to mental hospitals, (para)suicides and depression and even elevated doctors' visits and sick-leave rates. On the other hand, the sick are more prone to be unemployed than the healthy. WHO has taken a leading role in fighting ill-health not least if caused by faulty lifestyle; smoking, alcohol, drug abuse, unhealthy nutrition and many of the 'Western hazards' of life which are more or less self-inflicted. A child born into a family facing unemployment or an adolescent who is him/herself hit by long-term unemployment has a reduced chance of creating a healthy and meaningful life. In that case their ill-health cannot be labelled self-inflicted.