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The length of unemployment predicts mortality, differently in men and women, and by cause of death: A six year mortality follow-up of the Swedish 1992–1996 recession


  • Garcy, Anthony M.
  • Vågerö, Denny


This study examines the relationship between the total amount of accumulated unemployment during the deep Swedish recession of 1992–1996 and mortality in the following 6 years. Nearly 3.4 million Swedish men and women, born between 1931 and 1965 who were gainfully employed at the time of the 1990 census were included. Almost 23% of these individuals were unemployed at some point during the recession. We conduct a prospective cohort study utilizing Cox proportional hazard regression with a mortality follow-up from January 1997 to December 2002. We adjust for health status (1982–1991), baseline (1991) social, family, and employer characteristics of individuals before the recession. The findings suggest that long-term unemployment is related to elevated all-cause mortality for men and women. The excess mortality effects were small for women and attributable to a positive, linear increase in the hazard of alcohol disease-related mortality and external causes-of-death not classified as suicides or transport accidents. For men, the excess hazard of all-cause mortality was best represented by a cubic, non-linear shape. The predicted hazard increases rapidly with the shortest and longest accumulated levels of unemployment. However, the underlying pattern differed by cause-of-death. The cancer, circulatory, and alcohol disease-related analyses suggest that mortality peaks with mid-levels of accumulated unemployment and then declines with longer duration unemployment. For men, we observed a positive, linear increase in the hazard ratios associated with transport and suicide mortality, and a very steep non-linear increase in the excess hazard ratio associated with other external causes of death that were not classified as suicide or transport accidents. In conclusion, mortality risk increases with the duration of unemployment among men and women. This was best described by a cubic function for men and a linear function for women. Behind this pattern, different causes-of-death varied in their relation to the accumulation of unemployment.

Suggested Citation

  • Garcy, Anthony M. & Vågerö, Denny, 2012. "The length of unemployment predicts mortality, differently in men and women, and by cause of death: A six year mortality follow-up of the Swedish 1992–1996 recession," Social Science & Medicine, Elsevier, vol. 74(12), pages 1911-1920.
  • Handle: RePEc:eee:socmed:v:74:y:2012:i:12:p:1911-1920
    DOI: 10.1016/j.socscimed.2012.01.034

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    References listed on IDEAS

    1. Ruhm, Christopher J, 1991. "Are Workers Permanently Scarred by Job Displacements?," American Economic Review, American Economic Association, vol. 81(1), pages 319-324, March.
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    3. Stewart, Jennifer M., 2001. "The impact of health status on the duration of unemployment spells and the implications for studies of the impact of unemployment on health status," Journal of Health Economics, Elsevier, vol. 20(5), pages 781-796, September.
    4. Mossakowski, Krysia N., 2008. "Is the duration of poverty and unemployment a risk factor for heavy drinking?," Social Science & Medicine, Elsevier, vol. 67(6), pages 947-955, September.
    5. Gerdtham, Ulf-G. & Johannesson, Magnus, 2003. "A note on the effect of unemployment on mortality," Journal of Health Economics, Elsevier, vol. 22(3), pages 505-518, May.
    6. Christopher J. Ruhm, 2000. "Are Recessions Good for Your Health?," The Quarterly Journal of Economics, Oxford University Press, vol. 115(2), pages 617-650.
    7. Marcus Eliason & Donald Storrie, 2009. "Does Job Loss Shorten Life?," Journal of Human Resources, University of Wisconsin Press, vol. 44(2).
    8. Daniel Sullivan & Till von Wachter, 2009. "Job Displacement and Mortality: An Analysis Using Administrative Data," The Quarterly Journal of Economics, Oxford University Press, vol. 124(3), pages 1265-1306.
    9. Stefansson, Claes-Göran, 1991. "Long-term unemployment and mortality in Sweden, 1980-1986," Social Science & Medicine, Elsevier, vol. 32(4), pages 419-423, January.
    10. Kate Strully, 2009. "Job loss and health in the U.S. labor market," Demography, Springer;Population Association of America (PAA), vol. 46(2), pages 221-246, May.
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    Cited by:

    1. de Goeij, Moniek C.M. & Suhrcke, Marc & Toffolutti, Veronica & van de Mheen, Dike & Schoenmakers, Tim M. & Kunst, Anton E., 2015. "How economic crises affect alcohol consumption and alcohol-related health problems: A realist systematic review," Social Science & Medicine, Elsevier, vol. 131(C), pages 131-146.
    2. repec:spr:ijphth:v:62:y:2017:i:5:d:10.1007_s00038-016-0936-3 is not listed on IDEAS
    3. Bonamore, Giorgio & Carmignani, Fabrizio & Colombo, Emilio, 2015. "Addressing the unemployment–mortality conundrum: Non-linearity is the answer," Social Science & Medicine, Elsevier, vol. 126(C), pages 67-72.
    4. Lawrence Pellegrini & Rosa Rodriguez-Monguio & Jing Qian, 2014. "The US healthcare workforce and the labor market effect on healthcare spending and health outcomes," International Journal of Health Economics and Management, Springer, vol. 14(2), pages 127-141, June.
    5. repec:spr:soinre:v:133:y:2017:i:2:d:10.1007_s11205-016-1384-4 is not listed on IDEAS
    6. Nikolaos Antonakakis & Rangan Gupta, 2017. "Is Economic Policy Uncertainty Related to Suicide Rates? Evidence from the United States," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 133(2), pages 543-560, September.
    7. Reeves, Aaron & Karanikolos, Marina & Mackenbach, Johan & McKee, Martin & Stuckler, David, 2014. "Do employment protection policies reduce the relative disadvantage in the labour market experienced by unhealthy people? A natural experiment created by the Great Recession in Europe," Social Science & Medicine, Elsevier, vol. 121(C), pages 98-108.


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