Unemployment is strongly associated with mortality on the individual level. The reasons for this association are not fully established. The authors estimated the effects of unemployment and workplace downsizing on mortality during periods of low (1989) and high (1994) unemployment in Finland. They used prospective population registration data containing detailed socioeconomic and demographic information on two cohorts aged 35-64 years at the beginning of 1989 (N = 87,317) and 1994 (N = 72,419) followed up for mortality in 1990-1997 and 1995-2002, respectively. Unemployment was found to be associated with a 2.38-fold increase in the hazard of mortality after 1989 and with a 1.25-fold increase after 1994. No excess mortality was observed among those who, at baseline, were employed at workplaces that had experienced large reductions in employment. Furthermore, the association between unemployment and mortality was weaker among those working in establishments that had been strongly downsized. By showing that, in the context of either a high level of unemployment or rapid downsizing, the effects of unemployment on mortality are modest, this study provides strong evidence of unaccounted confounding. Individual-level studies may thus overestimate the causal effects of unemployment on mortality.

No abstract

Long-term unemployment seems to have causal effects on suicide, which may be partly mediated by low income. As the effect of unstable employment is lower during the recessionary stage of the economic cycle some part of the excess suicide among the unstably employed is likely to be attributable to selection into unemployment.

Martikainen, P., Ma¨ki, N., and Blomgren, J., 2004, The effects of area and individual social characteristics on suicide risk: A multilevel study of relative contribution and effect modification, European Journal of Population, 20: 323-350.Abstract. The aim of this study is to analyse how area characteristics affect suicide mortality and to assess whether the effects of individual socio-economic characteristics vary in socioeconomically different areas. Data come from the 1990 census records of 15-99-year-old Finns linked to death records in 1991-2001 including 13,589 suicides. Area characteristics were obtained for 85 functional regions. We show that hypotheses of interaction between individual and area socio-economic status for suicide mortality are not supported. However, area socioeconomic characteristics, family cohesion and voting turnout are consistently related to suicide. The effects of median income and income inequality are less consistent. Adjusting for individual level variables partly attenuate these associations. The results indicate that improving the areas people live in may prevent suicide. Martikainen, P., Ma¨ki, N., et Blomgren, J., 2004, Effets des caracte´ristiques sociales re´gionales et individuelles sur le risque de suicide : une e´tude multiniveau de leur contribution relative et de leur prise en compte, Revue Europe´enne de De´mographie, 20: 323-350. Re´sume´. Dans cette e´tude, nous analysons comment les caracte´ristiques locales pe`sent sur la mortalite´par suicide et comment les effets des caracte´ristiques socio-e´conomiques des individus varient en fonction des diffe´rentes re´gions. Pour ce faire, les de´ce`s enregistre´s en Finlande entre 1991 et 2001, dont 13 589 suicides, ont e´te´couple´s aux enregistrements individuels du recensement de 1990, pour les personnes de 15 a`99 ans. Les caracte´ristiques locales concernent 85 re´gions. L'hypothe`se de l'existence d'une interaction entre le statut socio-e´conomique de la re´gion et celui de l'individu n'est pas confirme´e. Cependant, certaines caracte´ristiques socio-e´conomiques de la re´gion, ainsi que la cohe´sion familiale et la European Journal of Population (2004) 20: 323-350 323participation e´lectorale, sont nettement associe´es au suicide. Les effets du revenu me´dian et des ine´galite´s de revenus sont moins nets. Ces relations sont atte´nue´es si l'on controˆle les variables individuelles. Les re´sultats montrent que l'ame´lioration globale de la situation socio-e´conomique des re´gions peut avoir un effet pre´ventif sur le suicide des individus qui y vivent.

This study analyses occupational class inequalities in all-cause mortality and four specific causes of death among men, in Europe in the early 2000s, and is the most extensive comparative analysis of occupational class inequalities in mortality in Europe so far. Longitudinal data, obtained from population censuses and mortality registries in 14 European populations, from around the period 2000–2005, were used. Analyses concerned men aged 30–59 years and included all-cause mortality and mortality from all cancers, all cardiovascular diseases (CVD), all external, and all other causes. Occupational class was analysed according to five categories: upper and lower non-manual workers, skilled and unskilled manual workers, and farmers and self-employed combined. Inequalities were quantified with mortality rate ratios, rate differences, and population attributable fractions (PAF). Relative and absolute inequalities in all-cause mortality were more pronounced in Finland, Denmark, France, and Lithuania than in other populations, and the same countries (except France) also had the highest PAF values for all-cause mortality. The main contributing causes to these larger inequalities differed strongly between countries (e.g., cancer in France, all other causes in Denmark). Relative and absolute inequalities in CVD mortality were markedly lower in Southern European populations. We conclude that relative and absolute occupational class differences in all-cause and cause specific mortality have persisted into the early 2000's, although the magnitude differs strongly between populations. Comparisons with previous studies suggest that the relative gap in mortality between occupational classes has further widened in some Northern and Western European populations.