Do Generous Unemployment Benefit Programs Reduce Suicide Rates? A State Fixed-Effect Analysis Covering 1968–2008

Abstract

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (β = -0.57, 95% confidence interval: -0.86, -0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude.

Unemployment Insurance and Physical Activity

“…Eligibility to receive benefits, as well as the amount of benefits received, is determined based on a worker's career, salary, and reason for job loss; each of these factors is plausibly an independent predictor of health behaviors. Cylus et al provide convincing 'quasi-experimental' evidence that the level of UI generosity can play an important role in health; exploiting variation across states and time in the maximum allowable state UI benefit level, the authors find that more generous UI benefit programs reduce the likelihood of poor self-assessed health among the unemployed (Cylus, Glymour et al 2015) and slightly moderate the effect of unemployment rates on suicides (Cylus, Glymour et al 2014). However whether the health effects of UI are driven by changes in income, leisure time, or a combination remains unclear.…”

Invited Commentary: Are There Unrealized Benefits of Unemployment Insurance Among the Employed?

“…In addition, the fitted model of Cylus et al's Figure 2 shows that, below an unemployment rate of 4.9%, suicide mortality is predicted to be lower in states with less generous UI benefits (2). If I interpret this figure correctly, generous UI benefits have a perverse effect on suicide in most years (i.e., in 38 of the 50 states in an average year, based on the mean unemployment rates shown in Cylus et al's Table 1 (2)).…”

“…In this issue of the Journal, Cylus et al (2) follow in the "economy and health" tradition by examining the relationship between unemployment rates and suicide mortality. Whereas research on this topic holds over a 100-year history, Cylus et al offer a novel contribution: They examine whether the generosity of a state's unemployment insurance (UI) benefits attenuates the relationship between economic downturns and suicide mortality in the United States.…”

Challenges to an integrated population health research agenda: Targets, scale, tradeoffs and timing

“…As one moves towards interventions that are either more temporally or causally distal from individual health outcomes, it can be more challenging to provide rigorous evidence of causal impact. However, quasi-experimentsdfor example, using comparisons across places that have different policies or that have implemented policies at different points in timedcan provide important effectiveness evidence (Almond et al, 2011;Avendano et al, 2015;Case, 2004;Cylus et al, 2014;Glymour et al, 2008;Hoynes et al, 2015;Rossin, 2011).…”