The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain

Thumbnail Image
Full text at PDC
Publication Date
Advisors (or tutors)
Journal Title
Journal ISSN
Volume Title
Springer Verlag
Google Scholar
Research Projects
Organizational Units
Journal Issue
To estimate the impact of (particularly longterm) unemployment on the overall and mental health of the Spanish working-age population and to check whether the effects of unemployment on health have increased or been tempered as a consequence of the economic crisis. Methods We apply a matching technique to cross-sectional microdata from the Spanish Health Survey for the years 2006 and 2011–2012 to estimate the average treatment effect of unemployment on self-assessed health (SAH) in the last year, mental problems in the last year and on the mental health risk in the short term. We also use a differences-in-differences estimation method between the two periods to check if the impact of unemployment on health depends on the economic context.
Brenner, M.H., Mooney, A.: Unemployment and Health in the context of economic change. Soc. Sci. Med. 17(16), 1125–1138 (1983) Ruhm, C.J.: Macroeconomic Conditions, Health and Mortality. NBER Working Paper No. 11007 (2004) Stuckler, D., Basu, S., Suhrcke, M., Coutts, A., McKee, M.: The public health effect of economic crises and alternative policy responses in Europe: an empirical analysis. Lancet 374, 315–323 (2009) CSDH: Closing the Gap in a Generation: Health Equity Through Action on the Social Determinants of Health. Final report of the Commission on Social Determinants of Health. World Health Organization, Geneva (2008) Ruhm, C.J.: Are recessions good for your health? Q. J. Econ. 115(2), 617–650 (2000) Gerdtham, U.G., Ruhm, C.J.: Deaths rise in good economic times: evidence from the OECD. Econ. Hum. Biol. 4(3), 298–316 (2006) Egan, M.L., Mulligan, C.B., Philipson, T.J.: Adjusting Measures of Economic Output for Health: Is the Business Cycle Countercyclical? NBER Working Paper No. 19058 (2013) Neumayer, E.: Recessions lower (some) mortality rates: evidence from Germany. Soc. Sci. Med. 58(6), 1037–1047 (2004) Buchmueller, T., Grignon, M., Jusot, F.: Unemployment and Mortality in France, 1982–2002. CHEPA Working Paper 07-04 (2007) Ross, C., Mirowsky, J.: Does employment affect health? J. Health Soc. Behav. 36, 230–243 (1995) Dooley, D., Fielding, J., Levi, L.: Health and unemployment. Annu. Rev. Public Health 17, 949–965 (1996) Platt, S., Pavis, S., Akram, G.: Changing labour market conditions and health: a systematic literature review (1993–98). In: Research Unit in Health and Behavioural Change. University of Edinburgh Medical School, Edinburgh (1999) Kasl, S., Jones, B.: The impact of job loss and retirement on health. In: Berkman, L., Kawachi, I. (eds.) Social Epidemiology, pp. 118–136. Oxford University Press, Oxford (2000) Darmon, N., Drewnowski, A.: Does social class predict diet quality? Am. J. Clin. Nutr. 87(5), 1107–1117 (2008) Mossakowski, K.N.: Is the duration of poverty and unemployment a risk factor for heavy drinking? Soc. Sci. Med. 67, 947–955 (2008) Fagan, P., Shavers, V., Lawrence, D., Gibson, J.T., Ponder, P.: Cigarette smoking and quitting behaviors among unemployed adults in the United States. Nicotine Tob. Res. 9(2), 241–248 (2007) Grayson, J.P.: Health, physical activity level, and employment status in Canada. Int. J. Health Serv. 23(4), 743–761 (1993) World Bank: Averting A Human Crisis During the Global Downturn. World Bank, Washington (2009) Dávila, C.D., González, B.: Crisis económica y salud. Gac. Sanit. 23, 261–265 (2009) Catalano, R., Dooley, D., Rook, K.: A test of reciprocal risk between undesirable economic and noneconomic life events. Am. J. Community Psychol. 15, 633–651 (1987) Artazcoz, L., Benach, J., Borrell, C., Cortés, I.: Unemployment and mental health: understanding the interactions among gender, family roles, and social class. Am. J. Public Health 94(1), 82–88 (2004) Vinokur, A.D., Price, R.H., Caplan, R.D.: Hard times and hurtful partners: how financial strain affects depression and relationship satisfaction of unemployed persons and their spouses. J. Pers. Soc. Psychol. 71, 166–179 (1996) Paul, K.I., Moser, K.: Unemployment impairs mental health: meta-analyses. J. Vocat. Behav. 74, 264–282 (2009) Goldman-Mellor, S.J., Saxton, K.B., Catalano, R.C.: Economic contraction and mental health. A review of the evidence, 1990–2009. Int. J. Ment. Health 39(2), 6–31 (2010) Pharr, J.R., Moonie, S., Bungum, T.J.: The impact of unemployment on mental and physical health, access to health care and health risk behaviors. ISRN Public Health (2012). doi:10.5402/2012/483432 Laufey, T., Corman, H., Noonan, K. et al.: Are Recessions Good for Your Health Behaviors? Impacts of the Economic Crisis in Iceland. NBER Working Paper 18233 (2012) Jenkinson, C.E., Dickens, A.P., Jones, K., Thompson-Coon, J., Taylor, R.S., Rogers, M., et al.: Is volunteering a public health intervention? A systematic review and meta-analysis of the health and survival of volunteers. BMC Public Health 13, 773 (2013) Boone, J., van Ours, J.C.: Are recessions good for workplace safety? J. Health Econ. 25, 1069–1093 (2006) Davies, R., Jones, P., Nu´n˜ez, I.: The impact of the business cycle on occupational injuries in the UK. Soc. Sci. Med. 69, 178–182 (2009) Corcoran, P., Arensman, E.: Suicide and employment status during Ireland’s Celtic Tiger economy. Eur. J. Public Health 21(2), 209–214 (2010) Martikainen, P.T., Valkonen, T.: Excess mortality of unemployed men and women during a period of rapidly increasing unemployment. Lancet 348, 909–912 (1996) Ostamo, A., Lahelma, E., Lonnqvist, J.: Transitions of employment status among suicide attempters during a severe economic recession. Soc. Sci. Med. 52, 1741–1750 (2001) Platt, S., Kreitman, N.: Long term trends in parasuicide and unemployment in Edinburgh, 1968–87. Soc. Psychiatry Psychiatr. Epidemiol. 25, 56–61 (1990) Preti, A., Miotto, P.: Suicide and unemployment in Italy, 1982–1994. J. Epidemiol. Community Health 53, 694–701 (1999) Ahs, A.M., Westerling, R.: Mortality in relation to employment status during different levels of unemployment. Scand. J. Public Health 34, 159–167 (2006) Bank of Spain: Economic Bulletin. nEconomico/13/May/Files/be1305e.pdf (2013). Accessed 30April 2013 Benavides, F.G., Garcı´a, A.M., Sa´ez-Lloret, I., Librero, J.: Unemployment and health in Spain. The influence of socio-economic environment. Eur. J. Public Health 4(2), 103–107 (1994) Tapia-Granados, J.A.: Recessions and mortality in Spain: 1980–1997. Eur. J. Popul. 21, 393–422 (2005) Pascual, N., Rodríguez, I.: Effects of unemployment on selfassessed health and mental health: empirical evidence for Catalonia (2006–2012). Masters Project. Masters in Health Economics and Policy, Barcelona Graduate School of Economics (2013) Spanish Ministry of Health. National health survey 2006 (2007) Spanish Ministry of Health. National health survey 2011–2012 (2013) Böckerman, P., Ilmakunnas, P.: Unemployment and self-assessed health: evidence from panel data. Health Econ. 18, 161–179 (2009) Rosenbaum, P.R., Rubin, D.B.: The central role of the propensity score in observational studies for causal effects. Biometrika 70(1), 41–55 (1983) Kunst, A.E., Bos, V., Lahelma, E., Bartley, M., Lissau, I., Regidor, E., Mielck, A., Cardano, M., Dalstra, J.A., Geurts, J., Helmert, U., Lennartsson, C., Ramm, J., Spadea, T., Stronegger, W.J., Mackenbach, J.P.: Trends in socioeconomic inequalities in self-assessed health in 10 European countries. Int. J. Epidemiol. 34(2), 295–305 (2005) Hernández-Quevedo, C., Masseria, C., Mossialos, EA.: Analysing the Socioeconomic Determinants of Health in Europe: New Evidence from EU SILC. Eurostat Working Paper (2010) Lucas, R.E., Clark, A.E., Georgellis, Y., Diener, E.: Unemployment alters the set point for life satisfaction. Psychol. Sci. 15, 8–13 (2004) Goldberg, D.: Mental health priorities in a primary care setting. Ann. N. Y. Acad. Sci. 310, 65–68 (1978) Turner, J.B.: Economic context and the health effects of unemployment. J. Health Soc. Behav. 36, 213–229 (1995) Karlsdotter, K.: Ana´lisis de la Influencia de las Desigualdades Socioecono´micas Regionales Sobre la Salud de Los Andaluces y Españoles en el Periodo 2004–2007. PhD Dissertation, University of Granada (2012) Novo, M.: Young and unemployed: does the trade cycle matter for the health. In: A Study of Young Men and Women During Times of Prosperity and Times of Recession. Umea: Umea Universitet (2000) Stewart, J.M.: The impact of health status on the duration of unemployment spells and the implications for studies of the impact of unemployment on health status. J. Health Econ. 20, 781–796 (2001) STATA. Stata 12 Software (2012) Karasek, R., Theorell, T.: Healthy work: stress, productivity, and the reconstruction of working life. Basic Books, New York (1990) Gili, M., Roca, M., Basu, S., McKee, M., Stuckler, D.: The mental health risks of economic crisis in Spain: evidence from primary care centres, 2006 and 2010. Eur. J. Public Health 23, 103–108 (2013) Urbanos, R., González, B.: Desempleo y salud: un análisis de la repercusión de la crisis económica sobre la salud de los españoles. Estudios de Economía Aplicada 31(2), 303–326 (2013) Ayala, L., Rodrı´guez, M.: Health-related effects of welfare-towork policies. Soc. Sci. Med. 93, 103–112 (2013)