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Unemployment at a young age and later sickness absence, disability pension and death in native Swedes and immigrants
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. (Eva Vingård)
Occupational and Environmental Medicine, Uppsala University Hospital, Uppsala, Sweden. (Eva Vingård)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. (Eva Vingård)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Occupational and Environmental Medicine. (Eva Vingård)
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2013 (English)In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 23, no 4, 606-610 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

Youth unemployment is an increasing problem for societies around the world. Research has revealed negative health effects of unemployment, and this longitudinal register-based cohort study examined the relationship between unemployment and later sickness absence, disability pension and death among youth in Sweden.

METHOD:

The study group of 199 623 individuals comprised all immigrants born between 1968 and 1972 who immigrated before 1990 (25 607) and a random sample of native Swedes in the same age-range (174 016). The baseline year was 1992, and the follow-up period was from 1993 to 2007. Subjects with unemployment benefit in 1990-91, disability pension in 1990-92, severe disorders leading to hospitalization in 1990-92 and subjects who emigrated during follow-up were excluded.

RESULTS:

Those who were unemployed in 1992 had elevated risk of ≥60 days of sickness absence (OR 1.02-1.49), disability pension (HR 1.08-1.62) and all except native Swedish women had elevated risk of death (HR 1.01-1.65) during follow-up compared with non-unemployed individuals. The risk of future sickness absence increased with the length of unemployment in 1992 (OR 1.06-1.54), and the risk of sickness absence increased over time. A larger part of the immigrant cohort was unemployed at baseline than native Swedes. Selection to unemployment by less healthy subjects may explain part of the association between unemployment and the studied outcomes.

CONCLUSION:

Unemployment at an early age may influence the future health of the individual. To a society it may lead to increased burdens on the welfare system and productivity loss for many years.

Place, publisher, year, edition, pages
2013. Vol. 23, no 4, 606-610 p.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-190477DOI: 10.1093/eurpub/cks099ISI: 000322338200014PubMedID: 22930745OAI: oai:DiVA.org:uu-190477DiVA: diva2:583574
Available from: 2013-01-08 Created: 2013-01-08 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Unemployment at a young age and sickness absence, disability pension, death and future unemployment - A register-based study of native Swedish and immigrant young adults
Open this publication in new window or tab >>Unemployment at a young age and sickness absence, disability pension, death and future unemployment - A register-based study of native Swedish and immigrant young adults
2014 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Youth unemployment is an increasing burden on societies around the world. This prospective, register-based cohort study examined the relationship between unemployment and sickness absence, disability pension, death and future unemployment among youth in Sweden. A comparison was also made between immigrants and native Swedes. Another aim was to see if Active Labour Market Programs (ALMPs) and attained education moderated the outcomes. The baseline year was 1992, a year of severe economic downturn. The follow-up period was from 1993 to 2007, divided into three 5-year periods. The study group of 199,623 individuals comprised all immigrants born between 1968 and 1972 who immigrated before 1990 (25,607) and a random sample of native Swedes in the same age range (174,016). Individuals with unemployment benefit in 1990-1991, disability pension in 1990-1992 or severe disorders leading to hospitalization in 1990-1992 were excluded in order to minimize selection bias. Those who were unemployed in 1992 had elevated risk, measured as odds ratios, of ≥60 days of sickness absence, disability pension, ≥100 days of unemployment and all, except native Swedish women, had elevated risk of death during follow-up. The risk of future unemployment declined until the last follow-up period, while the elevated risk of future sickness absence was about the same in all three follow-up periods. Higher level of education at baseline decreased the risk of future unemployment. Individuals participating in ALMPs had an increased risk of future unemployment, and immigrant women had an increased risk of sickness absence, compared to non-participating individuals. Attained education between 1993 and 1997 decreased the risk of future unemployment and decreased the risk of sickness absence among immigrants. The risk of both future unemployment and future sickness absence increased with the length of unemployment in 1992. Immigrants had higher risk of unemployment both at baseline and follow-up compared with native Swedes, but followed the pattern of native Swedes when unemployed. The conclusion are that exposure to unemployment are associated with elevated risk of future unemployment, sickness absence, disability pension and death fifteen years after exposure. To a society this will mean substantial costs in the form of increased welfare payments and loss of productivity and tax income. Selection to unemployment by individuals already sick, may explain part of the association between unemployment and the studied outcomes.

Place, publisher, year, edition, pages
Uppsala: Inget Förlag, 2014. 32 p.
Keyword
Unemployment, Sick Leave, Disability Pension, Immigrants, Young Adult
National Category
Environmental Health and Occupational Health
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-213108 (URN)
Presentation
2014-01-24, Frödingsalen, Ulleråkersvägen 40A, Uppsala, 12:23 (Swedish)
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2011-0289
Available from: 2013-12-19 Created: 2013-12-18 Last updated: 2013-12-19Bibliographically approved
2. Unemployment and sick leave at a young age and associations with future health and work
Open this publication in new window or tab >>Unemployment and sick leave at a young age and associations with future health and work
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this register-based longitudinal study was to explore the relationship between exposure to unemployment and sick leave at a young age and later health and work related outcomes. A comparison was also made between immigrants and native Swedes. The study population consisted of all immigrants, born between 1968 and 1972, and a random sample of native Swedes in the same age range. The follow-up period was 15 years, divided into three 5-year periods. Unemployment in 1992 was associated with later ≥60 days of sickness absence, disability pension and, for all subjects except native Swedish women, also mortality during follow-up. The risk of future sickness absence was about the same in all three follow-up periods. There was an increased risk of ≥100 days of unemployment in all three follow-up periods, but the risk declined, however, until the last follow-up period. Higher level of education at baseline as well as education attained between 1993 and 1997 decreased the risk of future unemployment. Participating in active labour market programmes was associated with higher risk of future unemployment. The risk of both future unemployment and future sickness absence increased with the length of unemployment in 1992. Immigrants had a higher risk of unemployment both at baseline and at follow-up compared with native Swedes, but matched the pattern of native Swedes during follow-up. Exposure to ≥60 days of sickness absence in 1993 was associated with increased risk for ≥60 days of sickness absence, ≥100 days of unemployment, disability pension and mortality during follow-up compared with no sick leave at baseline. The income from work, during the follow-up period, among individuals with spells of sick leave ≥60 days in 1993 was around two-thirds of that of individuals not on >60 days of sick leave. There was a rapid increase in future work absence for the first 1–7 days of sick leave claimed. Thereafter there was a lower, but steady increase in days of future work absence for every increase in sick leave. This of course affects the individual in the first place and to a society it means substantial costs in the form of increased welfare payments, and loss of productivity and tax income.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2015. 65 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1067
National Category
Medical and Health Sciences
Research subject
Epidemiology
Identifiers
urn:nbn:se:uu:diva-242149 (URN)978-91-554-9147-5 (ISBN)
Public defence
2015-03-12, Frödingsalen, Ulleråkersvägen 40, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2015-02-19 Created: 2015-01-21 Last updated: 2015-03-09

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