Sofia Hernnäs

Is long-term economic stress from occupational decline linked to poor health or death? Using Swedish administrative data matched with US occupational trends, I examine this in reduced form and using instrumental variables. Workers who in 1985 worked in occupations that subsequently declined unexpectedly were more likely to die early than similar workers in non-declining occupations, with effect sizes of 6–19 percent of mean mortality. Cardiovascular deaths rose among men, while women faced higher mortality from alcohol, drugs, and suicide. Hospitalization days rose, as did prescription drug use for mental health problems. Effects were strongest for the lowest-paid.

Little is known about the physiological outcomes of unemployment during life. The aim of this study is to analyse if exposure to unemployment during different age periods can lead to metabolic syndrome (MetS) in middle-aged men and women. Can sensitive periods be identified? Data from the Northern Swedish Cohort was used, a longitudinal study of school leavers from 1981. Over the 40-year period, the retention rate was 90%. MetS at age 56 was measured with clinical examinations, while the exposure was measured with retrospective matrices between follow-ups. Exposure was cut into tertiles in each age group, the contribution to risk from each month of exposure was also analysed, using logistic regression. Short-term exposure to unemployment in early teens (<12 weeks) as well as long-term exposure to unemployment during life (>24 months) was related to MetS among women. In addition, exposure to unemployment >24 months during age 22-30 was related to MetS in adult life among both men and women. A significant dose-response was found among men and women in the ages 22-30 and among women in the whole age period. All results were controlled for socioeconomic status, obesity and drinking, used as time-dependent confounders. Our study showed that long-term exposure to unemployment during life can lead to MetS in adult age among women. Sensitive periods were identified in young age among both men and women. Our findings can be understood as a maladaptive response to chronic stress over life becoming embodied as MetS in adult life and calls for offensive, age-adjusted gender-sensitive interventions on the labour market.