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Does unemployment contribute to poorer health-related quality of life among Swedish adults?
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-0457-2175
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.ORCID iD: 0000-0002-1633-2179
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
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2019 (English)In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 19, article id 457Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Previous studies have shown that unemployment has negative impacts on various aspects of health. However, little is known about the effect of unemployment on health-related quality of life. Our aim was to examine how unemployment impacts upon health-related quality of life among Swedish adults, and to investigate these effects on population subgroups defined by education level, marital status, previous health, and gender.

METHODS: As part of a cross-sectional study, a questionnaire was sent to 2500 randomly selected individuals aged 20 to 64 years living in Sweden in 2016. The questionnaire included the EuroQol 5 dimensions (EQ-5D) instrument and was answered by 967 individuals (39%). Quality-adjusted life year (QALY) scores were derived from the EQ-5D responses. Of the respondents, 113 were unemployed and 724 were employed. We used inverse probability-weighted propensity scores in our analyses to estimate a risk difference. Gender, age, education level, marital status, and previous health were used as covariates in our analyses.

RESULTS: There was a statistically significant lower QALY score by 0.096 points for the unemployed compared to the employed. There were also statistically significant more problems due to unemployment for usual activities (6.6% more), anxiety/depression (23.6% more), and EQ-5D's Visual Analogue Scale (7.5 point lower score). Grouped analyses indicated a larger negative health effect from becoming unemployed for men, those who are married, and young individuals.

CONCLUSIONS: In our study, we show that the health deterioration from unemployment is likely to be large, as our estimated effect implies an almost 10% worse health (in absolute terms) from being unemployed compared to being employed. This further highlights that unemployment is a public health problem that needs more focus. Our study also raises further demands for determining for whom unemployment has the most negative effects and thus suggesting groups of individuals who are in greatest need for labor market measures.

Place, publisher, year, edition, pages
BioMed Central, 2019. Vol. 19, article id 457
Keywords [en]
EuroQol 5 dimensions, Labor market, Propensity scores, Quality-adjusted life years
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Epidemiology; Public health
Identifiers
URN: urn:nbn:se:umu:diva-158631DOI: 10.1186/s12889-019-6825-yISI: 000467017800001PubMedID: 31035994OAI: oai:DiVA.org:umu-158631DiVA, id: diva2:1313575
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00647Available from: 2019-05-03 Created: 2019-05-03 Last updated: 2019-06-13Bibliographically approved

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Norström, FredrikWaenerlund, Anna-KarinLindholm, LarsSahlén, Klas-Göran

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