Tag Archives: Heart Disease

Frailty: what is the connection with our working lives?

People are living longer, and the number of over-65s is expected to reach around one in four of the UK population by 2050. But is retirement a golden age, or will we be dogged by poor health? Wentian Lu from University College London and colleagues investigated how our working pattern throughout our lives affects our health after we retire, and found interesting differences between men and women.

Government policies are focused on extending our working lives, and record numbers of people are now working beyond state pension age. But what effect is it having on our health?

The UK government’s former older workers champion, and pensions expert, Dr Ros Altmann argues that raising the state pension age is a blunt instrument for managing old-age support, which could compound existing social and health inequalities.

With people being expected to work for longer, it is critical to understand whether and how people’s working lives affect their later life health.

A recent study led by colleague Dr Giorgio Di Gessa found no significant health benefits from working beyond state pension age, once social background, previous health and employment histories were taken into account.

Our investigation was the first in England to focus on the impact of earlier working patterns on health in later life.

We used information on more than 1,600 men and nearly 2,800 women from the English Longitudinal Study of Ageing. Health-related information on a range of things such as chronic conditions, pain, depression, heart disease, falls, fractures and joint replacement was used to develop a frailty index.

Using detailed work histories between the ages of 16 and 64 for men (16 and 59 for women), they were divided into groups which ranged from ‘full-time employment throughout’ to ‘unemployed throughout’. For men, we considered those who left work early, at either 60 or 49 years, and those who started work late (e.g because they went to University or spent time gaining other qualifications) and retired at 60.

For women’s employment histories, we also took account of part-time working, long and short career breaks, family care, and those who only had occasional work and retired early.

Frailty over time

The study confirmed that frailty increased with age, accelerating after 65 for women and 70 for men.

The findings showed that women who took a short break for family care and then worked part-time until they were 59 had better health at retirement age than those who were mostly in full-time work. Experiencing long career breaks or only working occasionally also appeared to be more detrimental for women’s health. This finding supports the importance of work-life balance for women’s health in later life.

Women who returned to work part-time after a short career break were healthier than those who went from family care to full-time work. If further studies confirm this result, it would indicate that working part-time while their children are young can have long-term positive benefits for women’s health. The key to maintaining the long-term health of today’s generation of working mothers will be to promote flexible working policies, such as flexible start and finish times, allowing women to balance work and childcare.

Consistent with previous studies, our investigation found that women who have never worked tend to have poorer health than those who worked full-time until the age of 60. What was more surprising was that women who never worked experienced a slower decline in their health beyond the age of 60, even when social background and health-affecting behaviours such as smoking and drinking were taken into account.

Early retirement

Men who retired early at either 49 or 60 had poorer health than those who worked until they were 65. However, leaving paid employment before the age of 65 slowed down the progress of poor health in later life.

This supports the findings of previous studies which show that the burden of ill-health is substantially relieved by early retirement. With Government policies encouraging older people to work longer, our research lends further weight to concerns that this may not be good for those already suffering poor health.

Another unexpected finding was that men who started working later in life and retired at around 60, who tended to be those more highly educated and with greater social advantage, actually experienced more rapid declines in health after the age of 65 than those who worked full-time from an earlier age and retired early. This was a small group, so further research is needed to explore this in more depth.

Despite limitations imposed by some of our employment history groups being quite small, as well as possible biases coming from participants’ subjective reporting of health issues, our findings offer important pointers for developing effective strategies to improve health for older people in the UK.

If, as Dr Altmann suggests, the government could replace the blunt instrument of raising state pension age with more finely-tuned policies, allowing those who can and want to extend their working lives to do so in a flexible way, this would be fairer and give the most vulnerable a better chance of enjoying a healthy retirement.

Further information

Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing is research by Wentian Lu, Rebecca Benson and Amanda Sacker of University College London, Karen Glaser and Laurie Corna of King’s College London, Loretta Platts of Stockholm University, Diana Worts and Peggy McDonough of the University of Toronto, Giorgio Di Gessa from the London School of Economics and Political Science, and Debora Price of the University of Manchester. It is published in the Journal of Epidemiology & Community Health.

 

Want to be fit at forty? Don’t have a baby early!

Having a family early may not be good for your health later on. That was the conclusion of a team of researchers at the ESRC International centre for Lifecourse Studies when they looked at the interplay between the work and family lives of men and women, whose lives have been tracked over time in the 1958 Birth Cohort Study. But was it the same story for people born earlier and has it been the same for people who were born later? Dr Rebecca Lacey, who led the research, has been looking at the lives of thousands of adults in three Birth Cohort Studies to see whether the way their work and family lives intertwine impacts on the likelihood of them becoming overweight or obese later on.

In a recent blog for WorkLife, my colleague Anne McMunn outlined some of our research showing that, for both men and women, having children early, especially as a teenager, was closely linked with poorer health once they got into their forties.

Not only did the people we looked at for that piece of research have bigger waists, but they also had a great deal more fat circulating in their blood and less ‘good’ cholesterol, both of which are linked with a heightened risk of heart disease and diabetes.

Those findings stayed strong, even for young parents who had a job and were married, a clear indication that having children early on, with all the associated stresses and strains, seems to take a heavy toll on health over the life course.

For that piece of research, we looked only at people who had taken part in the National Child Development Study, also known as the 1958 Birth Cohort. For this research we looked, in addition at thousands more people, born in 1946 (National Survey of Health and Development) and another group born in 1970 (the British Cohort Study) whose lives had been tracked since birth.

Across cohorts

The reason for looking across cohorts was to see whether changes across generations in how we combine work and family (having children later, more cohabitation and less marriage, more women working etc.) have contributed in some way towards poorer health for some.

As with the earlier research, we made use of 12 specially created lifecourse types covering information on employment, partnerships and parenthood, such as ‘Work, Later family’ ‘Later family, Work break’, ‘Teen parent’.

Each individual in each birth cohort was ascribed a lifecourse type and this was then linked to their Body Mass Index (BMI) and how that changed over time. We went on to see how those figures differed between lifecourse types within and across the three cohorts. We used the World Health Organisation’s (WHO) definition of overweight (BMI greater than or equal to 25) and obesity (BMI greater than or equal to 30).

In addition, we took a host of other factors including our participants’ socio-economic background, prior health and educational attainment into consideration.

We anticipated that, as our earlier research had shown, that people who worked less and had children earlier would show steeper increases in BMI and that across the three cohorts, those increases would become more pronounced.

Changing attitudes and behaviours

The distribution of lifecourse types across the three cohorts reflected, as we thought it would, changing attitudes and behaviours across generations, with increasingly more women in employment and early parenthood becoming less and less common.

In the 1946 cohort, the average BMI of a very small group of men who were ‘Teen parents’ increased from 20.3 to 26.76 between age 16-42, significantly more than any other work-family combination. The same was true for male teen parents in the 1958 cohort and also for those who worked and had a family early. In the 1970 cohort, men who had no children or had children later had BMI that increased significantly less than those who became parents earlier. The only exception to this was a group of men with no family and unstable work.

Another notable finding across all three cohorts was that average BMIs for men at age 42 in all of the work-family groups were higher than the WHO threshold for overweight. The only exception was men who had children later or no children at all.

For women in the 1946 study, there was no real difference between the groups when we looked at how their BMI increased between the ages of 16 and 42. The average BMI of the 1958 cohort women who had children early increased significantly more than that of women who had them later. Women in the 1970 cohort who did not work and had children early had the biggest BMI rise (6.69) with teen parents (6.31) close behind. The average BMI of the 42 year-old women in these two groups was on the WHO obesity threshold (30), with the average BMI for the remaining work-family groups all falling under the WHO definition of overweight (25 and above).

Other interesting things to emerge included:

  • BMI increased more for male teen parents than female in the 1970 cohort
  • Marriage seems to have particular health benefits for men
  • Divorce has greater negative health effects for men than women

Negative impact

This research reinforces what we found earlier, which is that for both men and women having children early (especially in your teens) no matter what your background, is likely to have a negative impact on your health in mid life, especially if you don’t have a job or if your work is irregular or unstable. Looking across three cohorts, we can also see that those differences have become more pronounced.

How to explain and better understand how all this plays out in the day to day lives of younger parents is a challenge. Having children early may disrupt someone’s education or career. Younger parents may also be more likely to smoke and drink and exercise less than their older counterparts, unhealthy behaviours which can become established early and set in across adulthood.

Whatever the context and the reasons, there are some important messages here for young people, prospective parents, health and education professionals as well as for Government; not least that decisions about how to combine work and family life, especially when to become a parent, may have long lasting ramifications for your health.

This research adds to a growing body of evidence which makes it clear that, as far as obesity is concerned, early intervention is key and that we need to consider the complex way in which our biological and social lives intertwine over time.

Further information

Work-family life courses and BMI trajectories in three British birth cohorts is research by Rebecca Lacey, Amanda Sacker, Steven Bell, Meena Kumari, Diana Worts, Peggy McDonough, Diana Kuh, and Anne McMunn. It is published in the International Journal of Obesity.

Photo credit: Baby Fingers, Thomas

Having a baby early? It might not be good for you later

Being employed is generally good for your health. That’s what a large body of research has shown over the years. But what about when you put having a family into the mix? That’s a question that Dr Anne McMunn at the ESRC International Centre for Lifecourse Studies at UCL has been asking in a series of studies looking at the interplay between work-family life and health in middle age. Here she outlines her findings and explains why having children early may not be good for you.

When couples think about starting a family, they may make decisions around a host of concerns. Finances, careers, childcare all spring readily to mind as things that could crop up in discussions about when it might be best to have a child. Not many people will stop and think about how and when having a child might affect their health later on in life – but maybe they should.

Research to date has shown that combining paid work with family responsibilities is usually linked with better health outcomes, although existing research has a number of shortcomings: men are often excluded, health measures have tended to be self-reported rather than objective, few studies take account of the role health plays in whether or not people work, get married and have children in the first place, and, crucially, few studies look across the lifecourse at the timings of entry into parenthood.

Combining work and family life

Using the National Child Development Study, which is following the lives of 17 thousand people born in 1958, our research has looked at how they combined their work and family lives between the ages of 16 and 42 and what that meant for their health in their mid 40s.

The thinking behind the research was that those people with more stressful work-family lives (often characterised by having children very young, being unemployed, and not marrying or forming a long-term partnership) would go on to have physical signs or indicators of poor health such as high cholesterol and blood pressure, being overweight etc.

All the men and women in the study were ascribed one of 12 lifecourse types e.g. ‘Work, Later family’, ‘Later family, Work break’, ‘Teen parent’.

Table 1-1

Almost all men were in a group characterised by long-term full-time employment, with most (34%) entering family life later (the ‘Work, Later family’ group), with nearly as many entering family life earlier (the ‘Work, Earlier family’ group at 32%). Conversely fewer than half of women (47%) were in a group characterised by long-term full-time employment. The ‘Part-time work, Earlier Family’ was the most common group (18%) for women.

Similar proportions of men and women were in the ‘Work, Cohabitation, Later Parent’ group (7% and 5%, respectively), the ‘Work, Marriage, Non-Parent’ group (8% of men, 9% of women) and the ‘Work, No Family’ group (13% of men, 10% of women). Only 4% of women were in the ‘No Paid Work, Earlier Family’ group, and few men or women were in groups characterised by marital dissolution, teen parenthood or weak ties to work or family.

Early parenthood – poorer health

As we expected, those men and women who were in full-time long-term employment, were married and had children later on enjoyed better health. Early parenthood, especially teen parenthood was clearly linked to poorer health, regardless of whether they were in paid work or in a stable long-term marriage.

For example, the waist circumference of teen parents was four inches larger, on average, than those who were in full-time long-term employment, were married and had children later (fat accumulated around the waistline is known to be particularly risky for health). Groups who entered parenthood earlier had 10-18% more fat circulating in the blood and 2-8% less of the ‘good’ HDL cholesterol than those who were in full-time long-term employment, were married and had children later.

Teen parents tended to be less well educated, which accounted for some of the link. However, even those who had stable employment and marriages, but had children early, had poorer health.

It seems that for both men and women, having children early is linked with poor health later on, possibly as a result of chronic stress from parenting in straitened circumstances with fewer financial and emotional resources.

Less human and social capital

Authors of other studies showing links between early parenthood and health problems such as depression, heart disease and long term illnesses, speculate that younger parents have accumulated less human and social capital to cope with the stresses of parenting. It is also possible that those who are older when they become parents have had time to establish healthier behaviours such as exercise and healthy eating prior to starting their families, making it easier to maintain those behaviours through the busy parenting years.

There is need for further evidence on how timing of parenthood influences health and we are currently replicating this study with participants from the 1970 birth cohort.

In the meantime, perhaps those family planning discussions around finances, careers and childcare should incorporate an extra question? If we have a child now rather than later, how might it affect our health later on? It’s a question that will be of interest not just to prospective parents, but to all those concerned with improving the long term health and well-being of our society.

Work-family life courses and metabolic markers in mid-life: evidence from the British National Child Development Study is research by Anne McMunn, Rebecca E Lacey, Meena Kumari, Diana Worts, Peggy McDonough and Amanda Sacker.

Photo credit: Darren Johnson

 

Are permanently sick people less sick nowadays?

Brexit aside, there have few topics more hotly contested in recently years than who should get incapacity benefits. The steady rise in the incapacity benefits bill over several decades led some to question whether greater numbers of people could actually be sick and whether this group is actually healthier, with less serious health problems, than had been the case in decades past. But what does research evidence tell us? Bola Akinwale from Public Health England and colleagues at the ESRC International Centre for Lifecourse Studies have looked at 30 years’ worth of data to see.

In the last 30 years of the 20th century, life expectancy for those aged 65 increased more than it had in the previous 70 years. A job market that had been almost completely dominated by men became dramatically more diverse. By the turn of the century, very few men aged 60-64 were in paid work, although that number has since increased.

On the face of it, many of these changes represent good news, but they have also created new challenges around funding pensions and how to keep increasing numbers of older people healthy and active for longer.

Our research looked at the proportions of men and women around State Pension Age who were employed, unemployed, permanently sick (those we might expect to claim incapacity benefits) or retired. We went on to look at their health immediately after retirement age to see if they had died prematurely or had a limiting long-term illness or disability.

When we compared the labour market positions of 60-64 year-old men in 1971 compared with 2001, we saw some big changes:

  • Working – 78.4 percent v 47.5 percent
  • Retired – 7.2 percent v 24.7 percent
  • Permanently sick – 9 percent v 19.7 percent

By 2001, women were almost as likely as men to describe themselves as retired after State Pension Age and 12.4 percent of 55-59 year-old women described themselves as permanently sick in 2001 compared with 3.4 percent back in 1971.

So we see the proportions of permanently sick men doubling over 30 years and quadrupling for women.

Across the same time frame, the risk of dying just before State Pension Age decreased substantially – by more than 60 percent for men and by more than 50 percent for women, irrespective of whether they are in work or permanently sick. In other words, both groups benefited equally from these changes – staying healthier and living longer than their counterparts 30 years previously.

Are sick people less sick nowadays?

 The answer is no and yes – it depends on the comparator.

To try to get to the bottom of this idea that people who are permanently sick are less sick than their historical predecessors, we compared the likelihood of them dying prematurely with that of their working peers.

On the one hand, if they were less sick, we would expect to see the gap between the chances of dying prematurely for these two groups get smaller over the 30-year period. We don’t see that.

Permanently sick men aged 65-69 were three times more likely to die prematurely than their working peers in 2001 and this was an increase on the 1971 figure. For women, the figure was between four and five times over the period we looked at.

On the other hand, it’s clear that this 30 year period brought about some remarkable changes in the working lives and general health of older people, including among permanently sick group. Their life expectancy has increased in line with other people of their age.

But despite these improvements in life expectancy among permanently sick people, compared with employed people their likelihood of dying has, if anything, slightly increased and certainly not decreased.

So, taken together, our research does not support the argument that the permanently sick have less serious health conditions nowadays than they used to.

A key plank of the Government’s policies for people who are unable to work due to illness is to try to support them back to work wherever possible. Our research shows that achieving this aim, requires careful consideration of the types of jobs and working environments that might be suitable for people with chronic illnesses.

If we don’t create enough jobs that older people with chronic illness can sustain and thrive in, life expectancy gaps between those in work and those who leave the workforce prematurely due to ill-health may widen further.

Work, permanent sickness and mortality risk: a prospective cohort study of England and Wales, 1971-2006 is research by Bola Akinwale, Kevin Lynch, Richard Wiggins, Seeromanie Harding, Mel Bartley and David Blane. It made use of linked census and death records in the ONS Longitudinal Study.

Photo credit: ILO in Asia and the Pacific

Work and family – how it affects our health

How our working and family lives affect our health as we get older is of increasing interest to us all. Researchers at the ESRC International Centre for Lifecourse Studies have used the 1958 Cohort Study to look at levels of inflammation (indicators of being at risk of illnesses such as heart disease) and and how people combine their work and family lives to see if any patterns emerge that could tell us more.

In this episode of the ICLS Podcast, Dr Rebecca Lacey explains the background and context of the research and what the team has found.

You can also listen to a policy seminar talk about the research.

How travelling to work can work for you

There can’t be too many commuters who aren’t now aware that ditching the car and walking to work is much better for them. Considerable evidence has shown that walkers and cyclists are likely to weigh less and be slimmer than their car commuting counterparts. What they may be less aware of is that ditching the car in favour of the bus, train or the tube could have nearly the same benefits. A programme of research by a team at the London School of Hygiene and Tropical Medicine and the ESRC International Centre for Lifecourse Studies, UCL has been taking a closer look at the benefits of being an ‘active commuter’. As researcher Ellen Flint explains, the findings point to some clear ways forward, not just for individuals, but for policy makers too.

Physical inactivity and being sedentary for large parts of the day are a leading cause of obesity and premature death. In England alone something like two thirds of adults do not meet the recommended levels of daily exercise. At the same time there are growing numbers of people commuting to work. In England and Wales that figure is around 24 million people, 67% of whom take the car.

The time of life when most adults become obese is in middle age, with 50-65 year-olds less than half as likely as young adults aged 16-29 to use public transport, nearly half as likely to walk to and from work and two thirds less likely to get on their bikes. So it’s this age group that we have focused on in our programme of research looking at the relationship between active commuting and obesity in mid life.

To help us do this, we have used information from a long term household survey called Understanding Society and a large study called UK Biobank.

Public transport benefits

Our first piece of research used Understanding Society and showed us that not just walking or cycling to work but even catching the bus or the tube are all linked to lower body weight and body fat composition compared with those who get to work by car.

7,534 BMI and 7,424 percentage body fat measurements from men and women who took part in the survey were used in conjunction with information about journeys to work.

Men who commuted via public or active modes had BMI scores around 1 point lower than those who used private transport, equating to a difference in weight of 3kg (almost half a stone) for the average man.

Women who commuted via public or active transport had BMI scores around 0.7 points lower than their private transport using counterparts, equating to a difference in weight of 2.5kg (5.5lb) for the average woman.

When it came to body fat, men who actively travelled to work (walking, cycling or public transport) had body fat that was roughly one per cent point lower than those who commuted by car, confirming the picture seen when looking at BMI.

What’s important to note here is that these differences are larger than those seen in the majority of individually focused diet and physical activity interventions to prevent overweight and obesity.

Second study reinforces

In work just published in The Lancet Diabetes and Endocrinology, we were able to use information from more than 70,000 men and 80,000 women aged 40-69.

More than 60% of these people commuted by car, with only 4 percent and 7 percent respectively reporting walking as their only method of commute and 4 percent and 2 percent cycling. Around one in five was an active commuter some or all of the time.

Except for those who mixed car and public transport, all other groups had significantly lower BMI and percentage body fat than those men and women who ONLY commuted by car.

The biggest differences were for cyclists and the results stayed strong even when we accounted for a wide range of other factors such as social and economic background, their general health and even whether or not they did exercise outside of their daily commute.

The men who cycled were around 5 kg lighter whilst women cyclists were on average nearly 4.5kg lighter than their car commuting counterparts.

Unsurprisingly, walking to work had the next biggest association with reduced obesity. Compared with their car commuting counterparts, men who walked to work were on average 3.0kg lighter; and women typically weighed 2.1kg less.

However, what was perhaps more interesting, and what also reinforced our interesting earlier findings from Understanding Society, was that even those who used a mixture of public transport and active methods of commuting still had significantly lower BMI and body fat percentage than those who commuted exclusively by car.

In fact, it was similar to those who only walked to work. Compared with car commuters, men and women who mixed public transport with some walking or cycling typically weighed 3.1kg and 2.0kg less, respectively.

Active commuting at heart of policy

Separately these two studies make interesting reading, but together they combine to make a powerful and growing body of evidence around the benefits of active commuting and do more than hint at potential interventions for policy makers.

There is now a clear case for the health benefits of active commuting to be taken into consideration by transport planners, town planners and urban designers.

Cities can be active by design and the more evidence that we have to confirm that people who commute actively really are lighter and have a healthier body composition, the more impetus there is for these health related outcomes to be at the heart of policy.

It is time to realise the untapped population health improvements potential of these big shifts we can make in how people travel to and from work.

Photo credit: Chris Rubberdragon

A question of inflammation

Inflammation can be good and bad for us. Find out more in this presentation from researcher Rebecca Lacey, who uses inflammatory markers in mid life to look at whether the way in which we combine our work and family lives early on affects our health later on.

The research,  presented at an ESRC International Centre for Lifecourse Studies policy seminar, concludes that homemakers and people who have children early, particularly teen parents, are at greater risk of poor health in mid life and recommends increased support and opportunities for young parents.

Listen to Rebecca’s presentation and view the slides below.

Work, family and health – a question of inflammation? from Chris Garrington on Vimeo.

Photo credit: Fixers

Can unemployment kill – Podcast

Our first blog showcased recent research from the team at ESRC International Centre for Lifecourse Studies about the links between long term unemployment and stress markers linked to killer diseases. If you were interested in that, you can also listen on Soundcloud to researcher Amanda Hughes discussing the research for the ICLS Podcast.

Can unemployment kill?

At the height of the recent recession around 2.7 million people were unemployed, and youth unemployment accounted for nearly 40 per cent of that total. Given growing evidence that unemployment is linked to long term illness and increased mortality, we can expect health implications for those affected. In a week when unemployment rose for the first time in over a year, Amanda Hughes presents new evidence from the ESRC International Centre for Lifecourse Studies on the links between unemployment and killer diseases such as heart disease.

In 1984 a study was published which had linked census data to mortality records and found that men unemployed in the week of the 1971 census were 36 per cent more likely to have since died than men of the same age who had been in work. Accounting for differences in social background only explained part of the excess, raising the question: can unemployment kill, and if so how?

That unemployment might damage health was not a new idea. Marie Jahoda’s research on unemployment in the 1930s had shown that the non-financial benefits of work, such as defining aspects of status and identity and providing regular social contact, are for many people crucial to mental wellbeing. And since job loss usually brings a sharp drop in income, it is intuitive that unemployment could affect physical health by reducing quality of diet or opportunities for exercise.

But there tends to be more scepticism as to whether serious physical illness or mortality could be causally influenced by the undoubtedly stressful experience of unemployment. Might those unemployed men have developed serious illness when employed, lost their jobs as a result, and then died from their illness? Or might their increased mortality simply be caused by unemployed people smoking and drinking more? In neither case could it be claimed that unemployment itself has caused any deaths.

New approach

Since the 1980s, the tools available to scientists researching the health impacts of social conditions have moved on considerably. One new approach involves molecules called ‘inflammatory markers’ which circulate in the bloodstream and appear to be influenced by stressful experiences.

Elevated concentrations have been found in the recently bereaved and caregivers; inflammatory markers are also typically higher for people of disadvantaged socioeconomic position as measured by income or occupational social class. Crucially, raised concentrations of these molecules are linked to atherosclerosis and predict heart disease, presenting a possible causal pathway between a stressful social environment and increased mortality.

It was for this reason that we wanted to see if two inflammatory markers – C-reactive protein and fibrinogen – were elevated in jobseekers compared to employed counterparts.

We used the Health Survey for England and Scottish Health Survey, annual government surveys used to track changes in the health of both countries’ populations. To isolate elevations in these molecules due to unemployment-related stress, we considered a number of additional factors beyond participants’ age and gender.

To rule out elevations due to serious illness predating job loss, we considered whether participants had a long-term illness of any type. To rule out elevations caused by disadvantaged socioeconomic position more generally, we took into account housing tenure and occupational social class from current or most recent job.

Finally, to test whether elevations might be explained by worse health-related behaviours of jobseekers, we took into account participants’ smoking, alcohol consumption and body mass index.

Stress markers

In our sample of over 23,000 men and women of working age, unemployed people had elevated circulating levels of both molecules even after consideration of these factors. These differences were moreover clinically relevant, since unemployed participants were 40 per cent more likely to have C-reactive protein over 3mg/L, the level at which cardiovascular risk becomes elevated.

Effects were not uniform across the population. Firstly, older jobseekers (48-64) were more affected than younger jobseekers. This might indicate that unemployment is more stressful for jobseekers facing age discrimination, or equipped with outdated skills.

Since older jobseekers will have accumulated more unemployment over their lifetimes than younger counterparts, it could alternatively indicate that long-term or repeated unemployment is especially damaging to this aspect of health.

Secondly, we found substantial differences in results by country, with much greater elevations in both molecules for jobseekers in Scotland than in England. Data from the Labour Force Survey and the British Household Panel Study show that during the years of data collection (1998-2010) unemployment was higher in Scotland than England, and unemployment spells on average longer, which suggests two possible explanations.

Firstly, the jobseekers in Scotland may have been unemployed for longer, or had more recent unemployment spells, than English counterparts. Secondly, unemployment could be more stressful in times and places where the background rate is higher, since jobseekers will rationally perceive their prospects for re-employment as worse.

Since these surveys only collect information from people at one point in time, it was not possible in this analysis to investigate effects in the context of people’s employment histories. But unpicking these explanations will be crucial if we are to better understand the conditions under which unemployment is most likely to damage health, and which groups are most at risk.

Crucially, given last week’s news of a 21,000 rise in unemployment for the first time in a year  to 1.7 million people, policy makers interested in the long term health of the population should not divert their gaze from its wider consequences.

Photo credit: Kate Hiscock

Further information

Amanda Hughes is a Senior Research Officer at the Institute for Social and Economic Research at the University of Essex.

Elevated inflammatory biomarkers during unemployment: modification by age and country in the UK is research by Amanda Hughes, Anne McMunn, Mel Bartley and Meena Kumari and is published in the Journal of Epidemiology and Community Health.

References

Unemployment and mortality in the OPCS Longitudinal study is research by K.A Moser, A.J Fox, and D.R. Jones, and is published in the Lancet.

Unemployment durations: evidence from the British Household Panel Survey is research by K. Long and is published in Economic & Labour Market Review.