Tag Archives: Mental health

Retiring early: the links with childhood

When we think of why someone might retire early, our minds are unlikely to make the leap to their childhood for the answer. But a group of researchers interested in what sorts of things affect our later working lives, believe that early retirement may indeed have some of its roots in our younger years. The research sheds new and important light on worldwide efforts to plug pensions gaps and get more people working longer. Hanno Hoven from the University of Dusseldorf outlines why he and colleagues from the International Centre for Lifecourse Studies at UCL think early retirement can be traced right back to having had a tougher childhood. He goes on to explain what the findings might mean for policy in this area.

All sorts of things are likely to influence the point at which older people stop working. External factors like tax incentives to stay in work or changes to when we can claim our State Pension play a role. Then there are our working conditions, what’s going on with our health and how our personal circumstances change as we get older.

A substantial body of research has shown in recent years that people whose socioeconomic circumstances are poor are more likely to retire early than their better off peers. But in our research, we wanted to see if retiring early can additionally be traced back to earlier stages of the life course, more specifically, to having had a tougher life as a child or during mid adulthood.

In addition we wanted to dig a bit deeper into older people’s working lives, by giving a clearer and more detailed picture that describes entire patterns of employment trajectories (and not retirement timing only). To do this, we took into account the employment history between 50 and 70, including details on type of job people did, whether they worked full- or part-time or whether they were self-employed.

We used information collected by the Survey of Health, Ageing and Retirement in Europe (SHARE), which has carried out interviews with more than 28,000 older people from 14 different countries. For our research, we focused on 5,857 men and women from the survey who wereaged 70 or over and who had provided details of their previous working and personal lives.

Work and retirement

We created clusters of their work and employment histories, and you can see in the table below the proportion of men and women in each cluster. On this basis we could link these clusters or types of employment histories to earlier adversity for both men and women.

Looking at types of employment histories between the ages of 50 and 70, we could see that men were more likely than women working in full-time employment or self-employed.. Women worked more likely in a part-time job or looked after home or family during those years.

Adversity in childhood

After modelling the effect of early life information and taking a range of background factors into account (e.g., among others, health conditions prior and during working life in mid adulthood), we were able to see that men who had experienced adversity in childhood were 5 percentage points more likely to have retired early (around age 55) from full-time employment, but they were less likely self-employed in late life. The same was true of men who experienced adversity in adulthood, although it is important to note that the effects were independent of each other.

Women who had suffered adversity in childhood were also less likely to be self-employed and retire later on. However, it was not related to early (around age 55) retirement from a full-time job. Women who faced adversity in adult life were more likely to work part-time or to look after the home/family than their peers who suffered no adversity during that period. This was not the case for childhood adversity.

Some other interesting things emerged from the research, which we believe provides a more comprehensive picture than has been provided before.

One very notable point was that early retirement was more closely associated with being in full-time employment rather than being self-employed. This could be because employed people have more restricted opportunities to work for longer (even if they want to) compared with their self-employed counterparts who have more freedom in deciding when to retire.

Food for thought

For those, including the Government’s Business Champion for Older Workers, who want to see thousands more older workers in British companies by 2022, this will be food for thought. More flexible retirement arrangements are likely to be necessary for employed workers who want to work longer, for example, through retirement schemes that allow a reduction of working time before leaving the labour market. This argument is further supported by the fact that such a cluster (where employed people reduced their working hours before retiring) was not found in our research.

Interesting differences emerged between men and women when it came to their employment histories and the way in which childhood adversity was linked to them. Whilst men were more likely to follow a path of full-time employment into retirement, women were more likely to have been continuously looking after home or family (without retirement) or have worked part-time.

When we factored in childhood adversity in the women’s lives, there was a close link with discontinuous employment in later life. This link was stronger for women than for men. Other research has suggested that traditional gender roles make it harder for women to gain a foothold in the labour market, a disadvantage that any adversity in childhood is likely to compound.

Looking across the lifecourse in this way sheds considerable new and important light on the timing of retirement, and offers some pointers for policymakers looking to increase the numbers of older workers. One specific implication is that certain measures are likely to work better for different age groups and should address different stages of the lifecourse.

There has been a great deal of focus on pension age and working conditions for older people. However, our research suggests that our childhood circumstances are also important and that policies to tackle childhood poverty and create good stable jobs for young people may also have a key role to play over time.

Early Adversity and Late Life Employment History—A Sequence Analysis Based on SHARE is research by Hanno Hoven, Nico Dragano, David Blane and Morten Wahrendorf and is published in Work, Aging and Retirement.

 

Organisational change: impact on early retirement

Motivating older employees to stay working longer is seen as a key way of tackling the current pensions crisis facing many countries. Something of a fly in the ointment for those looking to address the problem is the option to take voluntary early retirement, especially where among those who are in good health and best placed to continue working. Dr Nina Breinegaard and colleagues at the University of Copenhagen have been researching the situation in Denmark and, as Nina explains here, they find that a key area of focus for employers and policymakers could be organisational change.

A whole host of things influence our decision around when to retire. These include obvious things like our finances, the state of our physical and mental health and what’s going on with our family and close friends.

Another key influence is what is happening in the workplace. A job may have become too physically demanding for example. A number of studies have shown that when a company is restructuring or downsizing, employees may feel less secure about their position. This in turn can be a catalyst for early retirement, sometimes on the grounds of ill health.

In our research, however, we wanted to try to get to the bottom of how organisational change might influence those without any health problems to retire early. We also wanted to take a close look at the combined influences of the psychological and social sides of work on that decision.

Claiming benefits

In Denmark, men and women who have paid into an early retirement benefits insurance fund can claim those benefits between the ages of 60-64 even if they are in good health. At the end of 2012, 34 per cent of women and 27 per cent of men aged 60-64 received these early retirement benefits.

We linked Denmark’s DREAM database, which collects information on all public benefit payments, with a survey collected over a two month period in 2011 from more than 28,000 public sector workers. This enabled us to look at which employees decided to take early retirement benefits and whether changes at work were linked to that decision.

All this information was then linked to administrative data to take a range of social and economic background factors into account.

We ended up with a group of 3254 employees aged 60-64 who were entitled to early retirement benefits. Details of any changes at their workplace: a change of manager, a merging or demerging of departments or workgroups, moving to a different office or having a new base, were collected independently from current or previous managers.

They also rated the quality of their work environment e.g. how good their managers were at leading, how positive relationships were with other colleagues and how fairly and well concerns and conflicts were dealt with (organisational justice). The answers to all these questions were then used to create overall scores for each employee’s work environment.

Follow-up

When we followed up with our survey participants, we found that one in five women and one in seven men had taken early retirement benefits with early retirement being common in all occupational groups except for doctors and dentists.

65.1 per cent of the 2206 employees for whom we had information about all types of organisational change had experienced one or more changes. Change was most frequent among social and healthcare workers (74.9 per cent) and least frequent among laboratory technicians (46 per cent).

Employees whose workplace had undergone a change of management or a merger were much more likely to have taken early retirement than those who had not. After taking background factors including age, marital status, gender etc. into account where a change in management had occurred, the likelihood of early retirement increased even more. Adjusting for the same factors for those whose workplace had experienced a merger made no difference to the likelihood of early retirement.

Relocation was linked somewhat less closely to early retirement and the demerging of departments or workgroups had no effect at all.

On their own, poor quality work relationships and networks and low levels of organisational justice were also associated with early retirement. How well people felt they were managed had an effect only once background factors (apart from age) were taken into account. When any organisational change was factored in as well as the quality of the work environment variables, the likelihood of an employee retiring early increased further.

Organisational change matters

Taking everything into account, we can say, for the first time, and with considerable confidence, that when it comes to early retirement, organisational change makes a difference, particularly where it involves a change of management. Organisational changes on top of a work environment that is perceived to be poor compounds the likelihood of an employee retiring early.

Given that our research focuses on people who are not retiring because of poor health or disability – the very employees that organisations and policy makers want to encourage to work for longer – our findings are likely to be of considerable interest.

Key would seem to be careful consideration of the impacts of any restructuring within a business or organisation. Improving the workplace environment could also have a role in reducing the numbers of employees calling time on work before the age of 65.

The frequent occurrence of organisational change in the Danish healthcare sector is interesting in the light of medical doctors, nurses and other health and social care workers recently being identified as shortage occupations in Denmark. Managing those changes and improving the working environments of people working in these occupations could be a priority, not least because ageing populations not just in Denmark, but the world over, clearly need these groups of workers more than ever before.

Organizational change, psychosocial work environment, and non-disability early retirement: a prospective study among senior public employees
 is research by Nina Breinegaard, JH Jensen and JP Bonde and is published in the Scandinavian Journal of Work, Environment and Health.

Photo credit: Workers, Justin Lynham

Healthy pensioners: Is working in our 60s good for us?

Pension ages in the UK are rising from the traditional 65 for men and 60 for women, as people live longer. But is working in later life good for us? The Government’s Chief Medical Officer Professor Dame Sally Davies says people aged 50-70 are more likely to stay healthy if they stay in work, but what does the evidence show? Dr Giorgio Di Gessa from the London School of Economics and Political Science and colleagues have investigated how being in paid work beyond state pension age affects our physical and mental health and how well we sleep and find a different story.

By 2020, it is estimated that one third of workers will be over 50. By then the state pension age will also have risen to 66 for everyone in the UK, climbing to 67 by 2028.

Figures from the Office for National Statistics reveal more than 1.2 million over-65s remain in work, an increase of nearly 50 per cent since the Default Retirement Age was banned in 2011, meaning employers cannot make staff retire when they reach state pension age.

With so many older people working, and with UK policies, and those of other western nations, designed to extend working lives, it is important to understand how continuing to work might affect our health.

Many studies have shown that working is good for physical and mental health in adults of normal working age. There is also evidence that retirement can be good for health. But little research has focused on the impact on health of working beyond State Pension age.

A previous study using the British Household Panel Survey suggests those working beyond state pension age self-report better health, but their lifetime health history was not studied. Given that healthier people are more likely to stay working, this needs to be taken into account for a more accurate picture.

Previous work history is also important, as there is evidence of poorer health among those with significant periods out of work. This is also likely to affect decisions about whether to continue working in later life.

Working longer

Using information on more than 1,600 people from the English Longitudinal Study of Ageing, we looked at the health and employment histories of men aged 65 to 74, and women aged 60 to 69. After those ages few men or women worked. Around a quarter of the women and 15 per cent of the men worked past State Pension age.

Participants in the study were asked if they had difficulties falling or staying asleep and whether they felt tired on waking up. Their grip strength was measured, and they also rated their own health, reporting any medical problems such as a long standing illness, heart disease, stroke, or loss of mobility.

For those who were employed, we looked at whether they worked more or less than 20 hours each week, and whether they had sedentary or active jobs. We also looked for differences between those in managerial and professional occupations through to those with routine and manual jobs.

Periods of unemployment for men and part-time working and career breaks for women were taken into account, together with the individual’s education, wealth, housing situation, marital status, caring responsibilities and factors like smoking and exercising.

Good health

Men and women in good health were more likely to be working past state pension age, as were those with a better education and those who had been in better health throughout their lives . Among women, those who were divorced or separated, still had mortgages and were not carers were more likely to continue working.

One third of those working beyond state pension age were in managerial positions, 45 per cent worked part-time, and one third of men and 41 per cent of women had a desk job. Men and women who worked throughout their lives were more likely to continue working after state pension age.

Men and women in paid work were less likely to be depressed or to have disturbed sleep, and reported better physical health, than those who didn’t work.

However, when social background, and previous health and employment histories were taken into account, we did not find any significant health benefits of working past state pension age. This is most likely to be because only a select group of healthy older adults work beyond this age.

Population health

What is clear is that the decision and ability to continue working past state pension age is strongly affected by current and lifetime health.

Overall, our study shows that extending our working lives has no effect on our health. However, it remains an open question whether changing the state pension age could worsen population health if everyone, including those in poor health, is required to work longer.

To support policies aimed at extending working lives, it will be essential for governments to focus on health promotion and policies which help to improve the health of the population throughout their working life.

Going forward it would be useful to know more about the reasons people continue working. Is it through choice or because they need the money? It would also be good to look at the timing of previous poor health to see at what stage ill health stops people from working.

Further information

Is being in paid work beyond state pension age beneficial for health? Evidence from England using a life-course approach is research by Giorgio Di Gessa of the London School of Economics and Political Science, Laurie Corna of King’s College London, Loretta Platts of Stockholm University, Diana Worts and Peggy McDonough of the University of Toronto, Amanda Sacker of University College London, Debora Price of the University of Manchester, and Karen Glaser of King’s College London. It is published in the Journal of Epidemiology & Community Health.

Photo credit: Farmer stepping into cab, United Soybean

Who works post State Pension Age?

Across Europe and indeed other parts of the world, we’re being told we need to work longer than in the past. The reason? We’re all living longer and pension systems everywhere are collapsing under the strain. But with age can come poorer health and reduced physical capabilities and what if doing our job is physically or mentally demanding? Raising the State Pension Age for this group of workers compared say with someone working in a less stressful job could end up creating pressure on specific disadvantaged groups, whilst favouring already advantaged groups. Morten Wahrendorf from the University of Dusseldorf and ESRC International Centre for Lifecourse Studies has been investigating.

A number of Governments across Europe have already increased the state pension age beyond 65 and are actively looking to introduce incentives and measures that they hope will get more people of working age to retire later.

Quite a lot of research has looked at what things are going on in people’s lives that might lead them to retire early from work, but far fewer questions have been asked about what might lead to someone working beyond state pension age. What sorts of jobs do they tend to do? What are their working conditions like? How do those compare with people who retire earlier?

It’s important to get a grasp of this if we are to ensure that any changes made to the pension system are fair and just and that they don’t adversely affect specific or already disadvantaged groups.

Using information on nearly 18,000 men and women aged 65 and over from 16 European countries we were able to look into this in some depth and effectively compare prior working conditions of those people who retired early with current conditions of those who worked longer.

Work and conditions

Our information came from the Survey of Health, Ageing and Retirement in Europe (SHARE). We looked at whether the participants were employed or not, their job (at the time of the survey and immediately before retiring), how long they had been doing their job, working hours and how stressful their job was.

In addition we looked at what the participants said about how much freedom they had at work, whether there were opportunities to develop new skills, whether their job was physically demanding or time-pressured and how supported and recognised they felt at work.

As far as survey participants’ health was concerned, we were able to see how they rated their own health, whether they were depressed, their quality of life, and how mentally and physically capable they were.

Workers better-off and better-educated

Of everyone we looked at in the study, 755 (4.3 per cent) were still working between the ages of 65 and 80. They tended, on average, to be better off and better-educated than those who had retired.

Those still working were three times as likely to be self-employed as our retired group, who were also less likely to have been in a managerial or professional job before retiring.

Those who had retired reported higher levels of stress in their last job, particularly when it came to how valued and supported they felt. They also had poorer health across the board on all the measures we looked at.

Figure 1. Prevalence of poor health by labour market situation among older men and women (aged 65 to 80 years) in percentage (n=17625

ICLS-health

These findings were still seen even after accounting for a host of other factors including their sex, education, whether or not they were in a relationship, if they had children and how well off they were, and also country affiliation.

There is robust evidence here that across Europe people who are likely to work longer are those who are self-employed or in a good job where they are in control and feel well supported and valued. They are also in better physical and mental shape than their retired counterparts.

Raising the State Pension Age or offering tax incentives to people to work longer may well favour certain groups who are already doing better than their peers in a number of ways. It could also place increased pressure on people already in poor health and in poor quality jobs.

All this needs to be taken into account by Governments looking to plug the pensions gap and by employers who will need to provide good jobs in a better, less stressful working environment if their workers are to remain productive post 65.

Further information

Photo credit: Fish, nico_enders

Out of work again? The psychological impacts of repeated unemployment

Being unemployed is bad for our mental well-being, but if we lose our job more than once does the psychological blow lessen in some way? Researchers Cara Booker from the University of Essex and Amanda Sacker at the International Centre for Lifecourse Studies at UCL used the long-running British Household Panel Survey to examine the psychological well-being of people who have repeatedly lost their jobs. Their findings show that our employment history makes a difference and could have implications for welfare to work initiatives from Governments looking to get people back to work.

Continuous employment may be what is best for us, but of course life is not always that straightforward and, at any given time, a significant proportion of the population will be out of work. This could be because we choose to take time out to undertake training or to have a family. We may fall ill or be made redundant.

The world of work is also becoming more flexible. Fewer people are staying with the same firm for long periods of time and more people are moving from contract to contract or job to job, sometimes with spells of unemployment in between.

At the same time, the Government wants to get more people off benefits and into work and is looking to make its Work Programme more effective.

Using 17 years of data collected from the participants in the British Household Panel Survey (1991-2008), we looked at any individual who had reported at least one spell of unemployment. Of these 1,642 participants, 82 per cent were unemployed once, 15 per cent twice and 3 per cent three or more times.

Mental health score

Participants were asked a range of questions about their mental health and answers to these were used to allot a score with 0-11 indicating good psychological health and 12 or more indicating stress or anxiety that could lead to ill health. The time periods before and after a spell of unemployment were also taken into account because job loss isn’t generally something that happens suddenly and there can be weeks or months building up to it.

Looking at the group as a whole, we found their psychological well-being was generally poorer during all spells of unemployment compared with when they were not unemployed, but there was no evidence of a lowering or increasing of the effect from one spell of unemployment to the next.

When we dug deeper into participants’ prior work history, however, we saw some differences between those people who had previously been ‘economically inactive’ (voluntarily not working e.g. to look after family or study) and those who had been working.

Those who prior to being employed had been ‘voluntarily’ not working suffered poorer psychological well-being after they went on to lose their job but became notably worse in the third spell of unemployment.

The previously employed group’s psychological well-being also took a knock after losing a job once and then again, but, by the third time there was no change, a possible indication that the individual is somehow adapting or getting used to dealing with the ‘shock’ of becoming unemployed.

When we compared levels of psychological well-being between these two groups, they were notably lower among the previously employed at unemployment spells one and two, but this was reversed at spell three.

Employment history matters

So only when we took into consideration being economically inactive as opposed to employed, did a slightly clearer picture emerge around this question of whether people adapt to the ‘shock’ of unemployment, with those previously employed seeming to adapt and those previously economically inactive becoming increasingly sensitive to it. These findings were given further weight when we looked at retrospective employment histories before the BHPS began.

One explanation for this is that those who come from an employed background tend to find work again after each unemployment spell they experience, so they become less anxious about finding another job. The economically inactive, meanwhile, seem to find it harder to enter and re-enter the job market which could account for increased anxiety with more attempts to sign up as ‘unemployed and seeking work’.

Household income also played a role with those who were economically inactive on higher than average incomes experiencing worse psychological well-being than their less off counterparts when making an unsuccessful attempt to enter employment.

In its recent Welfare-to-Work report, the Work and Pensions Committee pointed out that key to the programme’s success was providing unemployed people with “the right help at the right time” and a better understanding of the barriers and characteristics that prevent a swift return to work. A better understanding of the impacts of repeated spells of unemployment on people’s well-being would seem to resonate here.

It is also clear that good quality, secure employment opportunities with long term prospects are key to people’s health and happiness.

Psychological well-being and reactions to multiple unemployment events: adaptation or sensitisation? is research by Cara Booker and Amanda Sacker and is publishes in the Journal of Epidemiology and Community Health

Photo credit: Kathryn Decker

 

Does having a rotten job in middle age leave us depressed in retirement?

People’s working conditions have been high up the news agenda recently and not just in non European parts of the world either. Understandably, considerable concern has been expressed about the impact that low paid jobs with poor and uncertain conditions have on workers’ lives. But what are the impacts of poor or stressful working conditions and job uncertainty on people’s mental health further down the line once they stop working? Morten Wahrendorf from University of Düsseldorf in Germany and colleagues at the ESRC International Centre for Lifecourse have carried out research across Europe and found that those with poor jobs and working conditions in mid life are considerably more likely to suffer with depression after they retire.

Right across Europe people are living longer – on the face of it – a good thing. Unfortunately, for many, that increased life expectancy is accompanied by extended periods of poor health or disability – both physical and mental. The consequences of this are deeply worrying for policy makers funding services to care for people, overstretched health professionals and, of course for people themselves and their families.

It’s really important, therefore, to get a better handle on what goes on in our lives before we retire that might be linked to this later poor health. If we can identify what might lie behind it, we are more likely to be able to make changes and put things in place that reduce the risk for future generations.

The research looked at the mental health of nearly 5000 men and 4000 women with an average age of around 70 in 13 European countries and then looked back at their working lives in mid life to see what picture might emerge.

Using information from the Survey of Health, Ageing and Retirement in Europe (SHARE), we looked at how stressful their job had been both physically and mentally, how well rewarded and supported they felt, whether they had been laid off or had a period of unemployment. We used a special set of questions asked in the survey to identify whether or not the participants showed signs of depression.

Physically and mentally demanding work

More then a quarter of the men and a fifth of the women reported their job had been highly physically and/or highly mentally demanding. The proportion of women who worked in low-skilled jobs was lower among women compared with men (80 per cent women, 68 per cent men).

With regard to stressful conditions at work, 15 per cent of men and 23 per cent of women said they had had low levels of control at work. 20 per cent of men and 27 per cent of women said the rewards were low and 17 per cent of men and 20 per cent of women said they received low levels of social support.

When we linked their earlier working life to their mental health in retirement, both men and women who had previously worked in mentally stressful jobs were more likely to exhibit signs of depression later on. For men, the strongest links with depression were for those who reported having jobs with a low level of control, whilst for women it was jobs with low levels of social support.

Both men and women who had worked in poor quality jobs were considerably more likely to be depressed than their peers with good jobs. Unsurprisingly, those people who had been unexpectedly laid off from a job in mid life were also more likely to be depressed later. Surprisingly, though unemployment and a fragmented career were associated with depression in men only.

The results stayed strong even after taking account of the workers’ health and social circumstances before middle age.

Clear and robust link

The research reinforces a number of studies drawing a clear and robust link between poor mental health in later life and a disadvantaged working life in middle age, whether that be in terms of working environment or job uncertainty. What’s new here though is tracing that link over people’s lifecourse from middle age into retirement. The research also shows some important and interesting distinctions between men and women.

There is a clear message here too for policy makers, business and health professionals that mid-life is a critical period where appropriate interventions and employment-related policies, such as lifelong learning programmes, through programmes increasing job security, or even mindfulness training, could bring significant benefits to individuals and society more widely, especially in the undeniable context of us all living and working longer.

Working conditions in mid-life and mental health in older ages is research by Morten Wahrendorf, David Blane, Mel Bartley, Nico Dragano and Johanes Siegrist and is published in Advances in Life Course Research.

Photo credit: World Bank

 

 

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.