No abstract

Background: Mass unemployment in Europe is endemic, especially among the young. Does it cause mortality? Methods: We analyzed long-term effects of unemployment occurring during the deep Swedish recession 1992–96. Mortality from all and selected causes was examined in the 6-year period after the recession among those employed in 1990 (3.4 million). Direct health selection was analyzed as risk of unemployment by prior medical history based on all hospitalizations 1981–91. Unemployment effects on mortality were estimated with and without adjustment for prior social characteristics and for prior medical history. Results: A prior circulatory disease history did not predict unemployment; a history of alcohol-related disease or suicide attempts did, in men and women. Unemployment predicted excess male, but not female, mortality from circulatory disease, both ischemic heart disease and stroke, and from all causes combined, after full adjustment. Adjustment for prior social characteristics reduced estimates considerably; additional adjustment for prior medical history did not. Mortality from external and alcohol-related causes was raised in men and women experiencing unemployment, after adjustment for social characteristics and medical history. For the youngest birth cohorts fully adjusted alcohol mortality HRs were substantial (male HR = 4.44; female HR = 5.73). The effect of unemployment on mortality was not uniform across the population; men, those with a low education, low income, unmarried or in urban employment were more vulnerable. Conclusions: Direct selection by medical history explains a modest fraction of any increased mortality risk following unemployment. Mass unemployment imposes long-term mortality risk on a sizeable segment of the population.

Objectives. We tested 2 hypotheses found in studies of the relationship between suicide and unemployment: causal (stress and adversity) and selective interpretation (previous poor health). Methods. We estimated Cox models for adults (n = 3 424 550) born between 1931 and 1965. We examined mortality during the recession (1993–1996), postrecession (1997–2002), and a combined follow-up. Models controlled for previous medical problems, and social, family, and employer characteristics. Results. During the recession there was no excess hazard of mortality from suicide or events of undetermined intent. Postrecession, there was an excess hazard of suicide mortality for unemployed men but not unemployed women. However, for unemployed women with no health-problem history there was a modest hazard of suicide. Finally, there was elevated mortality from events of undetermined intent for unemployed men and women postrecession. Conclusions. A small part of the relationship may be related to health selection, more so during the recession. However, postrecessionary period findings suggest that much of the association could be causal. A narrow focus on suicide mortality may understate the mortality effects of unemployment in Sweden.

No abstract

Although a small number of studies are available that evaluate the effects of Interviewer characteristics in substance use surveys conducted in person, none have done so using information collected via telephone interviews. We address this issue by examining the utility of social attribution and social desirability models for detecting the presence of Interviewer effects In a large statewide telephone survey concerned with substance use. The specific outcome variables ofinterest were reports oflifetime and 18-month composite drug use. Analyses focus on the direct effects of Individual Interviewer characteristics (to assess social attribution) and a summary measure of interviewer-respondent similarity (to assess social distance) and employ random effects regression models to control for respondent clustering by Interviewer. Results are most consistent with a social distance model and suggest that social distance between respondent and interviewermay decrease the probability ofrespondents reporting substance use behavior.

This study tests the hypothesis that a disjuncture between an individual's attained level of education and that held by average workers in the individual's occupation leads to higher mortality among those with a prolonged mismatched status. Swedish register data are used in a 19-year longitudinal mortality follow-up study of all causes and specific causes of mortality. Participants were all men and women born between 1926 and 1985 who were alive on 1 September 1990, who had concurrent information on their attained level of education and the specific occupation or industry they were employed in during this period for at least a consecutive year. An objective measure of educational and occupational mismatch was constructed from these data. Those with a stable, over-educated matched, or under-educated employment status are included in the final analysis (N = 2,482,696). Independent of social, family, employers' characteristics and prior health problems, the findings from a multivariate, stratified Cox regression analysis suggest there is excessive mortality among the over-educated, and a protective effect of under-education among native-born Swedish men and women.

AimThis study examined the long‐term cognitive and educational outcomes of being born small for gestational age (SGA) and assessed whether the family's attitude towards education modified the effect of being born SGA on educational attainment.MethodsWe used anonymised data on 9598 individuals from the Stockholm Birth Cohort. This study focused on babies born in 1953 in the Stockholm metropolitan area, who were followed up for 50 years, and included educational data at the age of 13 and 48. Ordinary least squares regression analyses, modification analyses and logistic regression analyses were conducted.ResultsThe findings suggested that individuals who were born SGA (n = 798) had lower mean verbal, spatial and numerical test scores than those born appropriate for gestational age (AGA) (n = 7364) and large for gestational age (n = 1436). The SGA/AGA differences were small, but statistically significant, and the effects of being born SGA on the test scores was modified by the family's attitude towards education. The findings also suggested that attaining higher education was largely, but not entirely, explained by the family's attitude towards education.ConclusionThe detrimental effects of being born SGA were limited on cognitive and educational outcomes, but may have been reduced by positive family attitudes.

Much of the literature related to the skimming or cropping of students by charter schools has ignored special education students. This article examines the relationship between the severity of student disabilities and their likelihood of having attended an Arizona charter school in the 2002-2003 school year. After adjusting for student traits, local education agency characteristics, and the mix of available special education services, a multilevel logistic regression analysis suggests that students who had more severe and thus more expensive disabilities were less likely to attend an Arizona charter school. Findings from an ancillary set of hierarchical linear models suggested that special education students enrolled in charter schools were less expensive on average than similar traditional public-school special education students.