Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a randomeffects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late-career. The risk of death was highest during the first 10 years of follow up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors. KeywordsUnemployment; All-cause Mortality; Meta-analysis; Meta-regression; Systematic Review; Psychosocial Stress; health behaviours According to the United States Department of Labor, the US unemployment rate was 9.6% in August 2010 (compared to 5.8% in July 2008), remaining near its highest level in 25 years (United States Department of Labor, 2010). As of July 2010, the unemployment rate was 7.1% in Canada, 5.3% in Australia, 4.9% in Japan, 9.6% in France, 7.3% in Germany, 8.5% in Italy, 4.4% (June 2010) in the Netherlands, 8.4% in Sweden, and 7.8% (May 2010) © 2011 Elsevier Ltd. All rights reserved.Contact information for corresponding author (David Roelfs): S-401 SBS Building Department of Sociology Stony Brook University Stony Brook, NY 11794-4356. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptSoc Sci Med. Author manuscript; available in PMC 2012 March 1. The London Times estimated that, as a result of the current economic crisis, the number of unemployed worldwide could climb further, from 179 million in 2007 to 230 million (Mortished, 2009). This recent rise makes understanding the health effects of unemployment particularly important.Over the last 4 decades the study of unemployment and its association with health and mortality has expanded significantly (see Hanisch, 1999 for an early comprehensive review on unemployment research). Wheth...

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The study of spousal bereavement and mortality has long been a major topic of interest for social scientists, but much remains unknown with respect to important moderating factors such as age, follow-up duration, and geographic region. The present study examines these factors using meta-analysis. Keyword searches were conducted in multiple electronic databases, supplemented by extensive iterative hand searches. We extracted 1381 mortality risk estimates from 124 publications, providing data on more than 500 million persons. Compared to married people, widowers had a mean hazard ratio (HR) of 1.23 (95% confidence interval [CI], 1.19–1.28) among HRs adjusted for age and additional covariates and a high subjective quality score. The mean HR was higher for men (HR, 1.27; 95% CI, 1.19–1.35) than for women (HR, 1.15; 95% CI: 1.08–1.22). A significant interaction effect was found between gender and mean age, with HRs decreasing more rapidly for men than for women as age increased. Other significant predictors of HR magnitude included sample size, geographic region, level of statistical adjustment, and study quality.

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The study of marital dissolution (i.e. divorce and separation) and mortality has long been a major topic of interest for social scientists. We conducted meta-analyses and meta-regressions on 625 mortality risk estimates from 104 studies, published between 1955 and 2011, covering 24 countries, and providing data on more than 600 million persons. The mean hazard ratio (HR) for mortality in our meta-analysis was 1.30 (95% confidence interval [CI], 1.23-1.37) among HRs adjusted for age and additional covariates. The mean HR was higher for men (HR, 1.37; 95% CI, 1.27-1.49) than for women (HR, 1.22; 95% CI: 1.13-1.32), but the difference between men and women decreases as the mean age increases. Other significant moderators of HR magnitude included sample size; being from Western Europe, Israel, the United Kingdom and former Commonwealth nations; and statistical adjustment for general health status.

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Never-married persons (singles) constitute a growing demographic group; yet, the magnitude of the all-cause relative mortality risk for nonelderly singles is not known and important moderating factors have not been explored. The authors used meta-analysis to examine 641 risk estimates from 95 publications that provided data on more than 500 million persons. The comparison group consisted of currently married individuals. The mean hazard ratio for mortality was 1.24 (95% confidence interval: 1.19, 1.30) among multivariate-adjusted hazard ratios with a high subjective quality rating. Meta-regressions showed that hazard ratios have been modestly increasing over time for both genders, but have done so somewhat more rapidly for women. The results also showed that the hazard ratio decreased with age and that study quality has an important relation to hazard ratio magnitude.