Study objective: To investigate the long term effects of early unemployment (a total of more than half a year of unemployment between the ages of 16 and 21) on health behaviour and psychological and somatic symptoms. Design: A 14 year follow up of a cohort of school leavers was conducted from 1981 to 1995. Information was collected by questionnaires. Setting: An industrial town in northern Sweden. Participants: The original cohort was defined as all pupils in a middle sized municipality in the last year of compulsory school at age 16 (n=1083). The participants were followed up between the ages of 16 and 30. The analysis included 96% of the original sample, 547 men and 497 women Main results: After controlling for initial health behaviour and symptoms as well as for working class background and late unemployment, early unemployment among young men and women showed a significant explanatory effect on smoking, psychological symptoms and-among men only-somatic symptoms after a follow up of 14 years. No correlation was found between early unemployment and late excess alcohol consumption. Conclusions: Early unemployment can contribute to adult health problems. Thus, youth unemployment constitutes a significant public health problem, which to a certain extent remains in adult age.T he short-term consequences of unemployment among young people have been well documented in literature with regard to psychological ill health, 1-3 somatic ill health, 4 alcohol consumption, 5 and smoking. 6 However, one of the crucial questions in unemployment research is whether unemployment has only a short-term effect, or if there also is an effect many years after the unemployment has come to an end. This question has a special interest within youth unemployment as work and working life is said to have a fundamental importance for the socialisation of young men and women.
7Only a few longitudinal studies have investigated the problem of long term effects of unemployment. [8][9][10][11][12] In most cases a relatively short period of unemployment at the beginning of a long observation period has been the basis for classifying a person as unemployed or not unemployed. This makes the relations between unemployment and health hard to illuminate.13 Besides these studies have had a narrow focus, for example on mortality.14 15 Few studies have had the possibility to follow up a cohort continuously and correlate outcome measures with unemployment. The British birth cohort study concluded that prolonged unemployment between the ages of 16 and 27 seemed to have a long term effect (after control for health at school as well as socioeconomic background variables) on young men's health. 16 However, the study was performed on men only and the health indicators used did not specify separate effects on health behaviour, psychological or somatic health.The aim of this long term follow up study of young men and women has been to analyse possible effects of early unemployment on adult health behaviour and health symptoms.
METHODIn a prospective cohort study...