Lost in transition: a systematic review of the association between unemployment and mental health

Virgolino, Ana; Costa, Joana; Santos, Osvaldo; Pereira, Maria Emília; Antunes, Rita; Ambrósio, Sara; Heitor, Maria João; Carneiro, António Vaz

doi:10.1080/09638237.2021.2022615

Cited by 33 publications

(26 citation statements)

References 114 publications

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“…Given that social health and mental health are intrinsically linked, a negative association with one’s social status (for example, because of unemployment) or social constructs and circumstances (such as housing instability) may contribute to symptoms of psychologic distress and unhealthy behaviors. This has been shown to have a dominant association with decreased level of capability [41].…”

Section: Discussionmentioning

confidence: 99%

Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain

Lin

Wagner

Trutner

et al. 2023

Clin Orthop Relat Res

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BackgroundMusculoskeletal providers are increasingly recognizing the importance of social factors and their association with health outcomes as they aim to develop more comprehensive models of care delivery. Such factors may account for some of the unexplained variation between pathophysiology and level of pain intensity and incapability experienced by people with common conditions, such as persistent nontraumatic knee pain secondary to osteoarthritis (OA). Although the association of one’s social position (for example, income, employment, or education) with levels of pain and capability are often assessed in OA research, the relationship between aspects of social context (or unmet social needs) and such symptomatic and functional outcomes in persistent knee pain are less clear.Questions/purposes(1) Are unmet social needs associated with the level of capability in patients experiencing persistently painful nontraumatic knee conditions, accounting for sociodemographic factors? (2) Do unmet health-related social needs correlate with self-reported quality of life?MethodsWe performed a prospective, cross-sectional study between January 2021 and August 2021 at a university academic medical center providing comprehensive care for patients with persistent lower extremity joint pain secondary to nontraumatic conditions such as age-related knee OA. A final 125 patients were included (mean age 62 ± 10 years, 65% [81 of 125] women, 47% [59 of 125] identifying as White race, 36% [45 of 125] as Hispanic or Latino, and 48% [60 of 125] with safety-net insurance or Medicaid). We measured patient-reported outcomes of knee capability (Knee injury and Osteoarthritis Outcome Score for Joint Replacement), quality of life (Patient-Reported Outcome Measure Information System [PROMIS] Global Physical Health and PROMIS Global Mental Health), and unmet social needs (Accountable Health Communities Health-Related Social Needs Survey, accounting for insufficiencies related to housing, food, transportation, utilities, and interpersonal violence), as well as demographic factors.ResultsAfter controlling for demographic factors such as insurance status, education attained, and household income, we found that reduced knee-specific capability was moderately associated with experiencing unmet social needs (including food insecurity, housing instability, transportation needs, utility needs, or interpersonal safety) (standardized beta regression coefficient [β] = -4.8 [95% confidence interval -7.9 to -1.7]; p = 0.002 and substantially associated with unemployment (β = -13 [95% CI -23 to -3.8]; p = 0.006); better knee-specific capability was substantially associated with having Medicare insurance (β = 12 [95% CI 0.78 to 23]; p = 0.04). After accounting for factors such as insurance status, education attained, and household income, we found that older age was associated with better general mental health (β = 0.20 [95% CI 0.0031 to 0.39]; p = 0.047) and with better physical health (β = 0.004 [95% CI 0.0001 to 0.008]; p = 0.04), but effect sizes w...

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Section: Discussionmentioning

confidence: 99%

Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain

Lin

Wagner

Trutner

et al. 2023

Clin Orthop Relat Res

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“…With regard to staying employed after the loss of a parent to suicide, our results indicate that men are more vulnerable to falling out of employment in the long term. This is troubling as becoming unemployed is associated with increased suicidal behaviour for men, 45 and so there seems to be an accumulation of risk factors for suicide in this group warranting the attention of clinicians and researchers. Our findings also illustrate the importance of taking into account both the gender of the bereaved and of the deceased when exploring the impact on work participation.…”

Section: Discussionmentioning

confidence: 99%

Employment status and bereavement after parental suicide: a population representative cohort study

et al. 2022

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ObjectivesTo examine employment status among adults bereaved by parental suicide at the time of bereavement and 2 and 5 years after the loss and to explore the importance of the gender of the adult child and the deceased parent.DesignPopulation-based register study.SettingNorwegian population-based registries linked using unique personal identifiers.ParticipantsNorwegian residents aged 25–49 years in the period 2000–2014. Participants were divided into three groups: bereaved by parental suicide, bereaved by parental death of other causes and non-bereaved population controls.Main outcome measuresORs for the risk of non-employment at the time of bereavement and 2 and 5 years after the loss.ResultsThose bereaved by parental suicide had a higher risk of non-employment already at the time of bereavement (OR 1.14, 95% CI 1.05 to 1.23). Stratified analyses showed that women accounted for this difference (OR 1.20, 95% CI 1.09 to 1.33), while no difference was found for men (OR 1.00, 95% CI 0.88 to 1.13). Looking at the gender of the parent, there was only a significant association of non-employment when losing a mother (OR 1.24, 95% CI 1.08 to 1.42), while not for losing a father (OR 1.09, 95% CI 0.99 to 1.20). Among those working at the time of bereavement, offspring bereaved by suicide were more likely to be non-employed at both 2 (OR 1.13, 95% CI 0.99 to 1.30) and 5 (OR 1.20, 95% CI 1.02 to 1.40) years after the loss compared with the general population.ConclusionsWomen bereaved by parental suicide and those losing a mother to suicide were found to have a weaker attachment to the labour market already before losing their parent. Those who were employed when bereaved by suicide were somewhat more likely to be non-employed 5 years after the event.

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“…Young adults are especially likely to experience job instability which we found to be associated with depression, consistently with other studies (6, 7, 26). Importantly, while persons who experience mental health difficulties may be especially likely to become unemployed (27), there is also evidence that the experience of unemployment predicts later symptoms of depression and anxiety (28). The COVID-19 epidemic, which had a major impact on employment irrespective of individuals’ characteristics, is an interesting set-up to examine the relationship between unemployment and mental health, as pre-existing psychological difficulties are likely to play a lesser role than prior to the pandemic.…”

Section: Discussionmentioning

confidence: 99%

Labor market participation and depression during the COVID-19 epidemic among young adults (18 to 30 years): a nationally representative study in France

Melchior

Florence

Davisse‐Paturet

et al. 2022

Preprint

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Objective: To examine the relationship between young adults labor force participation and depression in the context of the COVID-19 pandemic. Design, Setting, Participants: Data come from the nationally-representative EPICOV cohort study set up in France, and were collected in 2020 and 2021 (3 waves of online or telephone interviews) among 2217 participants aged 18-30 years. Participants with prior mental health disorder (n=50) were excluded from the statistical analyses. Results: Using Generalized Estimating Equation (GEE) models controlled for participant socio-demographic and health characteristics and weighted to be nationally-representative, we found that compared to young adults who were employed, those who were studying or unemployed were significantly more likely to experience depression assessed using the PHQ-9 (multivariate ORs respectively: OR: 1.29, 95% CI 1.05-1.60 and OR: 1.50, 1.13-1.99). Stratifying the analyses by age, we observed than unemployment was more strongly associated with depression among participants 25-30 years than among those who were 18-24 years (multivariate ORs respectively 1.78, 95% CI 1.17-2.71 and 1.41, 95% CI 0.96-2.09). Being out of the labor force was, to the contrary, more significantly associated with depression among participants 18-24 years (multivariate OR: 1.71, 95% CI 1.04-2.82, vs. 1.00, 95% CI 0.53-1.87 among participants 25-30 years). Stratifying the analyses by sex, we found no significant differences in the relationships between labor market characteristics and depression (compared to participants who were employed, multivariate ORs associated with being a student: men: 1.33, 95% CI 1.01-1.76; women: 1.19, 95% CI 0.85-1.67, multivariate ORs associated with being unemployed: men: 1.60, 95% CI 1.04-2.45; women: 1.47, 95% CI 1.01-2.15). Conclusions and relevance: Our study shows that in addition to students, young adults who are unemployed also experience elevated levels of depression in the context of the COVID-19 pandemic. These two groups should be the focus of specific attention in terms of prevention and mental health treatment. Supporting employment could also be a propitious way of reducing the burden of the Covid-19 pandemic on the mental health of young adults.

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Lost in transition: a systematic review of the association between unemployment and mental health

Cited by 33 publications

References 114 publications

Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain

Association of Unmet Social Needs With Level of Capability in People With Persistent Knee Pain

Employment status and bereavement after parental suicide: a population representative cohort study

Labor market participation and depression during the COVID-19 epidemic among young adults (18 to 30 years): a nationally representative study in France

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