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Abstract

Objectives - There were three main objectives in this investigation of the relationship of unemployment with ill health and hazardous health behaviour in young men. The first objective was to assess the role of direct and indirect health selection in explaining the relationship between unemployment and poor health: were men with pre-existing childhood chronic illnesses or greater vulnerability to illness more likely to experience adult unemployment? The second objective was to investigate whether the experience of unemployment was associated with deterioration in health behaviour. The third objective was to assess if the experience of unemployment resulted in deterioration of mental health.

Design and subjects - Data on men from a longitudinal birth cohort study, the National Child Development Study (NCDS) were used in these analyses. NCDS has collected data on all men and women born in one week in 1958 and living in Great Britain. Cohort members were followed up using interviews, self-completion questionnaires and medical examinations at birth and at ages 7, 11, 16, 23 and 33 years. Data were available for 4,999 men at age 33 years.

Methods - Logistic regression was used to investigate the risk of experiencing over one year of accumulated unemployment between ages 22 and 33 years, associated with having a pre-existing illness or vulnerability to illness prior to labour market entry. Accumulated and recent unemployment were used as exposure measures in logistic regression models, where the dependent variables were measures of health behaviour and Body Mass Index (BMI). Cox regression was used to model accumulated and recent unemployment as time dependent covariates, where the dependent variable was onset age of symptoms of depression and anxiety that resulted in medical consultation.

Results - Both childhood chronic illnesses and childhood indicators of vulnerability to illness were associated with an increased risk of adult unemployment. Unemployment was associated with having a less healthy diet and a deterioration in health behaviours, including cigarette smoking, between age 16 and 33 years. Men who had been unemployed reported significantly higher levels of physical exercise in leisure time at age 33 years. Low BMI, but not obesity, was associated with greater amounts of accumulated unemployment. The experience of unemployment was associated with subsequent onset of symptoms of depression and anxiety, resulting in medical consultation. All analyses were adjusted for socioeconomic background and relevant measures of behaviour and health prior to the experience of unemployment.

Conclusions - Unemployment is associated with deterioration in some health behaviours and mental health. Men who experience unemployment are also more likely to have higher levels of pre-existing vulnerability to poor health. Some coping strategies for unemployment may be protective for health, but others may themselves be health risks. Further research into the relationship between unemployment and ill health should model the causal pathways from birth to middle and old age, in order to assess the accumulation of risks associated with unemployment.

Publication Type:	Thesis (Doctoral)
Subjects:	H Social Sciences > HA Statistics H Social Sciences > HM Sociology R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Departments:	School of Policy & Global Affairs > School of Policy & Global Affairs Doctoral Theses School of Policy & Global Affairs > Sociology & Criminology Doctoral Theses

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