Selected References These references are in PubMed.
Discussion The most interesting finding of this study is that all the unemployed, with either less or greater than one year of unemployment, reported significantly worse perceived mental health scores as compared to employed or OLF participants.
However, when age, income, gender, and education were used as covariates, only those unemployed for greater than one year had significantly worse scores.
It is of note that those who were unemployed, but not looking for work OLFhad more favorable mental health scores than did those who were involuntarily unemployed.
It also appears that members of the OLF group may be better off financially than the involuntarily unemployed as a much smaller proportion of this group were assigned to the lowest income group see Table 1. It is also possible that because unemployment is a planned and expected event for those who choose to retire, rather than an undesired, disruptive event, and beyond the control of the involuntarily unemployed, differences in mental health status between these groups are seen.
These factors likely explain why our findings do not agree with those of Jahoda or Paul et al, who found that the employed tend to have better mental health profiles than all unemployed groups, regardless of the impetus for being unemployed, be it voluntary or involuntary [ 52021 ].
The lack of control that the involuntarily unemployed may feel is supportive of a model developed by Karasek and Theorell [ 23 ]. This finding is also supportive of the work of Poortinga, Dunstan, and Fune, who have shown that lack of control affects health [ 24 ].
The data in Table 3 suggest that duration of unemployment is also a factor in determining the severity of effects of being jobless. These findings are plausible and are consistent with those of Montgomery et al.
This is relevant in America because unemployment benefits expire after the ninety-ninth week of idleness. Unemployed participants, both those out of work for less, and longer, than one year, were over four times more likely to lack health care coverage and over two times more likely to report delaying health care services due to cost compared to employed participants after adjusting for age, income, gender, race, and education.
This lack of health care for the unemployed exists in spite of a federal program, COBRA, that was designed to provide health care insurance to the unemployed [ 26 ]. Although these findings are not surprising, they are of concern considering that unemployed participants were more likely to report poorer perceived mental health and, therefore, are more likely to need mental health services [ 11 ].
People who experience involuntary unemployment or whose unemployment persists may be a targeted group which needed preventive mental health services. Although most of our results identified negative associations of unemployment and health, that relationship was not universal.
We found that unemployed participants were no more likely to engage in binge drinking and were not less likely to participate in physical activity than employed participants. This finding is inconsistent with previous studies that showed higher rates of alcohol consumption and binge drinking among the unemployed [ 9172728 ].
Our findings also fail to support earlier work that showed more smoking and decreased physical activity among the unemployed [ 161729 ]. However, they also found that people who had been unemployed for greater than six months were more likely to successfully stop smoking than people who had been unemployed for less than six months.
Findings from this study and Fagan et al. In general, smoking and alcohol consumption decrease when the economy is in decline, when unemployment rates increase, and people have less discretionary money [ 27 ]. Limitations of This Study There were limitations with this study.
Because we cannot be certain of the temporal sequence of unemployment and mental health in this study, we must consider the possibility that those with poor mental health may be more likely to be unemployed, rather than those who are unemployed having poorer mental health [ 15 ].
There was also a possibility of bias resulting from self-reported information. The participants may have over- or under-reported information if they perceived it to be a socially desirable response [ 30 ].
People without a home telephone or those who exclusively use a cell phone were excluded from the survey. There was no direct method for correcting for those who do not have a home telephone and this may have resulted in an underestimation of the true prevalence of employment or unemployment in this group [ 22 ].
Conclusion Inunemployment rates reached their highest level since the early s in the United States. During that year, people who reported being unemployed greater than one year also had significantly worse perceived mental health scores, while all unemployed were less likely to have access to health care coverage and were more likely to delay medical treatment due to cost when compared to employed people or people who were voluntarily out of the labor force.
Among the group studied, mental health scores seemed to be impacted by the source of the unemployment, voluntary versus involuntary, with those who were voluntarily unemployed having mental health scores similar to those who were employed.
This study highlights the need for more research to fully understand the impact of unemployment, be it voluntary or involuntary, on mental health.
References United States Department of Labor. Bureau of Labor Statistics. It is irrelevant to my job now. View at Google Scholar A. View at Google Scholar M. Jahoda, Employment and Unemployment: View at Google Scholar D. View at Google Scholar P.Higher incidence of children with chronic health conditions, learning difficulties, and child care issues create the added need for flexibility as parents try to balance these conflicting responsibilities (Richman, Johnson & Buxham, ).
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