American Journal of Epidemiology Advance Access published online on March 15, 2007
American Journal of Epidemiology, doi:10.1093/aje/kwm057
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The Effects of Unemployment on Mortality following Workplace Downsizing and Workplace Closure: A Register-based Follow-up Study of Finnish Men and Women during Economic Boom and Recession
1 Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
2 Population Research Unit, Department of Sociology, University of Helsinki, Helsinki, Finland
3 Department of Economics, Åbo Akademi University, Turku, Finland
Correspondence to Dr. Pekka Martikainen, Helsinki Collegium for Advanced Studies, P.O. Box 4, FIN-00014, University of Helsinki, Helsinki, Finland (e-mail: pekka.martikainen{at}helsinki.fi).
Received for publication June 8, 2006. Accepted for publication September 22, 2006.
Unemployment is strongly associated with mortality on the individual level. The reasons for this association are not fully established. The authors estimated the effects of unemployment and workplace downsizing on mortality during periods of low (1989) and high (1994) unemployment in Finland. They used prospective population registration data containing detailed socioeconomic and demographic information on two cohorts aged 35–64 years at the beginning of 1989 (N = 87,317) and 1994 (N = 72,419) followed up for mortality in 1990–1997 and 1995–2002, respectively. Unemployment was found to be associated with a 2.38-fold increase in the hazard of mortality after 1989 and with a 1.25-fold increase after 1994. No excess mortality was observed among those who, at baseline, were employed at workplaces that had experienced large reductions in employment. Furthermore, the association between unemployment and mortality was weaker among those working in establishments that had been strongly downsized. By showing that, in the context of either a high level of unemployment or rapid downsizing, the effects of unemployment on mortality are modest, this study provides strong evidence of unaccounted confounding. Individual-level studies may thus overestimate the causal effects of unemployment on mortality.
economics; follow-up studies; mortality; personnel downsizing; research design; unemployment; workplace
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