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J Epidemiol Community Health 64:5-6 doi:10.1136/jech.2009.089797
  • Commentary

Do we need to worry about the health effects of unemployment?

  1. M Bartley1,
  2. J Ferrie2
  1. 1
    ESRC International Centre for Life Course Studies, Department of Epidemiology & Public Health, University College London, London, UK
  2. 2
    Department of Epidemiology & Public Health, University College London, UK
  1. Correspondence to Professor M Bartley, ESRC International Centre for Life Course Studies, Department of Epidemiology & Public Health, University College London, 1–19 Torrington Place, London WC1E 6BT; m.bartley{at}ucl.ac.uk
  • Accepted 24 May 2009

The Journal of Epidemiology and Community Health has a tradition of publishing articles and commentaries on associations between unemployment and health; work that has helped shaped the agenda for future research in the field.1 2 3 4 5 The article by Lundin and colleagues in the current issue, (see page 22),6 is a welcome continuation of that tradition. Coming early in the current recession the article is a timely reminder of the individual health consequences of economic downturn.

Sweden’s military capacity is built on conscription, and until the early 1990s and the end of the Cold War nearly all men reaching the age of military service were conscripted. At enlistment all conscripts undergo a comprehensive physical examination, an interview with a psychologist and provide personal information by questionnaire. These data have been used previously to investigate a number of health and health-related outcomes.7 8 However, little previous work has made use of these data to study labour market exposures later in life, or capitalised to such a degree on record linkage to other register-based data widely available in Scandinavian countries.

The personal ID issued to all Swedish citizens has enabled the authors to link information from the conscription examination to data from four national registries at the level of the individual. Censuses provide socioeconomic data from childhood and early mid-life, questionnaire data at conscription is used to determine health-related behaviour and contact with the authorities in late adolescence. Information on psychiatric diagnoses in late adolescence is supplemented by hospital discharge data, and health status in the 2 years prior to the unemployment observation window is provided by sickness absence data from national registers. The result is a large and impressive dataset that allows the authors to bring a life course approach to the association between unemployment …