Article Text

Download PDFPDF

Long-term effects of youth unemployment on mental health: does an economic crisis make a difference?
  1. Emelie Thern1,
  2. Jeroen de Munter1,
  3. Tomas Hemmingsson2,3,
  4. Finn Rasmussen1,4
  1. 1Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
  2. 2Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
  3. 3Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
  4. 4Health Care Services, Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
  1. Correspondence to Emelie Thern, Child and Adolescent Public Health Epidemiology Unit, Department of Public Health Sciences, Karolinska Institutet, Tomtebodavägen 18A, Widerströmska huset, Stockholm 171 77, Sweden; emelie.thern{at}


Background Ill health is a risk factor and a consequence of unemployment, which might vary depending on the national rate of unemployment. We investigated the long-term effect of youth unemployment on mental health and explored the possible interaction during periods of high (economic crisis) and low (non-crisis) unemployment rates.

Methods A register-linked population-based cohort study was conducted including individuals aged 17–24 years. The crisis cohort (n=6410) took part in the Labour Force Survey during the economic crisis (1991–1994) in Sweden and the non-crisis cohort (n=8162) took part in the same survey before the crisis (1983–1986). Follow-up was 19 years. Adjusted HRs and 95% CIs for an inpatient care discharge mental diagnosis with employed people as the reference group were calculated by Cox regressions models.

Results In fully adjusted models, <3 months (HR: 1.69; 95% CI 1.14 to 2.49), 3–6 months (2.19; 1.43 to 3.37) and >6 months (2.70; 1.71 to 4.28) of unemployment were associated with increased risks of getting a mental diagnosis in the crisis cohort. In the non-crisis cohort the risks were: 1.92; 1.40 to 2.63, 2.60; 1.72 to 3.94 and 3.33; 2.00 to 5.57, respectively. No interactions between labour force status and level of unemployment were found.

Conclusions Youth unemployment is related to mental health problems, independent of the overall national rate of unemployment, which is important as the youth unemployment rates are currently at stable high level.


This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors FR conceived the study. ET conducted the statistical analysis and provided the first draft of the manuscript. All authors provided substantial editing to the final manuscript.

  • Funding This work was supported by a grant to Finn Rasmussen from the Swedish Research Council for Health, Working Life, and Welfare with contract number 2014–2009.

  • Competing interests None declared.

  • Ethics approval The study was approved by the Stockholm Regional Ethical Review Board (Dnr: 2016/112-31).

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.