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Unemployment has been demonstrated to be a stressful life event with severe health consequences. This paper reviews the literature on the relationship between unemployment and health. Specific risks and the mechanisms that lead to adverse outcomes are identified. Suggested social work interventions to reduce health risks during economic downturns are discussed.
In 1990, 2349 high school pupils from 21 high schools in the Stockholm, Uppsala and Södertälje regions answered a questionnaire concerning how important different characteristics of work were in their future job. The questionnaire also included an open question, "How would you describe an ideal job?" In 1993 the same questionnaire was answered by 1171 high school students. The two measurement occasions were separated by economic changes leading, from a condition of economic security and full employment, to a condition characterised by economic insecurity and high unemployment especially among young people. Results showed that the economic insecurity of 1993 lowered the students' ratings of the importance of all characteristics of work with the exception of the security of work. A strong gender factor influenced the ratings. Thus, the female students rated the importance of the characteristics of work higher than the male students did. The only exception concerned "good pay", which was rated higher by the male. In 1993 these effects were less pronounced, although still evident. The motivational structure seemed to be unaffected by the economic insecurity. The same four motivational factors, i.e. (1) the expressive work goals, (2) the working conditions, (3) the benefits of work and (4) the social aspects of work, appeared in the analyses of both measurement occasions.
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BACKGROUND: The economic recession and stringent economic adjustment programme that Jordan has gone through since the early 1980s have resulted in lower living standards and higher rates of poverty and unemployment. Poverty debilitates women and impairs their access to health care, proper nutrition and well-being in general. RATIONALE: Women's health behaviours and problems need to be analysed from the perspective of women themselves. The purpose of this study was to describe the health perceptions and health behaviours of poor urban Jordanian women aged 15-45 years in the context of the family and community in which they live. The sample consisted of 267 Jordanian women aged 18-45 years, whose household income was below the poverty line. METHOD: This was a community-based study that collected data using semi-structured interviews with women. Health perceptions were measured by asking the women to describe their health status, as they perceived it. Health behaviours were measured by asking the women about their personal hygiene, diet, activity and exercise, sleep, smoking, drinking alcohol, and safety and security. RESULTS: The average age of women was 33 years, 93% were or had been married, and 87.5% had received some form of education. Although the mean age at marriage was about 20 years, 13.6% were married when they were less than 16 years of age. Study women gave a lower rating of their health status than those reported in national studies. Although they reported bathing once a week, eating about three meals a day, and getting 8 hours sleep, there remain areas for improvement in their health behaviours in terms of performing regular exercise, carrying out regular health examinations, and the type and amount of food consumed. RECOMMENDATIONS: Implications for nursing, with a special focus on health education and meeting the health needs of these women, are presented.
The beginning of the 1980s saw the birth of Zimbabwe as a result of a protracted liberation war. It coincided with global interest in primary health care, the concept of universal primary school education and, unfortunately, moves towards economic stabilization and structural adjustment programmes. Economic structural adjustment was adopted by several sub Saharan African countries with dire consequences for the poor and vulnerable. Zimbabwe's commitment to social justice and to equitable distribution of resources demonstrated a practical move away from the culture of rhetoric so characteristic of many governments and non-governmental organisations and agencies. This commitment has been translated into impressive improvements in health and education. Current evidence shows that education has had a positive impact on health and related areas like contraceptive use, child mortality and the nutrition status of children. Conversely nutrition and health conditions among school children are important determinants of educational outcomes. Hitherto Zimbabwe's economy has been sufficiently strong to avoid excessive dependence on the International Monetary Fund, the World Bank and other foreign financial institutions. Unfortunately, however, the current economic recession together with economic structural adjustment programmes are beginning to have a negative impact on health and education. Will true synergism between health and education weather these structural problems? It seems that the people and government of Zimbabwe have the capacity and resolve to weather such a storm.
Trends in Australian heart disease mortality were assessed for association with the business cycle. Correlation models of mortality and unemployment series were used to test for association. An indicator series of "national stress" was developed. The three series were analyzed in path models to quantify the links between unemployment, national stress, and heart disease. Ischemic heart disease (IHD) mortality and national stress were found to follow the business cycle. The two periods of accelerating IHD mortality coincided with economic recession. The proposed "wave hypothesis" links the trend in IHD mortality to the high unemployment of severe recession. The mortality trend describes a typical epidemic parabolic path from the Great Depression to 1975, with a smaller parabolic trend at the 1961 recession. These findings appear consistent with the hypothesis that heart disease is, to some degree, a point source epidemic arising with periods of severe economic recession. Forecasts under the hypothesis indicate a turning point in the mortality trend between 1976 and 1978. (Am J Public Health 69:772-781, 1979).
BACKGROUND: It has been suggested that high unemployment rates in society may be less harmful to the health of people than low unemployment rates. Therefore, a study was carried out to compare, among young men and women, the relationship between health and long-term unemployment during periods of rapid economic growth 'boom' and economic recession. METHODS: Two study groups were chosen at age 21 y (5 y after compulsory schooling ended) from an industrial town in northern Sweden. The first group (number 1083) was chosen and surveyed in 1986 (under 'boom' conditions); the second (number 898) was chosen in 1994 (under economic recession conditions). The non-response rate was 2% for the boom group and 10% for the recession group. The main outcome measurements examined were somatic and psychological symptoms. RESULTS: Health criteria for general health among long-term unemployed young men and women did not differ between the group surveyed in boom conditions and the group surveyed in recession conditions. The only exception was for psychological symptoms, which scored lower among the men in the recession group. Individual unemployment had a high explanatory power for poor health, in particular, psychological ill health. CONCLUSIONS: When comparing periods of boom and recession there was no difference in somatic and psychological symptoms for those who were long-term unemployed. Thus, the trade cycle appeared to have had no impact on their health.
Consumers' self-assessments of materialism and status consumption may be influenced by external economic conditions. In this study, 239 Malaysian students were asked to describe their levels of materialism using Richins and Dawson's 1992 Materialism scale and status consumption using Eastman, Goldsmith, and Flynn's 1999 Status Consumption Scale. Half the students were told to respond assuming that they were in an expanding economy, and half as if the economy was in a recession. Comparison of the groups' mean scores showed no statistically significant differences.
PURPOSE: To assess perceptions of food insecurity (FI), socioeconomic change, and health among urban poor households in Thailand. Research questions were: (a) what are the experiences of food insecurity among households living in slum areas? and (b) what are the socioeconomic conditions, basic needs, food-related behaviors, and perceptions of health that have changed in this group since the 1997 economic recession? METHODS: A cross-sectional descriptive survey was conducted to identify experiences of FI and perceptions of health in households living in slum areas. Questionnaires on food security, health, and nutritional assessment, including 3-day dietary records, and anthropometric measurements, were collected from 199 female food providers of households. FINDINGS: Only 44.2% of the households reported food security, and 39.2%, 13.6%, and 3% reported FI without hunger, FI with moderate hunger, and FI with severe hunger, respectively. Overall, households reported lower income and worse health and life satisfaction as a result of the economic recession. In addition, a decrease in income led to difficulty meeting their basic needs, such as access to health service and food provision. CONCLUSIONS: FI was prevalent and the reported experiences of those with FI indicate areas for improvement of health policy for urban poor families. The results of the study are constructive for developing health programs to empower the urban poor and contribute to health promotion of food security in Thailand.
To clarify changes in mental disorder distribution in suicide attempters, a comparison was made between the period when an economic recession started (1992, 1993) and the period when the recession became serious (2000). The subjects were 212 suicide attempters admitted to the Emergency Medical Center of Tokai University Hospital during a 2-year period between 1992 and 1993 (group A) and 255 suicide attempters admitted during a 1-year period between January and December 2000 (group B). Mental disorders were classified according to the International Classification of Diseases (10th revision; ICD-10). Distribution was compared between groups A and B and significant differences were observed in mental disorder distribution (P < 0.001). The percentages of subjects with depression, those with neurotic disorders, and those with other disorders were higher in group B than in group A. Conversely, the percentage of subjects with schizophrenia was lower in group B than in group A. Mental disorder distribution in suicide attempters significantly changed. However, it was not certain that this change was related to the economic recession and increased unemployment in Japan.
This study examined changes over time in relative health inequalities among men and women in four Nordic countries, Denmark, Finland, Norway and Sweden. A serious economic recession burst out in the early 1990s particularly in Finland and Sweden. We ask whether this adverse social structural'development influenced health inequalities by employment status and educational attainment, i.e. whether the trends in health inequalities were similar or dissimilar between the Nordic countries. The data derived from comparable interview surveys carried out in 1986/87 and 1994/95 in the four countries. Limiting long-standing illness and perceived health were analysed by age, gender, employment status and educational attainment. First, age-adjusted overall prevalence percentages were calculated. Second, changes in the magnitude of relative health inequalities were studied using logistic regression analysis. Within each country the prevalence of ill-health remained at a similar level, with Finns having the poorest health. Analysing all countries together health inequalities by employment status and education showed no major changes. There were slightly different tendencies among men and women in inequalities by both health indicators, although these did not reach statistical significance. Among men there was a suggestion of narrowing health inequalities, whereas among women such a suggestion could not be discerned. Looking at particular countries some small changes in men's as well as women's health inequalities could be found. Over a period of deep economic recession and a large increase in unemployment, particularly in Finland and Sweden, health inequalities by employment status and education remained broadly unchanged in all Nordic countries. Thus, during this fairly short period health inequalities in these countries were not strongly influenced by changes in other structural inequalities, in particular labour market inequalities. Institutional arrangements in the Nordic welfare states, including social benefits and services, were cut during the recession but nevertheless broadly remained, and are likely to have buffered against the structural pressures towards widening health inequalities.
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This paper examines the changes in the economic environment which have taken place in Zimbabwe since independence in April 1980, concentrating on those which are relevant to health. It also describes the post-independence restructuring of the health sector itself. Finally, it considers some changes which have taken place in the health status of children. Despite a prolonged drought, economic recession and the imposition of economic stabilisation measures, there is evidence of a sharp improvement in infant and young child mortality. This has resulted almost certainly from an energetic expansion and reorientation of health care provision, and particularly from greatly improved access to immunisation and oral rehydration therapy. The adverse effects of drought and stabilisation measures have been partially offset by aid-supported relief feeding and particular health programmes. However, the economic crisis has resulted in a decline in real incomes for a large number of households since the immediate post-independence boom. This is reflected in high levels of childhood undernutrition which seem to have remained static despite the health care drive. This emerging divergence between death rates and quality of life as reflected by nutrition levels is reflective on the one hand of rapid expansion in effective health care provision, and on the other of little change in socio-economic conditions for the majority of the population.
The recent economic recession and slow-paced recovery have contributed to dampening out the shortage of hospital-employed registered nurses (RNs), a shortage that has persisted since the mid-1980s. While national unemployment rates remain relatively high and continue to exert economic pressure on RNs to maintain high levels of employment activity, hospital and nurse executives now have an opportunity to make strategic investments in the organizational infrastructure supporting nursing because once the economy rebounds, RN shortages could easily resurface.
Costa Rica is one of the world's success stories in primary health care. During the past 20 years the country has experienced a demographic and epidemiological transition. However, during the 80's the economic recession severely affected the country. The social, economic, political and geographic contexts are important for the assessment of health policy. The longstanding democracy, investments in public education and health all contribute to the peace and stability. Assessment of health policy needs both a quantitative and qualitative approach. The policy-making process--how policies are made, translated into action and evaluated--is a research challenge. The national health policy 1986-1990 includes commitment to Health for All strategy; development of the National Health Care System; strengthening of the health care infrastructure; consolidation of health achievements and undertaking of new problems and approaches on integral care for the population; community participation in all health care system activities; and health care priorities. Important research issues are the relationship between the needs of the population and health policy development and the impacts of health policy on the health of the population. A comprehensive study of policy-making includes studies of policy content, process, output and evaluation of impacts (including economy of health policy), and analysis for policy, i.e. information for policy making, process and policy advocacy. Recent successful health policy issues are child health and HIV/AIDS, while water pollution and traffic accidents have been more problematic policy issues.