Norström Fredrik, Virtanen Pekka, Hammarström Anne, Gustafsson Per E, Janlert Urban
Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-901 85 Umeå, Sweden.
BMC Public Health. 2014 Dec 22;14:1310. doi: 10.1186/1471-2458-14-1310.
Almost all studies on the effect on health from unemployment have concluded that unemployment is bad for your health. However, only a few review articles have dealt with this relation in recent years, and none of them have focused on the analysis of subgroups such as age, gender, and marital status. The objective of our article is to review how unemployment relates to self-assessed health with a focus on its effect on subgroups.
A search was performed in Web of Science to find articles that measured the effect on health from unemployment. The selection of articles was limited to those written in English, consisting of original data, and published in 2003 or later. Our definition of health was restricted to self-assessed health. Mortality- and morbidity-related measurements were therefore not included in our analysis. For the 41 articles included, information about health measurements, employment status definitions, other factors included in the statistical analysis, study design (including study population), and statistical method were collected with the aim of analysing the results on both the population and factor level.
Most of the studies in our review showed a negative effect on health from unemployment on a population basis. Results at the factor levels were most common for gender (25 articles), age (11 articles), geographic location (8 articles), and education level (5 articles). The analysis showed that there was a health effect for gender, age, education level, household income, and geographic location. However, this effect differed between studies and no clear pattern on who benefits or suffers more among these groups could be determined. The result instead seemed to depend on the study context. The only clear patterns of association found were for socioeconomic status (manual workers suffer more), reason for unemployment (being unemployed due to health reasons is worse), and social network (a strong network is beneficial).
Unemployment affects groups of individuals differently. We believe that a greater effort should be spent on specific groups of individuals, such as men or women, instead of the population as a whole when analysing the effect of unemployment on health.
几乎所有关于失业对健康影响的研究都得出结论，失业对健康有害。然而，近年来只有少数综述文章探讨了这种关系，而且没有一篇聚焦于年龄、性别和婚姻状况等亚组分析。我们这篇文章的目的是回顾失业与自我评估健康之间的关系，并重点关注其对亚组的影响。
在科学网进行检索，以查找衡量失业对健康影响的文章。文章的选择仅限于用英文撰写、包含原始数据且于2003年或之后发表的。我们对健康的定义仅限于自我评估健康。因此，与死亡率和发病率相关的测量未纳入我们的分析。对于纳入的41篇文章，收集了有关健康测量、就业状况定义、统计分析中包含的其他因素、研究设计（包括研究人群）以及统计方法的信息，目的是在总体和因素层面分析结果。
我们综述中的大多数研究表明，从总体上看，失业对健康有负面影响。在因素层面，关于性别的结果最为常见（25篇文章），其次是年龄（11篇文章）、地理位置（8篇文章）和教育水平（5篇文章）。分析表明，性别、年龄、教育水平、家庭收入和地理位置对健康有影响。然而，不同研究的这种影响有所不同，无法确定这些群体中谁受益更多或谁受害更多的明确模式。结果似乎反而取决于研究背景。唯一明确的关联模式是社会经济地位（体力劳动者受害更多）、失业原因（因健康原因失业情况更糟）和社会网络（强大的网络有益）。
失业对不同个体群体的影响不同。我们认为，在分析失业对健康的影响时，应更多地关注特定个体群体，如男性或女性，而不是整个总体。
