Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, California, USA.
Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.
J Gerontol B Psychol Sci Soc Sci. 2024 Oct 1;79(10). doi: 10.1093/geronb/gbae135.
In recent decades, risk of job loss in America after age 50 has been high, potentially causing significant stress during the period preceding retirement. Yet no study has quantified the burden of clinically relevant depressive symptoms attributable to job loss in this age group over this period or identified the most vulnerable populations.
Participants aged 50+ in the Health and Retirement Study (recruited 1992-2016) who were employed and scored <5 on the Center for Epidemiologic Studies-Depression 8-item scale (CESD-8) at baseline (N = 18,571) were followed for depressive symptoms until they first had CESD-8 ≥5 or died, or through the 2018 survey. Parametric g-formula analyses examined the difference in cumulative risk of having CESD-8 ≥5 if there had been no involuntary job loss compared to the observed scenario, adjusting for sex, race/ethnicity, age, and dynamic measures of recent marriage end (divorce or widowhood), having a working spouse, assets/debt, and health changes.
We estimated that risk of CESD-8 ≥5 would have been 1.1% (95% confidence interval [0.55, 1.37]) lower if no involuntary job loss had occurred; job loss accounted for 11% of the total burden among those who lost a job. Stronger associations were observed for women (1.2% [0.7, 1.8] vs men 0.5% [0.2, 1.1]), White respondents (1.0% [0.6, 1.5] vs Black respondents 0.5% [-0.1, 1.4]), and those in the lowest quartile of baseline assets (1.1% [0.4, 1.9] vs wealthiest quartile 0.5% [-0.4, 0.9]).
Involuntary job loss is associated with high depressive symptom burden in older persons, suggesting that screening and intervention soon after job loss may help mitigate depression.
近几十年来,美国 50 岁以上人群失业风险较高,这可能导致他们在退休前承受巨大压力。然而,尚无研究量化这一年龄段在此期间因失业而导致的具有临床意义的抑郁症状负担,也未确定最脆弱的人群。
参加健康与退休研究(1992-2016 年招募)的年龄在 50 岁及以上、基线时(N=18571)就业且中心流行病学研究抑郁量表 8 项(CESD-8)得分为<5 分的参与者,随访至首次 CESD-8≥5 分或死亡,或至 2018 年调查。参数 g 公式分析比较了如果没有非自愿性失业,与观察到的情况相比,CESD-8≥5 的累积风险差异,调整了性别、种族/民族、年龄以及最近婚姻结束(离婚或丧偶)、有在职配偶、资产/债务和健康变化的动态指标。
我们估计,如果没有非自愿性失业,CESD-8≥5 的风险将降低 1.1%(95%置信区间[0.55,1.37]);失业占失业者总负担的 11%。女性(1.2%[0.7,1.8]比男性 0.5%[0.2,1.1])、白人(1.0%[0.6,1.5]比黑人 0.5%[-0.1,1.4])和基线资产最低四分位数的参与者(1.1%[0.4,1.9]比最富有的四分位数 0.5%[-0.4,0.9])的关联更强。
非自愿性失业与老年人较高的抑郁症状负担相关,这表明失业后不久进行筛查和干预可能有助于缓解抑郁。