OBJECTIVES: We examined the relationship between unemployment and mortality in Germany, a coordinated market economy, and the United States, a liberal market economy. METHODS: We followed 2 working-age cohorts from the German Socio-economic Panel and the US Panel Study of Income Dynamics from 1984 to 2005. We defined unemployment as unemployed at the time of survey. We used discrete-time survival analysis, adjusting for potential confounders. RESULTS: There was an unemployment-mortality association among Americans (relative risk [RR]=2.4; 95% confidence interval [CI]=1.7, 3.4), but not among Germans (RR=1.4; 95% CI=1.0, 2.0). In education-stratified models, there was an association among minimum-skilled (RR=2.6; 95% CI=1.4, 4.7) and medium-skilled (RR=2.4; 95% CI=1.5, 3.8) Americans, but not among minimum- and medium-skilled Germans. There was no association among high-skilled Americans, but an association among high-skilled Germans (RR=3.0; 95% CI=1.3, 7.0), although this was limited to those educated in East Germany. Minimum- and medium-skilled unemployed Americans had the highest absolute risks of dying. CONCLUSIONS: The higher risk of dying for minimum- and medium-skilled unemployed Americans, not found among Germans, suggests that the unemployment-mortality relationship may be mediated by the institutional and economic environment.
OBJECTIVES: We examined the relationship between unemployment and mortality in Germany, a coordinated market economy, and the United States, a liberal market economy. METHODS: We followed 2 working-age cohorts from the German Socio-economic Panel and the US Panel Study of Income Dynamics from 1984 to 2005. We defined unemployment as unemployed at the time of survey. We used discrete-time survival analysis, adjusting for potential confounders. RESULTS: There was an unemployment-mortality association among Americans (relative risk [RR]=2.4; 95% confidence interval [CI]=1.7, 3.4), but not among Germans (RR=1.4; 95% CI=1.0, 2.0). In education-stratified models, there was an association among minimum-skilled (RR=2.6; 95% CI=1.4, 4.7) and medium-skilled (RR=2.4; 95% CI=1.5, 3.8) Americans, but not among minimum- and medium-skilled Germans. There was no association among high-skilled Americans, but an association among high-skilled Germans (RR=3.0; 95% CI=1.3, 7.0), although this was limited to those educated in East Germany. Minimum- and medium-skilled unemployed Americans had the highest absolute risks of dying. CONCLUSIONS: The higher risk of dying for minimum- and medium-skilled unemployed Americans, not found among Germans, suggests that the unemployment-mortality relationship may be mediated by the institutional and economic environment.
Authors: Mona Groß; Annika Herr; Martin Hower; Alexander Kuhlmann; Jörg Mahlich; Matthias Stoll Journal: Int J Public Health Date: 2015-10-01 Impact factor: 3.380
Authors: Cameron A Mustard; Amber Bielecky; Jacob Etches; Russell Wilkins; Michael Tjepkema; Benjamin C Amick; Peter M Smith; Kristan J Aronson Journal: BMC Public Health Date: 2013-05-04 Impact factor: 3.295
Authors: Xiaoshi Yang; Lutian Yao; Hui Wu; Yang Wang; Li Liu; Jiana Wang; Lie Wang Journal: Int J Environ Res Public Health Date: 2016-08-08 Impact factor: 3.390