Unemployment and mortality: a small area analysis.

It has been claimed that unemployment affects the health and thus the mortality of the unemployed, their families, and other members of their communities. This paper examines the relation between mortality and the unemployment experiences of small areas which vary in the extent to which their unemployment levels have changed in recent years. Quarterly numbers of unemployed, classified by age, sex, duration of unemployment, and unemployment office for 1977-81, have been aggregated to correspond to Family Practitioner Committee areas (FPCs), for which population and mortality data had been collected for a different study. There was little variation in long term (greater than 6 months) unemployment trends prior to July 1980, but subsequently there were large variations between FPCs in the rate of increase in unemployment rates. Mortality data for suicide, ischaemic heart disease, cerebrovascular disease, and all causes were examined for the period 1975-83. When the mortality trends of FPCs with different unemployment experiences were compared, no statistically significant differences in trends were found, although areas with greater increases in unemployment appeared to have slightly worse mortality trends for suicide, ischaemic heart disease, cerebrovascular disease, and total mortality for men in the younger age groups. If changes in the level of unemployment do have an effect on changes in trends in mortality levels, this effect is not of sufficient magnitude to be statistically significant with the sample available, in spite of the fact that it included the whole of England and Wales.