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Stress markers in the unemployed linked to poor health

New molecular evidence implicates direct effects of stress in the increased mortality and ill-health of unemployed people

University College London

Research from the ESRC International Centre for Lifecourse Studies at UCL suggests direct biological effects of stress during unemployment may help explain the increased mortality and morbidity among jobseekers. The study used biological signatures in blood samples called inflammatory markers, which are influenced by stress and are clinically important because mildly raised levels predict atherosclerosis (narrowing of the arteries due to fatty deposits) and heart disease.

Using data on 23,025 participants from the Health Survey for England and Scottish Health Survey, the researchers found that unemployed men and women had higher levels of inflammatory markers than employed counterparts, after taking into account a wide range of demographic and lifestyle factors: occupational social class from last job, housing tenure, smoking, alcohol consumption, body mass index, long-term health conditions, and depressive/anxiety symptoms. Older jobseekers (aged 48-64) were more affected than younger jobseekers. Effects were stronger in Scotland, where unemployment was higher and unemployment spells on average longer during the years of the study. The authors suspect this may point to 'accumulation effects', with inflammatory markers more affected if a person has been unemployed for a long time. This would also explain the stronger effects for older jobseekers, likely to have accumulated more unemployment than younger counterparts. Additionally, unemployment may be more stressful for older jobseekers facing age discrimination or with outdated skills.

It is well known that unemployed people are at greater risk of mortality and physical ill-health compared to employed counterparts, but it is still unclear exactly how unemployment damages health. A stressful experience often involving loss of status and social support as well as income, unemployment could damage health through direct effects of stress in a similar way to other negative life events such as bereavement, or by causing changes in lifestyle factors like smoking and exercise. Alternatively, jobseekers might be less healthy because poor health increases chance of unemployment. This is why inflammatory markers were used in this study - because mild increases in inflammatory markers reflect early stages of disease before people begin to feel ill, they should not on their own influence chance of job loss or re-employment.

The researchers said: 'These results indicate that stress itself may play a pathological role during unemployment which is independent of lifestyle factors, but that certain groups may be more affected than others. This research highlights the need to protect both the long-term unemployed and older jobseekers in the labour force.'

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The paper by Amanda Hughes, Meena Kumari, Anne McMunn and Mel Bartley was published in the Journal of Epidemiology and Community Health. It is available here: http://jech.bmj.com/content/early/2015/02/19/jech-2014-204404.short

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