Economic instability, income, and unemployment effects on mortality: using SUR panel data in Iran.

This study aims to investigate the effects of socioeconomic factors on mortality in Iran. To this end, this research examines how economic instability, income, and unemployment affect mortality using a seemingly unrelated regression (SUR) with panel data for 30 provinces in Iran from 2004 to 2019. The results indicate that unemployment and mortality have a countercyclical relationship among the working age-groups 20-59 but a procyclical pattern among old-age (60+), except for rural mortality. This result is harmonious between employment and age-group mortality. This finding implies that unemployment increases mortality in working age-groups due to psychological stress and poverty risk. In addition, the income level decreases mortality in all ages over 40 years due to the provision of higher access to health and medical services and social welfare. However, it increases mortality in rural areas and age-group 20-39 because of their hazardous, unsafe, and stressful work conditions. Therefore, policymakers should plan for an inclusive economic growth to reduce poverty and out-of-pocket payments and increase the quality and accessibility of public health services, especially for beneficiaries of lower social groups. Moreover, they should adopt strategies to alleviate the burden of premature, preventable, and treatable deaths.

Modelling for disability: How does artificial intelligence affect unemployment among people with disability? An empirical analysis of linear and nonlinear effects.

There is a growing debate among scholars regarding the impact of artificial intelligence (AI) on the employment opportunities and professional development of people with disability. Although there has been an increasing body of empirical research on the topic, it has generally yielded conflicting findings. This study contributes to the ongoing debate by examining the linear and nonlinear effects of AI on the unemployment of people with disability in 40 countries between 2007 and 2021. Using the system Generalized Methods of Moments and panel smooth transition regression, the main conclusions are as follows. First, AI reduces the unemployment of people with disability in the full sample. Second, upon disaggregating the sample based on income level (high income/non-high income) and gender (men/women), the linear model only detects an inverse correlation between AI and unemployment among people with disability in high-income countries and among men, whereas it does not influence unemployment in non-high-income countries and women. Third, the panel smooth transition regression model suggests that the effects of AI on the unemployment of people with disability and among women are only observed once artificial intelligence interest search exceeds a specific threshold level. The effects of AI in non-high-income economies and among women are not significant in the lower regime, which confirms the nonlinear association between AI and the unemployment rate of people with disability. These findings have important policy implications for facilitating the integration of people with disability into the labor market.

Returning to Work Following Hematopoietic Cell Transplantation: The Survivor's Perspective.

While curing a patient's underlying disease is the primary goal of physicians performing hematopoietic cell transplantation (HCT), the ultimate objective is to provide patients with optimal post-HCT quality of life. For many survivors, this includes returning to work (RTW). We conducted a survey of 1- to 5-yr post-HCT survivors at our center to evaluate their perspective on facilitators and barriers to RTW as well as to gauge interest in potentially useful RTW support interventions. Survivors aged 18 to 65 yrs (n = 994) were sent an annual survey that included 36 supplementary questions about post-HCT RTW. Survey questions were selected from published national cancer survivor surveys and then modified specifically for HCT survivors. Three hundred forty-four (35%) survivors with a mean age of 53 yrs completed the survey, of whom 272 (79%) had worked prior to their diagnosis. Of those 272 patients, 145 (53%) were working currently and another 22 (8%) had attempted to go back to work following HCT but were not presently working. We found that having had an allogeneic versus autologous HCT (P = .006) was associated with a decreased likelihood of currently working, whereas frequent employer communication (>once a month) (P = .070) and having a more supportive employer (P = .036) were associated with a greater chance of currently working. Of survivors currently working, 45% reported that they had made one or more changes to their work schedule (e.g., flexible schedule or part-time work) or environment (e.g., work from home) upon RTW. Ninety-five percent of responders reported that they could have benefited from RTW support provided by the transplant center, but only 13% indicated that they had received it. Education on RTW challenges, information on disability benefits, and access to physical therapy were among the most requested support interventions. To improve post-HCT quality of life for survivors open to assistance, providers should address work status and goals, recognize barriers to successful return, and offer RTW support including working directly with employers. Allogeneic HCT survivors are particularly vulnerable to failing attempts to RTW and should be the target of retention interventions. A previously published manuscript on RTW guidance for providers of stem cell transplant patients endorsed by the American Society of Transplant and Cellular Therapy is available in Open Access and can be used as a tool to counsel and support these patients.

Diversity patterns in non-standard employment and their relationship with self-rated health in urban China from 2010 to 2021.

In recent decades, the rise of non-standard employment in China is thought to profoundly influence workers' health. Using data from the China General Social Survey 2010-2021, this study compares the self-rated health of workers engaged in various non-standard employment types with those in unemployment or standard employment in urban China. The research also investigates how these patterns have evolved over time among urban residents with different hukou types amid the expansion of China's welfare system and labor market shifts. We find that while unemployment is significantly related to worse self-rated health, the effects vary across different types of non-standard employment. Precarious employment has a more substantial adverse effect on health than part-time and self-employment, although the effect is less severe than that of unemployment. Between 2010 and 2018, the health impact of precarious employment declined, aligning with China's enhanced welfare system. However, its negative effect re-emerged in 2021. These patterns are particularly pronounced for urban residents holding agricultural hukou, highlighting the intersection of non-standard employment with the household registration system in shaping health outcomes within evolving labor markets.

Death after cure: mortality among pulmonary tuberculosis survivors in rural Uganda.

OBJECTIVE: To determine the incidence of mortality and its predictors among pulmonary TB (PTB) survivors treated at a rural Ugandan tertiary hospital. METHODS: We conducted a retrospective chart review of data between 2013 and 2023. We included all people that met the WHO's definition of tuberculosis cure and traced them or their next of kin to determine vital status (alive/deceased). We estimated the cumulative incidence of mortality per 1,000 population, crude all-cause mortality rate per 1,000 person-years, and median years of potential life lost (YPLL) for deceased individuals. Using Cox proportional hazard models, we investigated predictors of mortality. RESULTS: Of 334 PTB survivors enrolled, 38 (11.4%) had died. The cumulative incidence of all-cause mortality was 113.7 per 1,000 population, and the crude all-cause mortality rate was 28.5 per 1,000 person-years. The median YPLL for deceased individuals was 23.8 years (IQR: 9.6-32.8). Hospitalization (aHR: 4.3, 95% CI: 1.1-16.6) and unemployment (aHR: 7.04, 95% CI: 1.5-31.6) at TB treatment initiation predicted mortality. CONCLUSION: PTB survivors experience post high mortality rates after TB cure. Survivors who were hospitalized and unemployed at treatment initiation were more likely to die after cure. Social protection measures and long-term follow-up of previously hospitalized patients could improve the long-term survival of TB survivors.

Self-Perceived Interpersonal Problems Among Long-Term Unemployed Individuals, and Vocational Rehabilitation Programs (In)ability to Change Them.

OBJECTIVE: Self-perceived interpersonal problems can challenge one's access to the work market, making it harder to attain and keep a job while adding to the distress of being outside of the labor market. METHODS: In this study, we compared the self-perceived interpersonal problems among long-term unemployed individuals taking part in vocational rehabilitation programs (VRPs) (N = 220) with those of the general population. In addition, we examined whether their self-perceived interpersonal problems changed while taking part in the VRPs. RESULTS: We found that participants report significantly higher levels of self-perceived interpersonal problems as measured by the Inventory of Interpersonal Problems (IIP), especially with regard to feeling cold/distanced, socially inhibited, vindictive/self-centered, and non-assertive. The participants did not report a significant decrease in self-perceived interpersonal problems after being part of VRPs for one year. CONCLUSION: These results are relevant as they may inform interventions targeted this population aimed at increasing employability and/or individual well-being. Importantly, the findings may be viewed as a reflection of both social and individual processes. Long-term unemployed individuals' tendency to feel insufficiently engaged may reflect difficulty with keeping up with a job market in constant change.

Long-term benzodiazepine use and risk of labor market marginalization in Finland: A cohort study with 5-year follow-up.

BACKGROUND: Benzodiazepines and related drugs (BZDRs) are widely used in the treatment of anxiety and sleep disorders, but cognitive adverse effects have been reported in long-term use, and these may increase the risk of labor market marginalization (LMM). The aim of this study was to investigate whether the risk of LMM is associated with new long-term BZDR use compared to short-term use. METHODS: This register-based nationwide cohort study from Finland included 37,703 incident BZDR users aged 18-60 years who initiated BZDR use in 2006. During the first year of use, BZDR users were categorized as long-term users (≥180 days) versus short-term users based on PRE2DUP method. The main outcome was LMM, defined as receipt of disability pension, long-term sickness absence (>90 days), or long-term unemployment (>180 days). The risk of outcomes was analyzed with Cox regression models, adjusted with sociodemographic background, somatic and psychiatric morbidity, other types of medication and previous sickness absence. RESULTS: During 5 years of follow-up, long-term use (34.4%, N = 12,962) was associated with 27% (adjusted Hazard Ratio, aHR 1.27, 95% CI 1.23-1.31) increased risk of LMM compared with short-term use. Long-term use was associated with 42% (aHR 1.42, 95% CI 1.34-1.50) increased risk of disability pension and 26% increased risk of both long-term unemployment and long-term sickness absence. CONCLUSIONS: These results indicate that long-term use of BZDRs is associated with increased risk of dropping out from labor market. This may be partly explained by cognitive adverse effects of prolonged BZDR use, which should be taken into account when prescribing BZDRs.

Mental health impacts of COVID-19: A retrospective analysis of dynamic modelling projections for Australia.

Background: In early 2020, we developed a dynamic model to support policy responses aimed at mitigating the adverse mental health effects of the COVID-19 pandemic in Australia. As the pandemic has progressed, it has become clear that our initial model forecasts overestimated the impacts of infection control measures (lockdowns, physical distancing, etc.) on suicide, intentional self-harm hospitalisation, and mental health-related emergency department (ED) presentation rates. Methods: Potential explanations for the divergence of our model predictions from observed outcomes were assessed by comparing simulation results for a set of progressively more refined models with data on the prevalence of moderate to very high psychological distress and numbers of suicides, intentional self-harm hospitalisations, and mental health-related ED presentations published after our modelling was released in July 2020. Results: Allowing per capita rates of spontaneous recovery and intentional self-harm to differ between people experiencing moderate to very high psychological distress prior to the pandemic and those developing comparable levels of psychological distress only as a consequence of infection control measures substantially improves the fit of our model to empirical estimates of the prevalence of psychological distress and leads to significantly lower predicted effects of COVID-19 on suicide, intentional self-harm hospitalisation, and mental health-related ED presentation rates. Conclusion: Accommodating the influence of prior mental health on the psychological effects of population-wide social and economic disruption is likely to be critical for accurately forecasting the mental health impacts of future public health crises as they inevitably arise.

Unemployed, Immigrant, and Older Asian Workers in a U.S.-Based Job-Training Program: Their Experiences and Well-Being, and Strategies for Reaching This Important Population.

The Senior Community Service Employment Program (SCSEP) is a U.S.-based job-training program that serves unemployed workers aged 55 and older with incomes at or below 125% of the federal poverty level. While federal funds are set aside to serve Asian workers in SCSEP, little is known about their characteristics and experiences. In response, this pilot study aimed to document the health, well-being, and experiences of older Asian SCSEP participants in Massachusetts through the completion of a survey. Respondents (N = 39) ranged in age from 58 to 73 and identified as either Chinese (72%) or Vietnamese (28%). All were immigrants, and almost all spoke a language other than English at home. Most reported "good" health as well as financial difficulties. They also stated that their supervisors in their placements were supportive. On average, respondents noted moderate interest in searching for a paid job after exiting SCSEP, although more reported interest in searching for a volunteer role. Key to the success of this study was a robust collaboration with a local human services organization with strong ties to the Chinese and Vietnamese communities. The findings highlight the importance of this growing group of older workers.

Support factors contributing to successful start-up businesses by young entrepreneurs in South Africa.

BACKGROUND: Unemployment and restricted work opportunities for youth are enduring social challenges that affect health, well-being, and quality of life, especially in low- to middle-income countries. When considering the advantages associated with work as a determinant of health, unemployment is understood to contribute to occupational injustice. However, self-employment, hailed the solution to youth unemployment, is often necessity-driven, precarious in nature and restricted by the low success rate of business start-ups. OBJECTIVE: Research was undertaken to explore factors perceived to contribute to the success of start-up businesses in an informal settlement in the Western Cape of South Africa. The importance of support in the success of business start-ups will be the focus of this article. METHODS: A collective case study, using narrative interviewing and - analysis, was undertaken in South Africa. Two narrative interviews were conducted with each of the five participants who were youth entrepreneurs and founders of start-up businesses. Data analysis comprised the use of narrative analysis and paradigmatic type narrative analysis. RESULTS: Three themes captured factors deemed to have contributed to the success of start-up businesses. The vital role of support systems and networks in business success was demonstrated. CONCLUSIONS: Support systems included family, friends, role models, mentors, team members and business partners. Identification, utilization, and ongoing development of support structures available in the social networks of young entrepreneurs were perceived to have contributed to the success of start-ups.

Partner's unemployment and subjective well-being: The mediating role of relationship functioning.

Unemployment affects not only the subjective well-being of the individual, but also that of the partner. Based on the life course perspective and the spillover-crossover-model, we examine the mediating role of relationship functioning for such crossover effects of partner's unemployment on subjective well-being. We also test whether gender differences in the mechanism of relationship functioning can explain the larger overall crossover effects on women compared to men. We use data from the German Family Panel pairfam (2008/09-2018/19), which provide more direct and comprehensive measures of relationship functioning than previous research, and allow us to examine couples' communication and interactions, their conflict styles and behaviors, relationship satisfaction, and perceived relationship instability as mediators. To analyze the impact of the partner's transition to unemployment on subjective well-being, we use fixed effects panel regression models and the product method of mediation analysis to estimate the indirect effects of relationship functioning. The results show that a partner's transition to unemployment has a negative impact on one's own well-being. The effects are more pronounced for women than men which can be partly explained by gender-specific effects of the partner's unemployment on various aspects of relationship functioning, rather than by differential effects of the latter on one's own well-being.

The decrease in alcohol consumption and suicide rate during the COVID-19 pandemic and their association.

Despite the considerable change in alcohol consumption during the COVID-19 pandemic, the impact of the pandemic on the suicide rate in terms of alcohol consumption was not studied. This study was performed to examine whether the change in the suicide rate during the COVID-19 pandemic was related to alcohol consumption and whether the relation was specific to suicides when compared to mortality due to other causes. We performed a comparative interrupted time series (CITS) analysis for the suicide rate of people aged 19 to 60 with three comparison groups (the suicide rate of people aged 19 and under, the cancer death rate of people aged 19 to 60, and alcohol induced death rates). The suicide rate of people aged 19 to 60 and alcohol consumption per capita, along with alcohol induced death rates, continued to decrease during the pandemic in 2020 and 2021 while the suicide rate of people aged 19 and under and the cancer death rate showed an increase. In the comparative interrupted time series model, alcohol consumption had an increasing effect on the adult suicide rate compared to comparison groups when time trends and changes associated with COVID-19 were adjusted. This study shows that the decrease in adult suicide rate in Korea during the pandemic was associated with the decrease in alcohol use among the adult population. Considering that means restriction is the most effective way of controlling suicide and that alcohol can be the most potent and final trigger to suicide, the decrease in suicides during the pandemic and its association with alcohol consumption should be understood as a call for further efforts to decrease alcohol consumption.

The effect of the local economic context and local public services on financial satisfaction among youth in European cities.

The post-2008 economic recovery period has seen varying degrees of improvement in the well-being of young individuals across different countries, regions, and cities of the EU. This study contributes to the literature on the geography of well-being by examining the impact of urban economic contexts on the subjective well-being of youth in Europe, a topic that has received limited attention so far. Specifically, we investigate how the local economic context has affected financial satisfaction among the young (15-35 age group) in European cities during the recovery period after the economic crisis. We study whether living in a city with better opportunities in the labor market, on the housing market, or with better local services (e.g., education or health care) affect financial satisfaction among the young. We carried out multilevel analysis of financial satisfaction among young adults on data from the Quality of Life in European Cities survey (years 2012, 2015, 2019), which asks about aspects of quality of life among a representative sample of the population in a large number of cities in EU Member States. Overall, the results suggest that a better labor market context (where it is in general easier to find a job) has a statistically significant positive effect on financial satisfaction among the young. Our results also show that satisfaction with the financial situation among young adults is significantly higher in cities with a higher quality of local social services. On the other hand, we have found only small (and statistically non-significant) contextual effect related to the local housing market.

Age Differences in Unemployment Risk and Reemployment Outcomes in Late Working Life in Sweden.

Participation of older workers in the labor market depends, among other things, on older workers employment chances. This study examines age differences regarding risk of unemployment and reemployment outcomes in late working life in Sweden. Using Swedish registry data, we analyzed the probability of unemployment as well as work-related activity following unemployment (wage- or self-employment; exit; downward mobility) of all people born between 1954 and 1968 (aged 49-63) and registered in Sweden between the years 2012 and 2018. Results show that although risk of unemployment does not differ significantly across age groups, younger age groups are more likely to be reemployed as wage-employed while older age groups are more likely to be reemployed as self-employed or exit working life. After an unemployment period, older employees are more likely to have a lower wage than during their previous employment or become part-time unemployed. We conclude that different age groups have unequal chances in late working life in terms of reemployment, risk of exit, and risk of downward mobility following unemployment. Policies for extending working life and promoting inequality should include measures for increasing employability of older workers such as anti-discriminatory laws and dealing with skills mismatch.

Among older people, the risk of unemployment does not differ across age groups.Among older people, reemployment chances decrease by age.After unemployment, the probability of exit or self-employment increases by age among older people.Older employees have higher risk of downward mobility after unemployment.Policies for the demand side and employability of older workers are needed.

Joint effects of Medicaid eligibility and fees on recession-linked declines in healthcare access and health status.

Whether Medicaid can function as a safety net to offset health risks created by health insurance coverage losses due to job loss is conditional on (1) the eligibility guidelines shaping the pathway for households to access the program for temporary relief, and (2) Medicaid reimbursement policies affecting the value of the program for both the newly and previously enrolled. We find states with more expansive eligibility guidelines lowered the healthcare access and health risk of coverage loss associated with rising unemployment during the 2007-2009 Great Recession. Rises in cost-related barriers to care associated with unemployment were smallest in states with expansive eligibility guidelines and higher Medicaid-to-Medicare fee ratios. Similarly, states whose Medicaid programs had expansive eligibility guidelines and higher fees saw the smallest recession-linked declines in self-reported good health. Medicaid can work to stabilize access to health care during periods of joblessness. Our findings yield important insights into the alignment of at least two Medicaid policies (i.e., eligibility and payment) shaping Medicaid's viability as a safety net.

Self-Reported Visual Disability and Unemployment: Findings from the National Health Interview Survey.

PURPOSE: To investigate the association between visual impairment and employment status due to disability, utilizing data from the 2022 National Health Interview Survey (NHIS). METHODS: Adults 18 years of age and older were extracted from the 2022 NHIS dataset. A multivariable logistic regression model was created to evaluate the odds of unemployment ("laid off" and "looking for work"). Persons over the age of 65, as well as persons retired, going to school, self-employed, seasonal, or contract workers were excluded. Independent variables for the model included gender, race, Hispanic ethnicity, urban residency, level of education, citizenship, and self-reported vision. The latter variable was categorized as seeing with "some" difficulty, with "severe" difficulty, "can't see at all," and "a lot of difficulty." Outcomes were reported as odds ratios (OR) with 95% confidence intervals (CI). RESULTS: Associations with unemployment included education less than high school (OR 6.05, 95% CI: 3.98-9.18) and high school (OR 3.80, 95% CI 2.78-5.21); severe vision difficulty (OR 3.68 95% CI 1.73-7.86); Asian race (OR 2.53, 95% CI 1.64-3.89); and Black race (OR 1.78, 95% CI 1.31-2.41). The odds of unemployment were marginally elevated for those living in large metropolitan areas, while being born in the United States had a modest protective effect (OR 0.53, 95% CI 0.42-0.66). CONCLUSION: The degree of visual impairment in this post-COVID-19 pandemic survey substantially affects employment, which is consistent with historical studies. Education among those with impaired vision is an important and modifiable variable that can positively influence the chances of employment.

A prospective cohort study of presenteeism and increased risk of unemployment among Japanese workers during the COVID-19 pandemic.

OBJECTIVES: Presenteeism adversely affects workers' quality of life, leading to further deterioration of their health and affecting their ability to continue working. Unemployment is one of the most serious consequences for workers experiencing presenteeism. A worker's ability to work depends on the degree of mismatch between their health status and job demands and work factors. The COVID-19 pandemic has affected workers' experiences of presenteeism as well as their employment status. We examined the association between presenteeism and risk of job resignations and unemployment among Japanese workers during the COVID-19 pandemic. METHODS: A prospective study of 27 036 internet monitors was conducted, starting in December 2020, with 18 560 (68.7%) participating in the follow-up by December 2021. The Work Functioning Impairment Scale (WFun) was used to measure the degree of work function impairment. RESULTS: The group with the highest WFun scores had higher odds ratios (ORs) for both retirement and unemployment for health reasons than the group with the lowest WFun scores. ORs were 2.99 (95% CI, 2.48-3.62; P < .001) and 1.82 (95% CI, 1.65-2.00; P < .001), respectively. CONCLUSIONS: Workers with work functioning impairment are at increased risk of resignation or unemployment. Management strategies for workers with work functioning impairment are needed to reduce their disadvantages in employment.

Disability, Unemployment, and Inequality: A Cross-Country Comparison of the Situation of Persons With Spinal Cord Injury.

Unemployment and inequality are growing concerns that disproportionately affect people with disabilities. We compared unemployment rates and barriers to labor market participation for persons with spinal cord injury (SCI) as an exemplary case of disability with different socioeconomic positions and from a cross-national perspective across 20 countries worldwide. We showed that persons with SCI have much higher unemployment rates than the general population. While this situation is many times worse for those in low-income groups, persons with SCI in high-income groups are often in a position comparable to the general population. The main barriers to entering the labor market are health status, the impossibility of finding suitable jobs, and the lack of information about employment opportunities. This is the first study that quantifies the extent of inequality in the labor market for persons with SCI. Across the 20 countries analyzed, facing disability has a much higher impact on those in low-income groups. This reality is explained by the fact that people in lower-income groups face many more barriers to entering the labor market than those in higher-income groups.

The impact of oil prices, foreign direct investment and trade openness on unemployment rates in an oil-exporting country: The case of Saudi Arabia.

This study analyzes the effects of major macroeconomic variables (oil price, foreign direct investment inflows, real gross domestic product and trade openness) on the unemployment rate in Saudi Arabia. The study adopted the ARDL model and bounds testing for co-integration approach and other diagnostic econometric techniques to check potential issues resulting from the use of time series data, from 1991 to 2019. Findings show that changes in the four variables exhibit a significant negative long-run effect on the unemployment rate. Additionally, we detected a non-linear relationship between unemployment and oil prices. The oil price effect is positive only if it exceeds $41.2 per barrel. A per-barrel price of oil below this threshold appears to worsen the labor market situation in Saudi Arabia. Revenues from oil exports account for major source of income for the country; unfortunately, oil prices are subject to factors beyond the control of the country (inconsistencies in global oil prices). The country needs to diversify its economy especially in growth-enhancing sectors of the economy to generate employment and moderate unemployment.

Understanding complex causes of suicidal behaviour among graduates in Bangladesh.

This study utilizes both fieldwork and desk-based discourse analysis of newspaper reports to investigate the concerning number of suicides among graduates in Bangladesh. According to some reports, a majority of suicide cases involve young adults who are either currently studying at university or have recently completed their degree (between the ages of 20 and 32). This research contends that patriarchal social expectations in Bangladesh place significant pressure on young adults to secure well-paying jobs to support their families and uphold their family's status, which can have a negative impact on their mental health. Furthermore, this article identifies additional risk factors that contribute to the high suicide rates among graduates in Bangladesh. These factors include unemployment, poverty, relationship problems, drug addiction, political marginalization, and the stigma of shame, all of which can cause low self-esteem and suicidal thoughts. Moreover, the research suggests that families in Bangladesh have not been providing adequate support to their young members when facing challenges in life. On the contrary, families have added to the pressure on young adults, which can be attributed to joiner's theory of the effect of industrialization on family norms and values.