title: Unemployment and mental health--who is (not) affected?
abstract: BACKGROUND
  The aim of this study is first, to investigate the association between periods of unemployment and mental distress, adjusting for previous health status, and second, to study differences and similarities between groups defined by age, sex, family situation, socioeconomic position and work environment.
  
  
  METHODS
  The analyses are based on a cohort of participants in Stockholm county council's Public Health Survey 2002 with a follow-up in 2007. Selected from the initial cohort are respondents 20-59 years who were employed at T1 and had no unemployment in 2001-02. Logistic regression is used and differences between groups are expressed as odds ratios. Interaction analyses are also performed.
  
  
  RESULTS
  Initial odds ratios of 1.84 in the group with 1 year of unemployment or more compared to the reference group with no unemployment is reduced to 1.52 after adjustment for prior mental and somatic health. Analyses show that the impact of unemployment in this sample is stronger for men, those working overtime, those with high social support or low control at their previous job, self-employed and those with low occupational class or low previous wage. Regarding family situation, unemployment is least associated with mental distress among individuals living in couples without children.
  
  
  CONCLUSIONS
  Results show an independent effect of unemployment on mental distress, but this effect varies between groups. Both proposed theories: role loss and differential susceptibility, receive some support. Since all interaction analyses are insignificant, results should be interpreted with caution.
authors: Department of Public Health Sciences, Occupational and Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. mona.backhans@ki.se
authors: Mona C
authors: MC
authors: Backhans
authors: Tomas
authors: T
authors: Hemmingsson