The influence of the economic crisis on the association between unemployment and health: an empirical analysis for Spain.
OBJECTIVE
To estimate the impact of (particularly long-term) unemployment on the overall and mental health of the Spanish working-age population and to check whether the effects of unemployment on health have increased or been tempered as a consequence of the economic crisis.


METHODS
We apply a matching technique to cross-sectional microdata from the Spanish Health Survey for the years 2006 and 2011-2012 to estimate the average treatment effect of unemployment on self-assessed health (SAH) in the last year, mental problems in the last year and on the mental health risk in the short term. We also use a differences-in-differences estimation method between the two periods to check if the impact of unemployment on health depends on the economic context.


RESULTS
Unemployment has a significant negative impact on both SAH and mental health. This impact is particularly high for the long-term unemployed. With respect to the impact on mental health, negative effects significantly worsen with the economic crisis. For the full model, the changes in effects of long-term unemployment on mental problems and mental health risk are, respectively, 0.35 (CI 0.19-0.50) and 0.20 (CI 0.07-0.34).


CONCLUSIONS
Anxiety and stress about the future associated with unemployment could have a large impact on individuals' health. It may be necessary to prevent health deterioration in vulnerable groups such as the unemployed, and also to monitor specific health risks that arise in recessions, such as psychological problems.
Complutense University of Madrid, Madrid, Spain.
Rosa M
RM
Urbanos-Garrido
Beatriz G
BG
Lopez-Valcarcel
D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D057172:Economic Recession / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data*; D008875:Middle Aged; D012111:Residence Characteristics; D057566:Self Report; D013030:Spain; D013997:Time Factors; D014478:Unemployment / Q000706:statistics & numerical data*; D055815:Young Adult