title: Health effects of unemployment in Europe (2008-2011): a longitudinal analysis of income and financial strain as mediating factors.
abstract: BACKGROUND
  Unemployment has a number of negative consequences, such as decreased income and poor self-rated health. However, the relationships between unemployment, income, and health are not fully understood. Longitudinal studies have investigated the health effect of unemployment and income separately, but the mediating role of income remains to be scrutinized. Using longitudinal data and methods, this paper investigates whether the effect of unemployment on self-rated health (SRH) is mediated by income, financial strain and unemployment benefits.
  
  
  METHODS
  The analyses use data from the longitudinal panel of European Union Statistics on Income and Living Conditions (EU-SILC) over the 4 years of 2008 to 2011. Individual fixed effects models are applied, estimating the longitudinal change in SRH as people move from employment to unemployment, and investigating whether this change is reduced after controlling for possible mediating mechanisms, absolute income change, relative income change, relative income rank, income deprivation, financial strain, and unemployment benefits.
  
  
  RESULTS
  Becoming unemployed is associated with decreased SRH (-0.048, SE 0.012). This decrease is 19 % weaker (-0.039, SE 0.010) after controlling for change in financial strain. Absolute and relative changes in household equalized income, as well as changes in relative rank and transitions into income deprivation, are not found to be associated with change in SRH.
  
  
  CONCLUSIONS
  Financial strain is found to be a potential mediator of the individual health effect of unemployment, while neither absolute income, relative income, relative rank, income deprivation nor unemployment benefits are found to be mediators of this relationship.
authors.affiliation: Department of Social Work, Child Welfare and Social Policy, Faculty of Social Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, NO-0130, Oslo, Norway. anne-grete.toge@hioa.no.
authors.forename: Anne Grete
authors.initials: AG
authors.lastname: Tøge
mesh_terms: D057172:Economic Recession / Q000706:statistics & numerical data; D005060:Europe; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*; D014478:Unemployment / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Europe; Financial strain; Fixed effects; Income; Recession; Self-rated health; Unemployment