Currently, US unemployment claims have skyrocketed to 30 million in the past six weeks, continuing in a stark upward trend, and labor economists estimate the unemployment rate at minimally 18.3%. ...These unemployment figures are a feature of the COVID-19 recession that is characterized by sharp gross domestic product (GDP) growth decline. Despite the greatly damaging impact of the opioid crisis over 2015 to 2017 resulting in a decrease in life expectancy over these three years, the long-term increases in average GDP per capita from 1999 to 2018 managed to save lives on average (i.e., age-adjusted mortality rates declined in the United States). For example, during 1999 to 2018, the average GDP per capita annually increased 1.2%, whereas the related age-adjusted mortality rate has shown an annual decrease of approximately 1% on average (0.99%). However, recessions erase some of this beneficial effect of GDP growth on mortality reduction.1The legislated relief measures have challenged the dichotomy between either combating the COVID-19 pandemic or concentrating on economic recovery. Similarly, an epidemic of chronic disease, mental illness, and mortality is a potential consequence of the COVID-19- related recession. This can be hypothesized considering both primary health care use decline and stress-induced illness likely to result from short- and long-term unemployment, including loss of income and employer-based health insurance as well as the destruction of wealth.These corollary effects of major economic distress need to be distinguished from the anxiety, fear, and depression that have arisen from the pandemic itself and its widespread mental health consequences. The supervening corollary public health outcomes are expected to be generated by unemployment, poverty, prevailing health disparities, and a decline in access to health care resulting from the COVID-19 economic breakdown. Public policy experts have already sounded the alarm, questioning whether the $2 trillion relief package as well as planned additional measures will be sufficient to stem the tide of economic shock, sharp GDP decline, and projected long-term damage to livelihoods. However, although the priority is to contain the spread of COVID-19, public health officials need to anticipate and plan for the potential health impact of the recession that results from the pandemic.
The SARS-CoV-2 (COVID-19) pandemic has contributed to increasing levels of anxiety, depression and other symptoms of stress around the globe. Reasons for this increase are understandable in the ...context of individual level factors such as self-isolation, lockdown, grief, survivor guilt, and other factors but also broader social and economic factors such as unemployment, insecure employment and resulting poverty, especially as the impacts of 2008 recession are still being felt in many countries further accompanied by social isolation. For those who are actively employed a fear of job and income loss and those who have actually become ill and recovered or those who have lost family and friends to illness, it is not surprising that they are stressed and feeling the psychological impact. Furthermore, multiple uncertainties contribute to this sense of anxiety. These fears and losses are major immediate stresses and undoubtedly can have long-term implications on mental health. Economic uncertainty combined with a sense of feeling trapped and resulting lack of control can contribute to helplessness and hopelessness where people may see suicide as a way out. Taking a macro view, we present a statistical model of the impact of unemployment, and national income declines, on suicide, separately for males and females over the life cycle in developed countries. This impact may reflect a potent combination of social changes and economic factors resulting in anomie. The governments and policymakers have a moral and ethical obligation to ensure the physical health and well-being of their populations. While setting in place preventive measures to avoid infections and then subsequent mortality, the focus on economic and social recovery is crucial. A global pandemic requires a global response with a clear inter-linked strategy for health as well as economic solutions. The models we have constructed represent predictions of suicide rates among the 38 highly industrialized OECD countries over a period of 18 years (2000-2017). Unemployment has a major effect on increasing suicide, especially in middle-aged groups. However, the impact of economic decline through losses of national income (GDP per capita) are substantially greater than those of unemployment and influence suicide throughout the life course, especially at the oldest ages.
...the relative lack of health insurance by private or government sources is heavily dominated by lower socioeconomic groups. ...the YLL argument for resource allocation based on economic ...productivity places an additional burden of minimization of health care resources allocated to those most in need. In YLL and related measures of premature death, we have a metric that denies the motivation to expand life beyond the "standard" working life.3,4 The use of YLL as an agediscriminatory measure for allocation of health resources compounds the fact that over the past fewdecades, in the United States and United Kingdom, age discrimination in older populations' receipt of health services has been rampant-even regarding cardiovascular illnesses and cancer.5 Indeed, such discrimination is contrary to law in the United States. There is evidence that age discrimination in health care leads to higher mortality in older populations. 6 Furthermore, age discrimination has been extensive in employment and reemployment in the United States, again despite its being contrary to established federal law. By contrast, the causes of death more common in younger industrialized country populations, heavily beset by mental and behavioral disorders (anxiety, depression, alcohol and opioid abuse) have proven more intractable to preventive measures.7 EQUALITY IN HEALTH RESOURCE ALLOCATION In the current US political climate, with impending legislation proposing major reductions in health insurance, the use of YLL legitimates further devaluation of older and less healthy populations.
Few studies have examined depression as both a cause and effect of unemployment, but no prior work investigated these relationships in the context of organisational downsizing. We explored whether ...the exposure to downsizing is associated with subsequent depression (social causation), and whether pre-existing depression increases the risk of being laid off when organisations downsize (health selection).
Two successive waves of the nationally representative Swedish Longitudinal Occupational Survey of Health represented the baseline (2008) and follow-up (2010) of this study. Analyses included 196 workers who lost their jobs through downsizing, 1462 layoff survivors remaining in downsized organisations and 1845 employees of non-downsized workplaces. The main outcomes were: (1) Depressive symptoms at follow-up, assessed with a brief subscale from the Symptom Checklist 90, categorised by severity levels ("major depression", "less severe symptoms" and "no depression") and analysed in relation to earlier downsizing exposure; (2) Job loss in persons with downsizing in relation to earlier depressive symptoms. The associations were assessed by means of multinomial logistic regression.
Job loss consistently predicted subsequent major depression among men and women, with a somewhat greater effect size in men. Surviving a layoff was significantly associated with subsequent major depression in women but not in men. Women with major depression have increased risks of exclusion from employment when organisations downsize, whereas job loss in men was not significantly influenced by their health.
The evidence from this study suggests that the relative importance of social causation and health selection varies by gender in the context of organisational downsizing. Strategies for handling depression among employees should be sensitive to gender-specific risks during layoffs. Policies preventing social exclusion can be important for female workers at higher risk of depression.
The manner in which organizational downsizing is implemented can make a substantial difference as to whether the exposed workers will suffer from psychological ill health. Surprisingly, little ...research has directly investigated this issue. We examined the likelihood of psychological ill health associated with strategic and reactive downsizing.
A cross-sectional survey included 1456 respondents from France, Sweden, Hungary and the United Kingdom: 681 employees in stable workplaces (reference group) and 775 workers from downsized companies. Reactive downsizing was exemplified by the exposures to compulsory redundancies of medium to large scale resulting in job loss or surviving a layoff while staying employed in downsized organizations. The workforce exposed to strategic downsizing was represented by surplus employees who were internally redeployed and supported through their career change process within a policy context of "no compulsory redundancy". Symptoms of anxiety, depression and emotional exhaustion were assessed in telephone interviews with brief subscales from Hospital Anxiety Scale (HADS-A), Hopkins Symptom Checklist (SCL-CD
) and Maslach Burnout Inventory (MBI-GS). Data were analyzed using logistic regression.
We observed no increased risk of psychological ill health in the case of strategic downsizing. The number of significant associations with psychological ill health was the largest for the large-scale reactive downsizing: surviving a layoff was consistently associated with all three outcome measures; returning to work after the job loss experience was related to anxiety and depression, while persons still unemployed at interview had elevated odds of anxiety. After reactive medium-scale downsizing, unemployment at interview was the only exposure associated with anxiety and depression.
The manner in which organizational downsizing is implemented can be important for the psychological wellbeing of workers. If downsizing is unavoidable, it should be achieved strategically. Greater attention is needed to employment and health policies supporting the workers after reactive downsizing.
Background The hypothesis that economic growth has been the principal source of mortality decline during the 20th century in the United States is investigated. This hypothesis is consistent with the ...large epidemiological literature showing socioeconomic status to be inversely related to health status and unemployment associated with elevated morbidity and mortality rates. Despite evidence over many years showing economic growth, over at least a decade, to be fundamental to mortality rate declines and unemployment rates showing lagged, cumulative effects on mortality rate increases, a recent paper argues that the impact of economic growth is to increase the mortality rate. Methods This study utilizes age-adjusted mortality rates over 1901–2000 in the United States as the outcome measure, while independent variables include real GDP per capita in purchasing power parity, the unemployment rate, and the employment to population ratio. A basic interaction model is constructed whereby (i) real GDP per capita, (ii) the unemployment rate, and (iii) the multiplicative interaction between real GDP per capita and the unemployment rate are analysed in relation to age-adjusted mortality rates. The Shiller procedure is used to estimate the distributed lag relations over at least a decade for variables (i), (ii), and (iii). The error correction method is used to examine these relations for both levels and annual changes in independent and dependent variables. Results While GDP per capita, over the medium- to long-term, is strongly inversely related to mortality rates during 1901–2000, in the very short term—i.e. within the first few months—rapid economic growth is occasionally associated with increased mortality rates estimated in annual changes. With respect to the unemployment rate, the first year (without lag) will frequently be associated with a decrease in mortality, but thereafter, and at least for the following decade, the effect is to increase the mortality rate. Thus, the net effect of increased unemployment is a substantial increase in mortality. This is also reflected in the entirely negative relation between the cumulative effects of the employment to population ratio and mortality rates over a decade. Conclusions Economic growth, cumulatively over at least a decade, has been the central factor in mortality rate decline in the US over the 20th century. The volatility of rapid economic growth as it departs from its major trend, has a very short-term effect (within a year) to increase mortality—partly owing to adaptation to new technology and the adjustment of the formerly unemployed to new jobs, social status, and organizational structures.
Organizational downsizing has become highly common during the global recession of the late 2000s with severe repercussions on employment. We examine whether the severity of the downsizing process is ...associated with a greater likelihood of depressive symptoms among displaced workers, internally redeployed workers and lay-off survivors.
A cross-sectional survey involving telephone interviews was carried out in France, Hungary, Sweden and the United Kingdom. The study analyzes data from 758 workers affected by medium- and large-scale downsizing, using multiple logistic regression.
Both unemployment and surviving layoffs were significantly associated with depressive symptoms, as compared to reemployment, but the perceived procedural justice of a socially responsible downsizing process considerably mitigated the odds of symptoms. Perception of high versus low justice was assessed along several downsizing dimensions. In the overall sample, chances to have depressive symptoms were significantly reduced if respondents perceived the process as transparent and understandable, fair and unbiased, well planned and democratic; if they trusted the employer's veracity and agreed with the necessity for downsizing. The burden of symptoms was significantly greater if the process was perceived to be chaotic. We further tested whether perceived justice differently affects the likelihood of depressive symptoms among distinct groups of workers. Findings were that the odds of symptoms largely followed the same patterns of effects across all groups of workers. Redeploying and supporting surplus employees through the career change process-rather than forcing them to become unemployed-makes a substantial difference as to whether they will suffer from depressive symptoms.
While depressive symptoms affect both unemployed and survivors, a just and socially responsible downsizing process is important for the emotional health of workers.
Can we estimate the consequences of world military expenditures for the physical and mental health of nations that produce and purchase armaments? If anxiety and fear are promoting military ...expenditures, then those sentiments may well reflect poorer mental health and war-related stress as it influences cardiovascular illness rates. Further, extensive military expenditure by a society implies that other societal needs are allocated fewer resources, including nutrition, water and sanitation, health care, and economic development. We use a model focused on military expenditures to predict cardiovascular mortality in world samples of industrialized and developing countries over 2000-2011. The cardiovascular mortality model controls for economic development, smoking, body mass index, systolic blood pressure, and carbon dioxide emissions. Military expenditures as proportion of gross domestic product show significant positive relations to cardiovascular disease mortality in linear multiple regression analyses, using both cross-sectional and pooled cross-sectional time-series approaches.
How do small groups play pivotal roles of invention and innovation in (human) organizations and cultures? Economic theories of human capital, i.e., knowledge-skills—provide classic formulations. The ...economic theories of human capital as intrinsic to societal development and physical survival have direct connections to small group theory of learning through communication and socioemotional interaction. These theories have important parallels in biological theories of the evolution of human intelligence. They are supplemented by social exchange theory and the ecological dominance-social-competition model. These theoretical approaches are common to the overlapping disciplines of social anthropology, sociology and the social psychology of small group behavior.
However, even these theories, while plausible and mutually reinforcing, do not fully account for the extraordinary influence of small groups in the invention and innovation process. A crucial moment of invention and innovation is the psychological stress involved in expression/presentation (even to oneself) of a new idea (on an important subject) that is contrary to accepted (i.e., conventional) wisdom. In this article the argument is made that the social support function of small groups, discussed extensively in the epidemiological literature, facilitates that presentation by: (1) reality testing, i.e., confirmation of the validity (truth value), significance and usefulness of abstract or empirical discovery/creation; (2) emotional support moderating the effects of anxiety or threat; and (3) material support of the discoverer/discovery through financing or provision of significant social contacts.
Thus, we observe trends in human knowledge and consequent economic development: (1) continuous enlargement of the base of knowledge through specialization and differentiation of disciplines and employment, where disciplinary knowledge is embedded in the structure of employment. (2) Sustainable economic development results in expanded human longevity—minus the losses through employment and income inequality.
The impact of economic growth on species survival, engendered by small-group-mediated innovation, can be observed in a statistical model over the beneficial impact of economic development on global cardiovascular mortality. The statistical model also demonstrates the harm to cardiovascular health brought about by employment losses and income inequality associated with world-wide automation.
PDF
