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2017 ; 32
(1
): 77-85
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Are some populations resilient to recessions? Economic fluctuations and mortality
during a period of economic decline and recovery in Finland
#MMPMID27730407
Avendano M
; Moustgaard H
; Martikainen P
Eur J Epidemiol
2017[Jan]; 32
(1
): 77-85
PMID27730407
show ga
This paper uses individual-level longitudinal data on working-age Finns to
examine the health effects of economic fluctuations during a period of economic
decline (1989-1996) and recovery (1997-2007) in Finland. We used a nationally
representative, longitudinal sample formed by linking population, employment and
mortality registers (n = 698,484; 7,719,870 person-years). We implemented a
region fixed-effect model that exploits within-regional variations over time in
the unemployment rate to identify the effect of economic fluctuations on
mortality, controlling for individual employment transitions. Unemployment rates
increased from 5.2 % in 1989 to 19.8 % in 1996, declining gradually thereafter
and reaching 9.7 % in 2007. Results indicate that these large fluctuations in the
economy had no impact on the overall mortality of most working age Finns. The
exception was highly educated men, who experienced an increase of 7 % (Rate
ratio = 1.07, 95 % confidence interval 1.04, 1.10) for every one-point increase
in the regional unemployment rate during the period 1989-1996 due to increased
mortality from cardiovascular disease and suicide. This increase, however, was
not robust in models that used the employment to population ratio as measure of
the economy. Unemployment rates were unrelated to mortality among females, lower
educated men, and among any group during economic recovery (1997-2007). For most
Finns, we found no consistent evidence of changes in mortality in response to
contractions or expansions in the economy. Possible explanations include the weak
impact of the recession on wages, as well as the generous unemployment insurance
and social benefit system in Finland.