Recession has unexpected effects on health, but growing unemployment increases mental health problems among men

During economic downturns, people's health improves when they pay more attention to their health behaviour. This is due to an increase in leisure time, which facilitates participation in health-promoting activities. Increased leisure time can be explained by factors such as reduced overtime and commuting, as well as lay-offs. Reduced work-related accidents, lower stress levels and a lack of rush may also be factors contributing to health.

However, the same effect does not extend to mental health: during an economic downturn, increasing unemployment alarmingly raises mental health problems among working-age men.

The results were obtained in a study conducted at the Oulu University Business School, examining the impact of unemployment on health. The researchers found a statistically significant relationship between the unemployment rate in the municipality of residence and the mental health index, meaning that the higher the unemployment rate in a municipality, the worse the mental health. Previous studies show that suicides also increase in a recession.

A study found that a one percentage point increase in unemployment increased psychiatric inpatient admissions by up to 8.7 percentage points. The use of antidepressants increased by 0.28 percentage points.

The researchers were surprised by the strong link between unemployment and mental health. "This is clearly visible in the age group of working-age men aged 25-64. A similar link is not found for women, for example, suggesting that factors other than labour market conditions have a greater impact on mental health in these groups," says University Researcher Marko Korhonen.

The researcher explains the finding by saying that men experience unemployment more strongly because their identity and self-esteem are often strongly linked to work and income generation. "Traditional gender roles play a role, meaning that men may be expected to be the financial pillar of the family, and thus unemployment may cause a mismatch between expectations and reality," says Korhonen.

Unemployment can be associated with stigma, which puts pressure on working-age men to appear stronger despite the difficulties unemployment causes. Men are also less likely to seek help and social support.

Tailored support measures are needed

The researchers found significant differences between Finnish municipalities in the prevalence of mental health problems and illnesses, as well as unemployment. Mental health, as measured by the municipal mental health index, deteriorated in more than half of the municipalities. The blackest region is Eastern Finland, but the association between mental health deterioration and unemployment is also significant in Northern Ostrobothnia and Southern Lapland. If you become unemployed in Northern Finland, it is difficult to find a job again, as the problem in the North is the lack of jobs. In southern Finland, there is a shortage of mental health services. In all municipalities, the unemployment rate ranged from 2.2% to 28.4%.

The data for the study consisted of unemployment statistics from more than 250 municipalities in Finland and statistics from the THL for the period 2002-2019, including the number of unemployed, the number of episodes of psychiatric inpatient care and the use of antidepressants.

Unemployment-related mental health problems increase health and social security expenditure and the number of disability pensions.

"It is important to recognise that investing in mental health services and supporting the unemployed can significantly reduce long-term costs and improve the well-being of society as a whole. Tailored support measures should be considered, for example when unemployment increases due to structural changes," says Marko Korhonen.

Researchers say more research is needed to shed light on the differences in mental health determinants between genders and age groups. The mental health effects of unemployment should also be examined at the most disaggregated level possible, as economic conditions can have very different effects across regions and groups of people.

A two-stage estimation method was used as the research methodology because the two-way correlation between unemployment and mental health makes it difficult to establish a causal relationship between unemployment and mental health. In this method, the variation in unemployment between municipalities was explained by an employment variable that was independent of municipal-specific economic changes. This allowed to isolate the part of the variation in unemployment that could potentially be the result of inter-municipal variation in mental health.

The research is published in the Social Indicators Research -journal: Saqib Amin, Marko Korhonen, Sanna Huikari: Unemployment and Mental Health: An Instrumental Variable Analysis Using Municipal-level Data for Finland for 2002–2019

On the left: Unemployment rate (%) by municipality in 2018. Source: Statistical information on welfare and health Sotkanet, National Land Survey of Finland (administrative regional divisions) and Syke, Centres for Economic Development, Transport and the Environment (Ranta10). Graph: Matti Koivuranta

On the right: Mental health index by municipality in 2018. The mental health index consists of three figures: the number of people on disability pension due to mental health problems, the number of suicides or suicide attempts leading to treatment, and the special reimbursement rights granted for psychotropic drugs. The index and comparison figure for the whole country is 100. The smaller the number, the healthier the population. No data are available for grey municipalities, as the indexes are only presented to municipalities with more than 2,000 inhabitants. Source: Finnish institute for health and welfare THL, National Land Survey of Finland (administrative regional divisions) and Syke, Centres for Economic Development, Transport and the Environment (Ranta10). Graph: Matti Koivuranta