Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)

Introduction While differences in mental health between recipients and non-recipients of unemployment benefits are well known, it is not known whether such differences exist for musculoskeletal and cardiovascular health problems. This study examined the difference in registry-based diagnoses between...

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Main Authors: Øystein Hetlevik, Gunnel Hensing, Ann Kristin Knudsen, Valborg Baste, Inger Haukenes, Tone Smith-Sivertsen, Sabine Ruths
Format: Article
Language:English
Published: BMJ Publishing Group 2025-04-01
Series:BMJ Public Health
Online Access:https://bmjpublichealth.bmj.com/content/3/1/e001758.full
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author Øystein Hetlevik
Gunnel Hensing
Ann Kristin Knudsen
Valborg Baste
Inger Haukenes
Tone Smith-Sivertsen
Sabine Ruths
author_facet Øystein Hetlevik
Gunnel Hensing
Ann Kristin Knudsen
Valborg Baste
Inger Haukenes
Tone Smith-Sivertsen
Sabine Ruths
author_sort Øystein Hetlevik
collection DOAJ
description Introduction While differences in mental health between recipients and non-recipients of unemployment benefits are well known, it is not known whether such differences exist for musculoskeletal and cardiovascular health problems. This study examined the difference in registry-based diagnoses between short term, long term and non-recipients of unemployment benefits in the Norwegian working-age population and further examined if these associations differed by educational level.Methods A cross-sectional repeated register study comprising all working-age individuals (age 21–67 years) with pensionable income in Norway in the period 2010 (N=2 610 956) to 2016 (N=2 791 103). Data were retrieved from the Norwegian population registry, the Education Database, the Database of Social Insurance and the Control and Reimbursement of Health Care Claims Database and linked on individual level. Associations between recipients and non-recipients of unemployment benefits and physician-certified diagnoses were examined with Poisson regression with robust variance estimates (relative risk (RR) with 95% CI) and stratified by education.Results Both short-term and long-term recipients of unemployment benefits were associated with an increased likelihood of having one or more musculoskeletal, psychological or cardiovascular diagnoses compared with non-recipients. The strength of the associations increased with cumulative days of unemployment, with adjusted RRs (95% CIs) for musculoskeletal disorder 1.7 (1.7 to 1.7); psychological diagnoses 2,.2 (2.2 to 2.3); subgroup depression 3.3 (3.2 to 3.3) and for cardiovascular disease 1.3 (1.3 to 1.3) compared with non-recipients. Among highly educated people, the association between unemployment and having a diagnosis was stronger than among unemployed with medium and low education.Conclusions Unemployment benefits recipiency were associated with musculoskeletal, psychological and cardiovascular diagnoses, and the strength of the association increased with higher education. The direction of the relationship could not be determined in this study.
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spelling doaj-art-e6a0d4dc87874e23b8a4f22c6c1e9c042025-07-02T03:40:17ZengBMJ Publishing GroupBMJ Public Health2753-42942025-04-013110.1136/bmjph-2024-001758Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)Øystein Hetlevik0Gunnel Hensing1Ann Kristin Knudsen2Valborg Baste3Inger Haukenes4Tone Smith-Sivertsen5Sabine Ruths6Global Public Health and Primary Care, University of Bergen, Bergen, NorwaySchool of Public Health and Community Medicine, University of Gothenburg, Gothenburg, SwedenDepartment of Disease Burden, Norwegian Institute of Public Health, Bergen, NorwayHealth and Social Sciences, National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, NorwayGlobal Public Health and Primary Care, University of Bergen, Bergen, NorwayDivision of Psychiatry, Haukeland University Hospital, Helse Bergen HF, Bergen, NorwayGlobal Public Health and Primary Care, University of Bergen, Bergen, NorwayIntroduction While differences in mental health between recipients and non-recipients of unemployment benefits are well known, it is not known whether such differences exist for musculoskeletal and cardiovascular health problems. This study examined the difference in registry-based diagnoses between short term, long term and non-recipients of unemployment benefits in the Norwegian working-age population and further examined if these associations differed by educational level.Methods A cross-sectional repeated register study comprising all working-age individuals (age 21–67 years) with pensionable income in Norway in the period 2010 (N=2 610 956) to 2016 (N=2 791 103). Data were retrieved from the Norwegian population registry, the Education Database, the Database of Social Insurance and the Control and Reimbursement of Health Care Claims Database and linked on individual level. Associations between recipients and non-recipients of unemployment benefits and physician-certified diagnoses were examined with Poisson regression with robust variance estimates (relative risk (RR) with 95% CI) and stratified by education.Results Both short-term and long-term recipients of unemployment benefits were associated with an increased likelihood of having one or more musculoskeletal, psychological or cardiovascular diagnoses compared with non-recipients. The strength of the associations increased with cumulative days of unemployment, with adjusted RRs (95% CIs) for musculoskeletal disorder 1.7 (1.7 to 1.7); psychological diagnoses 2,.2 (2.2 to 2.3); subgroup depression 3.3 (3.2 to 3.3) and for cardiovascular disease 1.3 (1.3 to 1.3) compared with non-recipients. Among highly educated people, the association between unemployment and having a diagnosis was stronger than among unemployed with medium and low education.Conclusions Unemployment benefits recipiency were associated with musculoskeletal, psychological and cardiovascular diagnoses, and the strength of the association increased with higher education. The direction of the relationship could not be determined in this study.https://bmjpublichealth.bmj.com/content/3/1/e001758.full
spellingShingle Øystein Hetlevik
Gunnel Hensing
Ann Kristin Knudsen
Valborg Baste
Inger Haukenes
Tone Smith-Sivertsen
Sabine Ruths
Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
BMJ Public Health
title Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
title_full Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
title_fullStr Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
title_full_unstemmed Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
title_short Unemployment and associations with diagnosed health problems in the Norwegian GP-DEP study: a repeated cross-sectional register study (2010–2016)
title_sort unemployment and associations with diagnosed health problems in the norwegian gp dep study a repeated cross sectional register study 2010 2016
url https://bmjpublichealth.bmj.com/content/3/1/e001758.full
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