Unemployment Insurance and Mortality Among the Long-Term Unemployed: A Population-Based Matched-Cohort Study

Higher unemployment benefits are associated with reduced drug overdose mortality in the United States before and during the COVID-19 pandemic

OBJECTIVES

Overdose mortality rates in the United States remain critical to population health. Economic , such as unemployment, are noted risk factors for drug overdoses. The COVID-19 pandemic exacerbated economic hardship; as a result, the US government enacted income protection programs in conjunction with existing unemployment insurance (UI) to dampen COVID-19-related economic consequences. We investigate whether UI, operationalized as the weekly benefit allowance (WBA) replacement rate, is negatively associated with drug-related overdoses.

METHODS

Data from the pooled 2014-2020 Detailed Restricted Mortality files for all counties from the Centers for Disease Control and Prevention, restricted to people ≥18 years of age, aggregated at the county-quarter level (n = 89,914). We included any fatal drug, opioid, and stimulant overdose. We modeled the association between WBA replacement rate (e.g., a greater proportion of weekly earnings replaced by UI) on each county-level age-adjusted mortality outcome using separate linear regression models during 2014-2020, pre-COVID (2014-2018), and post-COVID (2019-2020). We conducted sensitivity analyses using multi-level linear regression models.

RESULTS

Results indicated that a more robust WBA replacement rate any drug (Risk Difference [RD]: -0.06, 95 % Confidence Interval [CI]: -0.08, -0.05), opioid (RD: -0.04, 95 % CI: -0.06, -0.03), and stimulant (RD: -0.03, 95 % CI: -0.04, -0.02) across the entire study period (2014-2020). A more robust WBA replacement rate was associated with fewer fatal drug, opioid and stimulant overdoses in the pre-COVID-19 period and on fatal any drug and stimulant overdoses in the COVID-19 period.

CONCLUSIONS

Findings support the notion that income protection policies, such as robust UI, can have a supportive role in preventing fatal drug overdoses, calling for a broader discussion onthe role of the safety net programs to buffer drug-related harms.

Labour market status and mortality risk: The Finnmark cohort study 1987-2017

AIMS

The aim of this study was to investigate the age-varying mortality risk associated with different labour market status categories.

METHODS

Data from a population-based survey carried out among adults aged 30-62 years in Finnmark in 1987/1988 were linked to the Norwegian Cause of Death Registry to identify all deaths occurring by December 2017. We used flexible parametric survival models to examine the age-varying associations between different labour market status categories (no paid work/homemaker, part-time work, full-time work, unemployment benefits, sick leave/rehabilitation allowance, and disability pension) and mortality.

RESULTS

Men with part-time work, unemployment benefits, sick leave/rehabilitation allowance, or disability pension had an increased mortality risk compared with men with full-time work; however, these findings were restricted to ages below 60-70 years, varying with labour market status category. For women, excess mortality was linked to disability pension in the younger age groups; in older age groups it was linked to the labour market status category no paid work/homemaker. Non-employment was associated with low education level compared with full-time employment.

CONCLUSIONS

The study showed increased mortality risk for some non-employment categories, with decreasing relative risk with age. Our findings suggest that the increased mortality risk is partly explained by health, pre-existing illnesses, and health-related behaviour and partly by other factors, such as social network and economic factors.

Weathering the storm together: Does unemployment insurance help couples avoid divorce?

This study examines whether unemployment insurance benefit generosity impacts divorce, drawing on full population administrative data and a Swiss reform that reduced unemployment insurance maximum benefit duration. We assess the effect of the reform by comparing the pre- to the post-reform change in divorce rates among unemployed individuals who were affected by the reform with the change in divorce rates among a statistically balanced group of unemployed individuals who was not affected by the reform. Difference-in-differences estimates suggest that the reform caused a 2.8 percentage point increase in divorce (a 25% increase). Effects were concentrated among low-income couples (+58%) and couples with an unemployed husband (+32%) though gender differences are attributable to men's breadwinner status. Female main breadwinners were more strongly affected (+78%) than male main breadwinners (+40%). Results confirm the 'family stress model' which posits that job search and financial stress cause marital conflict. Policymakers should consider a broad array of impacts, including divorce, when considering reductions in unemployment insurance generosity.

Employment Insurance may mitigate impact of unemployment on food security: Analysis on a propensity-score matched sample from the Canadian Income Survey

Food insecurity, the inadequate access to food due to financial constraints, affects one-sixth of Canadian households, with substantial health implications. We examine the impact of unemployment and the mitigating effect of Employment Insurance (EI) on household food insecurity in Canada. Using the Canadian Income Survey 2018-2019, we sampled 28,650 households with adult workers 18-64 years old. We used propensity score matching to pair the 4085 households with unemployed workers with 3390 households with only continuously employed workers on their propensity towards unemployment. Among unemployed households, we also matched 2195 EI recipients with 950 nonrecipients. We applied adjusted logistic regression to the two matched samples. Food insecurity affected 15.1% of the households without unemployed workers and 24.6% of their unemployed counterparts, including 22.2% of EI recipients and 27.5% of nonrecipients. Unemployment was associated with 48% (adjusted odds ratio [aOR] 1.48, 95% confidence interval [CI] 1.32-1.66; 5.67 percentage points) higher likelihood of food insecurity. This association was significant and similar across income levels, full-time and part-time workers, and household compositions. EI receipt was associated with 23% (aOR 0.77, 95% CI 0.66-0.90; 4.02 percentage points) lower likelihood of food insecurity, but this association was only significant among households with lower income, full-time workers, and children under 18. The findings suggest a broad impact of unemployment on working adults' food insecurity and a substantial mitigating effect by EI on select unemployed workers. Making EI more generous and accessible for part-time workers may help alleviate food insecurity.

Barriers and Facilitators of Re-Employment among Senior Workers: Prospective Cohort Study

Re-entering the labour market after a period of unemployment can be challenging for seniors. This study investigates personal as well as circumstantial barriers and facilitators of re-employment. Unemployed seniors in Denmark (≥50 years, n = 1636) from the first wave (mid-2018) of the SeniorWorkingLife study were prospectively followed until March 2020 in national registers on labour market participation. Using weighted logistic-regression-modelled odds ratios (ORs), we estimated the association between personal and circumstantial factors at baseline and re-employment during follow-up. During follow-up, 28% re-entered paid employment. The desire to have a job (reference: not having the desire to have a job) increased the likelihood of re-employment (OR 2.35, 95% CI 1.14-4.85). Contrastingly, a higher age (60-63 vs. 50-54 years; OR 0.36, 95% CI 0.16-0.79) and poor health (OR 0.32, 95% CI 0.16-0.61) decreased the likelihood of re-employment. Sex, education and belief that age constitutes a barrier to re-employment were not associated with the likelihood of re-employment. Unemployed seniors desiring to have a job are more likely to get a job. However, a higher age and poor health are important barriers that should be taken into account, e.g., by ensuring employment opportunities for these groups in society.