Productivity costs of schizophrenia spectrum and other psychotic disorders by friction cost and human capital methods: The Northern Finland Birth Cohort 1966

PURPOSE

Psychotic disorders are associated with substantial productivity costs; however no previous studies have compared these between schizophrenia spectrum (SSD) and other psychotic disorders (OP). The human capital method (HCM) and the friction cost method (FCM) are the two most common approaches to assess productivity costs. The HCM focuses on employees' perspectives on the costs, whereas the FCM demonstrates employers' perspectives. Studies comparing these methods when estimating the productivity costs of psychoses are lacking.

METHODS

Utilizing the Northern Finland Birth Cohort 1966 with linkages to national registers, we compared the adjusted productivity costs of SSD (n = 216) and OP (n = 217). The productivity costs were estimated from ages 18 to 53 including projections to statutory retirement age using the FCM and HCM.

RESULTS

When estimated via the HCM, productivity losses were higher for SSD (€193,940) than for OP (€163,080). However, when assessed using the FCM, costs were significantly lower for SSD (€2,720) than for OP (€4,430). Productivity costs varied by sex and various clinical and occupational factors.

CONCLUSION

This study highlights how productivity costs vary by psychosis diagnosis. These differences should be noted when planning interventions. The low FCM estimates indicate the need of interventions before or during the early phases of psychoses. From a societal perspective, interventions are needed, particularly for those with highest HCM productivity losses, such as males with SSD. Besides psychiatric services, the roles of social services, employment agencies and occupational health care should be considered when helping individuals with psychoses to working life.

Did the Finnish depression of the early 1990s have a silver lining? The effect of unemployment on long-term physical activity

This paper studies the impact of long-term unemployment on physical activity. We examined the effects 6 and 15 years following a severe business cycle downturn in Finland over the period 1991-1994. The study sample comprised residents of Northern Finland. The unemployed individuals were 23-26 years old during the downturn. Physical activity, measured by MET minutes and meeting WHO guidelines, was higher 15 years later among those people who experienced the longest periods of unemployment in 1991-1994. Physical activity was somewhat lower among people with relatively shorter periods of unemployment.

Leisure-time physical activity is associated with socio-economic status beyond income - Cross-sectional survey of the Northern Finland Birth Cohort 1966 study

We apply neoclassical economic modelling augmented with behavioral aspects to provide a detailed empirical investigation into indicators of socio-economic status (SES) as determinants of leisure-time physical activity. We utilize the data from the Northern Finland Birth Cohort 1966 obtained at the most recent time point during 2012-2014 (response rate 67 %), at which time the participants were approximately 46 years old. Our final study sample consists of 3,335 employed participants (1520 men, 1815 women; 32.3 % of the target population). We apply logistic regression methods for estimating how the probability of being physically active is related to various indicators of socio-economic status, taking into account physical activity at work and individual lifestyle, family- and health-related factors. Overall, our findings show that belonging to a higher socio-economic group, whether defined by income level, educational attainment, or occupational status, is associated with higher leisure-time physical activity. However, when we analyze different socio-economic groups, defined in terms of education, income and occupation, separately, we find that income is not a significant determinant of leisure-time physical activity within any of the particular SES groups. Further, we find that leisure-time physical activity is negatively associated with higher screen time (i.e., watching TV and sitting at a computer), and other aspects of unhealthy lifestyle, and positively associated with self-assessed health. In addition, we note that proxies for individual motivational factors and childhood physical activity, such as the grade point average and the grade achieved in physical education when leaving basic education, are strongly correlated with leisure-time physical activity in middle age among men, but not among women. Our results are in line with behavioral economics reasoning that social comparisons and environments affect behaviors. We emphasize the importance of considering behavioral economic factors when designing policies to promote physical activity.

Economic crises and suicides between 1970 and 2011: time trend study in 21 developed countries

Background

Existing research on the relationship between economic recessions and suicides has almost completely concentrated on the most recent global financial crisis (2008). We provide the most comprehensive explanation to date of how different types of economic/financial crises since 1970 have affected suicides in developed countries.

Methods

Negative binomial regressions were used to estimate what the suicide rates would have been during and 1 year after each crisis began in 21 Organisation for Economic Co-operation and Development countries from 1970 to 2011 if the suicide rates had followed the pre-crisis trends.

Results

We found that every economic/financial crisis since 1970, except the European Exchange Rate Mechanism crisis in 1992, led to excess suicides in developed countries. Among males, the excess suicide rate (per 100 000 persons) varied from 1.1 (95% CI 0.7 to 1.5) to 9.5 (7.6 to 11.2) and, among females, from 0 to 2.4 (1.9 to 2.9). For both sexes, suicides increased mostly due to stock market crashes and banking crises. In terms of actual numbers, the post-1969 economic/financial crises caused >60 000 excess suicides in the 21 developed countries. The Asian financial crisis in 1997 was the most damaging crisis when assessed based on excess suicides.

Conclusions

Evidence indicates that, when considered in terms of effects on suicide mortality, the most recent global financial crisis is not particularly severe compared with previous global economic/financial crises. The distinct types of crises (ie, banking, currency and inflation crises, and stock market crashes) have different effects on suicide.