Unemployment and subsequent depression: A mediation analysis using the parametric G-formula

Maarten Bijlsma, Lasse Tarkiainen, Mikko Myrskylä and Pekka Martikainen

LSE Research Online Documents on Economics from London School of Economics and Political Science, LSE Library

Abstract: The effects of unemployment on depression are difficult to establish because of confounding and limited understanding of the mechanisms at the population level. In particular, due to longitudinal interdependencies between exposures, mediators and outcomes, intermediate confounding is an obstacle for mediation analyses. Using longitudinal Finnish register data on socio-economic characteristics and medication purchases, we extracted individuals who entered the labor market between ages 16 and 25 in the period 1996 to 2001 and followed them until the year 2007 (n = 42,172). With the parametric G-formula we estimated the population-averaged effect on first antidepressant purchase of a simulated intervention which set all unemployed person-years to employed. In the data, 74% of person-years were employed and 8% unemployed, the rest belonging to studying or other status. In the intervention scenario, employment rose to 85% and the hazard of first antidepressant purchase decreased by 7.6%. Of this reduction 61% was mediated, operating primarily through changes in income and household status, while mediation through other health conditions was negligible. These effects were negligible for women and particularly prominent among less educated men. By taking complex interdependencies into account in a framework of observed repeated measures data, we found that eradicating unemployment raises income levels, promotes family formation, and thereby reduces antidepressant consumption at the population-level.

Keywords: Unemployment; Mental health; Depression Young adults Life course; Causal inferenceg-formula (search for similar items in EconPapers)
JEL-codes: J01 R14 (search for similar items in EconPapers)
Date: 2017-10-22
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Citations: View citations in EconPapers (12)

Published in Social Science & Medicine, 22, October, 2017, 194, pp. 142-150. ISSN: 0277-9536

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