abstract: 'Background: International literature shows unemployment and income loss

  during the Great Recession worsened population mental health. This

  individual-level longitudinal study examines how regional economic

  trends and austerity related to depression using administrative

  prescription data for a large and representative population sample.

  Methods: Records from a sample of the Scottish Longitudinal Study (N=86

  500) were linked to monthly primary care antidepressant prescriptions

  (2009-15). Regional economic trends were characterized by annual

  full-time employment data (2004-14). Economic impact of austerity was

  measured via annual income lost per working age adult due to welfare

  reforms (2010-15). Sequence analysis identified new cases of

  antidepressant use, and group-based trajectory modelling classified

  regions into similar economic trajectories. Multi-level logistic

  regression examined relationships between regional economic trends and

  new antidepressant prescriptions. Structural equation mediation analysis

  assessed the contributory role of welfare reforms. Results: Employed

  individuals living in regions not recovering post-recession had the

  highest risk of beginning a new course of antidepressants (AOR 1.23;

  95\% CI 1.08-1.38). Individuals living in areas with better recovery

  trajectories had the lowest risk. Mediation analyses showed that 50\%

  (95\% CI 7-61 \%) of this association was explained by the impact of

  welfare benefit reforms on average incomes. Conclusions: Following the

  Great Recession, local labour market decline and austerity measures were

  associated with growing antidepressant usage, increasing regional

  inequalities in mental health. The study evidences the impact of

  austerity on health inequalities and suggests that economic conditions

  and welfare policies impact on population health. Reducing the burden of

  mental ill-health primarily requires action on the social determinants.'
affiliation: 'Pearce, J (Corresponding Author), Univ Edinburgh, Sch GeoSci, Ctr Res
  Environm Soc \& Hlth, Edinburgh EH8 9XP, Midlothian, Scotland.

  Cherrie, Mark; Curtis, Sarah; Baranyi, Gergo; Dibben, Chris; Pearce, Jamie, Univ
  Edinburgh, Sch GeoSci, Ctr Res Environm Soc \& Hlth, Edinburgh EH8 9XP, Midlothian,
  Scotland.

  Curtis, Sarah, Univ Durham, Sch Geog, Durham, England.

  Cunningham, Niall, Newcastle Univ, Sch Geog Polit \& Sociol, Newcastle Upon Tyne,
  Tyne \& Wear, England.

  Dibben, Chris, Univ Edinburgh, ESRC Adm Data Res Ctr, Newcastle Upon Tyne, Tyne
  \& Wear, England.

  Bambra, Clare, Newcastle Univ, Fac Med Sci, Populat Hlth Sci Inst, Newcastle Upon
  Tyne, Tyne \& Wear, England.'
author: Cherrie, Mark and Curtis, Sarah and Baranyi, Gergo and Cunningham, Niall and
  Dibben, Chris and Bambra, Clare and Pearce, Jamie
author-email: jamie.pearce@ed.ac.uk
author_list:
- family: Cherrie
  given: Mark
- family: Curtis
  given: Sarah
- family: Baranyi
  given: Gergo
- family: Cunningham
  given: Niall
- family: Dibben
  given: Chris
- family: Bambra
  given: Clare
- family: Pearce
  given: Jamie
da: '2023-09-28'
doi: 10.1093/eurpub/ckaa253
earlyaccessdate: FEB 2021
eissn: 1464-360X
files: []
issn: 1101-1262
journal: EUROPEAN JOURNAL OF PUBLIC HEALTH
keywords-plus: 'MENTAL-HEALTH; DEPRESSIVE SYMPTOMS; ECONOMIC RECESSION; FINANCIAL

  CRISIS; WELFARE-REFORM; INEQUALITIES; IMPACT; OUTCOMES; TRENDS; TIMES'
language: English
month: APR
number: '2'
number-of-cited-references: '43'
orcid-numbers: 'Bambra, Clare l/0000-0002-1294-6851

  Baranyi, Gergo/0000-0002-3287-3629

  Pearce, Jamie/0000-0002-0994-7140'
pages: 297-303
papis_id: cd8dc638610804c7ead368ade6f6d1a6
ref: Cherrie2021datalinkage
researcherid-numbers: 'Bambra, Clare l/C-1392-2010

  '
times-cited: '4'
title: A data linkage study of the effects of the Great Recession and austerity on
  antidepressant prescription usage
type: article
unique-id: WOS:000667794000013
usage-count-last-180-days: '1'
usage-count-since-2013: '11'
volume: '31'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2021'