abstract: 'Background: Even though population health is strongly influenced by

  employment and working conditions, public health research has to a

  lesser extent explored the social determinants of health inequalities

  between people in different positions on the labour market, and whether

  these social determinants vary across the life course. This study

  analyses mental health inequalities between unemployed and employed in

  three age groups (youth, adulthood and mid-life), and identifies the

  extent to which social determinants explain the mental health gap

  between employed and unemployed in northern Sweden.

  Methods: The Health on Equal Terms survey of 2014 was used, with

  self-reported employment (unemployed or employed) as exposure and the

  General Health Questionnaire (GHQ-12) as mental health outcome. The

  social determinants of health inequalities were grouped into four

  dimensions: socioeconomic status, economic resources, social network and

  trust in institutional systems. The non-linear Oaxaca decomposition

  analysis was applied, stratified by gender and age groups.

  Results: Mental health inequality was found in all age groups among

  women and men (difference in GHQ varying between 0.12 and 0.20). The

  decomposition analysis showed that the social determinants included in

  the model accounted for 43-51\% of the inequalities among youths,

  42-98\% of the inequalities among adults and 60-65\% among middle-aged.

  The main contributing factors were shown to vary between age groups:

  cash margin (among youths and middle-aged men), financial strain (among

  adults and middle-aged women), income (among men in adulthood), along

  with trust in others (all age groups), practical support (young women)

  and social support (middle-aged men); stressing how the social

  determinants of health inequalities vary across the life course.

  Conclusions: The health gap between employed and unemployed was

  explained by the difference in access to economic and social resources,

  and to a smaller extent in the trust in the institutional systems.

  Findings from this study corroborate that much of the mental health

  inequality in the Swedish labour market is socially and politically

  produced and potentially avoidable. Greater attention from researchers,

  policy makers on unemployment and public health should be devoted to the

  social and economic deprivation of unemployment from a life course

  perspective to prevent mental health inequality.'
affiliation: 'Brydsten, A (Corresponding Author), Stockholm Univ, Dept Publ Hlth Sci,
  SE-10691 Stockholm, Sweden.

  Brydsten, Anna, Stockholm Univ, Dept Publ Hlth Sci, SE-10691 Stockholm, Sweden.

  Hammarstrom, Anne, Uppsala Univ, Dept Publ Hlth \& Caring Sci, Publ Hlth Unit, SE-75122
  Uppsala, Sweden.

  San Sebastian, Miguel, Umea Univ, Dept Publ Hlth \& Clin Med, Epidemiol \& Global
  Hlth Unit, SE-90185 Umea, Sweden.'
article-number: '59'
author: Brydsten, Anna and Hammarstrom, Anne and San Sebastian, Miguel
author-email: anna.brydsten@su.se
author_list:
- family: Brydsten
  given: Anna
- family: Hammarstrom
  given: Anne
- family: San Sebastian
  given: Miguel
da: '2023-09-28'
doi: 10.1186/s12939-018-0773-5
eissn: 1475-9276
files: []
journal: INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH
keywords: 'Social determinants of health inequality; unemployment; Life course;

  Northern Sweden; Oaxaca decomposition analysis; Mental health'
keywords-plus: 'QUALITY-OF-LIFE; WELFARE-STATE; LABOR-MARKET; IMPACT; WORK; JOB;

  EXCLUSION; ADULTHOOD; SYMPTOMS; PROGRAMS'
language: English
month: MAY 16
number-of-cited-references: '66'
orcid-numbers: 'Hammarstrom, Anne/0000-0002-4095-7961

  Brydsten, Anna/0000-0002-4118-6441'
papis_id: 1c95cef0d5daf4c3807c1a275373df3a
ref: Brydsten2018healthinequalities
researcherid-numbers: 'Hammarström, Anne/HNI-3080-2023

  '
times-cited: '23'
title: 'Health inequalities between employed and unemployed in northern Sweden: a
  decomposition analysis of social determinants for mental health'
type: article
unique-id: WOS:000432845100001
usage-count-last-180-days: '2'
usage-count-since-2013: '21'
volume: '17'
web-of-science-categories: Public, Environmental \& Occupational Health
year: '2018'