Mortality in relation to employment status during different levels of unemployment

Aims: The aim of this study was to estimate whether the risk for total and cause-specific mortality was related to employment status, and whether mortality in different non-employed groups differed during high and low levels of unemployment. Methods: Structured interviews were used from the Swedish Survey of Living Conditions in 1984-89 and 1992-97, including women and men aged 18 to 64, classified as unemployed (n=2,067), retired or on temporary disability pension (n=2,674), economically inactive for other reasons (n=1,373), and employed (n=38,293). Data were linked to death certificates, as registered in the Cause of Death Register. Cox proportional hazards models were performed for the mortality risk up until eight and a half years following the interview. Results: Being unemployed (OR=1.43), retired, or on temporary disability pension (OR=2.28) or being economically inactive for other reasons (OR=1.63) was related to a risk for total mortality, after considering the level of unemployment, sociodemographic factors and longstanding illness. The risk of death due to external causes was excessive among the unemployed and among those retired or on temporary disability pension, and resulted to a large extent from suicide. The interaction between employment status and level of unemployment was not significant. Conclusions: The level of unemployment seems to have no major influence on the mortality risk. Future interventions for the non-employed groups should focus on preventing avoidable mortality, such as injury and suicide.