Essays on the relationship between unemployment and worklessness across the life course and cardiovascular disease risk factors in the United Kingdom

Williams, Gemma A. (2024) Essays on the relationship between unemployment and worklessness across the life course and cardiovascular disease risk factors in the United Kingdom. PhD thesis, London School of Economics and Political Science.

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Abstract

In this thesis I adopt a life course perspective to investigate whether and how experiences of unemployment and worklessness at different life stages are associated with various risk factors for cardiovascular diseases (CVD): mental health, hypertension and sleep. In three empirical chapters, I use methods such as fixed effects and structural equation modelling to account for endogeneity between unemployment and health, to explore the mechanisms through which unemployment may shape CVD risk factors, and whether any effects differ for population sub-groups. I show, first, that parental worklessness in adolescence (age 14) is associated with better psychological functioning for the UK-born population at ages 30 and above. This is potentially due to the increased attention parents can pay to their offspring during times of job loss; however, no significant relationship is shown for immigrants. Second, long-term (>1 year) youth unemployment at ages 16-24 is linked with higher hypertension risk at ages 30 and above. Both studies showed “scarring” effects, with unemployment exposure in adolescence and early adulthood having adverse consequences for later-in-life employment status and unhealthy behaviours such as smoking, which themselves negatively influence other CVD risk factors. Third, unemployment at ages 18-64 years is linked to poorer quality sleep and longer sleep duration for men but not women, nor those in a low-income household. Cross-cutting results emphasize that unemployment is processed differently according to other life circumstances, which moderate or augment subsequent effects on health. Mixed evidence was found in support of various life course models. Firstly, emerging adulthood was found to be a “sensitive period” in which exposure to youth unemployment has long-run, adverse effects on health. Yet, parental worklessness had no direct effects on mental health for immigrants and was linked to improved mental health for the UK-born. Scarring effects from exposure to both parental worklessness and youth unemployment were, however, found, with people set on a life course trajectory of disadvantage (through a “chains of risk” effect) that negatively shapes CVD risk factors. “Accumulation” of disadvantage across the life course was not shown for those exposed to parental worklessness or those experiencing youth unemployment. While I cannot conclusively prove mechanisms through which unemployment impacts CVD risk factors, it appears that the stress and psychological strain of unemployment may influence health status over and above the consequences of income losses. However, unemployment benefits may be partially protective against income loss associated with unemployment and its potential impacts. Overall, this PhD highlights the need for policymakers to consider the health effects of social protection measures such as unemployment benefits when costing and making policy decisions. The design of policy interventions to support the health and wellbeing of the unemployed should nevertheless be sensitive to differential responses among population sub-groups.

Item Type:	Thesis (PhD)
Additional Information:	© 2024 Gemma A. Williams
Library of Congress subject classification:	H Social Sciences > HC Economic History and Conditions R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Sets:	Departments > Social Policy
Supervisor:	Platt, Lucinda and McGuire, Alistair
URI:	http://etheses.lse.ac.uk/id/eprint/4690

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