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      The Health Effects of Economic Decline

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          Abstract

          Political pronouncements and policy statements include much conjecture concerning the health and behavioral effects of economic decline. We both summarize empirical research concerned with those effects and suggest questions for future research priorities. We separate the studies into groups defined by questions asked, mechanisms invoked, and outcomes studied. We conclude that although much research shows that undesirable job and financial experiences increase the risk of psychological and behavioral disorder, many other suspected associations remain poorly studied or unsupported. The intuition that mortality increases when the economy declines, for example, appears wrong. We note that the research informs public health programming by identifying risk factors, such as job loss, made more frequent by economic decline. The promise that the research would identify health costs and benefits of economic policy choices, however, remains unfulfilled and will likely remain so without stronger theory and greater methodological agreement.

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          Most cited references133

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          Natural Selection of Parental Ability to Vary the Sex Ratio of Offspring

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            Unemployment impairs mental health: Meta-analyses

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              Risk factors for suicide in psychiatric outpatients: a 20-year prospective study.

              To determine the risk factors for suicide, 6,891 psychiatric outpatients were evaluated in a prospective study. Subsequent deaths for the sample were identified through the National Death Index. Forty-nine (1%) suicides were determined from death certificates obtained from state vital statistics offices. Specific psychological variables that could be modified by clinical intervention were measured using standardized scales. Univariate survival analyses revealed that the severity of depression, hopelessness, and suicide ideation were significant risk factors for eventual suicide. A multivariate survival analysis indicated that several modifiable variables were significant and unique risk factors for suicide, including suicide ideation, major depressive disorder, bipolar disorder, and unemployment status.
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                Author and article information

                Journal
                Annual Review of Public Health
                Annu. Rev. Public Health
                Annual Reviews
                0163-7525
                1545-2093
                April 21 2011
                April 21 2011
                : 32
                : 1
                : 431-450
                Affiliations
                [1 ]School of Public Health, University of California, Berkeley, California 94720; email: , , , , ,
                [2 ]Center for Health and Community, University of California, San Francisco, California 94118; email:
                Article
                10.1146/annurev-publhealth-031210-101146
                3855327
                21054175
                04897d41-a451-4f58-9b10-dde894d8c91f
                © 2011
                History

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