Research Article: Unemployment and cause-specific mortality among the Belgian working-age population: The role of social context and gender

Date Published: May 2, 2019

Publisher: Public Library of Science

Author(s): Katrien Vanthomme, Sylvie Gadeyne, Brecht Devleesschauwer.


Life expectancy increased in industrialized countries, but inequalities in health and mortality by socioeconomic position (SEP) still persist. Several studies have documented educational inequalities, yet the association between health and employment status remains unclear. However, this is an important issue considering the instability of the labour market and the fact that unemployment now also touches ‘non-traditional groups’ (e.g. the high-educated). This study will 1) probe into the association between unemployment and cause-specific mortality; 2) look into the possible protective effect of sociodemographic variables; 3) assess the association between unemployment, SEP, gender and cause-specific mortality.

Individually linked data of the Belgian census (2001) and Register data on emigration and cause-specific mortality during 2001–2011 are used. The study population contains the Belgian population eligible for employment at census, based on age (25–59 years) and being in good health. Both absolute and relative measures of all-cause and cause-specific mortality by employment status have been calculated, stratified by gender and adjusted for sociodemographic and socioeconomic indicators.

Unemployed men and women were at a higher risk for all-cause and cause-specific mortality compared with their employed counterparts. The excess mortality among unemployed Belgians was particularly high for endocrine and digestive diseases, mental disorders, and falls, and more pronounced among men than among women. Other indicators of SEP did only slightly decrease the mortality disadvantage of being unemployed.

The findings stress the need for actions to ameliorate the health status of unemployed people, especially for the most vulnerable groups in society.

Partial Text

Life expectancy has increased substantially in industrialized countries in the last decades [1]. However, important differences in life expectancy, morbidity and mortality are observed between socioeconomic (SE) groups. Reducing SE inequalities in health and mortality are one of the major challenges of public health policies nowadays, even in western countries with high-quality and accessible health care systems [2,3]. In some settings, SE inequalities are even increasing, mostly related to SE disparities in unhealthy behaviours [4]. While many studies have documented educational inequalities in morbidity and mortality, employment status has less often been used as indicator of socioeconomic position (SEP) in relation to health.

Following the higher unemployment levels among the lower social strata, especially in combination with simultaneously being in other lower social strata, implies for urgent matters [7]. Special and tailored attention should be paid to tackle the adverse health status of these vulnerable groups [13] such as people living without a partner or financially less secure groups. In this regard, ensuring financial security, good housing and accessible health care provision are key [10].




0 0 vote
Article Rating
Notify of
Inline Feedbacks
View all comments