Academic Commons


Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality

Roelfs, David; Shor, Eran; Davidson, Karina W.; Schwartz, Joseph E.

Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a random effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late career. The risk of death was highest during the first 10 years of follow-up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors.


  • thumnail for Roelfs_Soc_Sci_Med_2011_PMC.pdf Roelfs_Soc_Sci_Med_2011_PMC.pdf application/pdf 405 KB Download File

Also Published In

Social Science and Medicine

More About This Work

Academic Units
Center for Behavioral Cardiovascular Health
Published Here
July 9, 2016