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There is a lack of large-scale studies exploring labor market marginalization (LMM) among individuals diagnosed with bipolar disorder (BD). We aimed to investigate the association of BD with subsequent LMM in Sweden, and the effect of sex on LMM in BD.
Methods
Individuals aged 19–60 years living in Sweden with a first-time BD diagnosis between 2007 and 2016 (n = 25 231) were followed from the date of diagnosis for a maximum of 14 years. Risk of disability pension (DP), long-term sickness absence (SA) (>90 days), and long-term unemployment (>180 days) was compared to a matched comparison group from the general population, matched 1:5 on sex and birth year (n = 126 155), and unaffected full siblings (n = 24 098), using sex-stratified Cox regression analysis, yielding hazard ratios (HRs) with 95% confidence intervals (CIs).
Results
After adjusting for socioeconomic factors, baseline labor market status, and comorbid disorders, individuals with BD had a significantly higher risk of DP compared to the general population (HR = 16.67, 95% CI 15.33–18.13) and their unaffected siblings (HR = 5.54, 95% CI 4.96–6.18). Individuals with BD were also more likely to experience long-term SA compared to the general population (HR = 3.19, 95% CI 3.09–3.30) and their unaffected siblings (HR = 2.83, 95% CI 2.70–2.97). Moreover, individuals diagnosed with BD had an elevated risk of long-term unemployment relative to both comparison groups (HR range: 1.75–1.78). Men with BD had a higher relative risk of SA and unemployment than women. No difference was found in DP.
Conclusions
Individuals with BD face elevated risks of LMM compared to both the general population and unaffected siblings.
The aim of this study was to understand how and why relational welfare works to support young people who are not in employment, education or training (NEET). It builds on research discussing the limitations of work-first and human capital strategies in social policy while responding to calls for theory-driven insights into initiatives that move beyond employability and rapid employment. The material for this realist evaluation includes programme documents, fieldnotes and 75 interviews with practitioners and participants in community-based multicomponent initiatives delivered by Swedish municipalities. These data were scrutinised against programme theories while integrating literature on relational welfare as underpinned by co-creation and capability approaches. The results illustrate how flexible, challenging and coordinated programming strengthen beings and doings of young people in NEET situations while improving their wellbeing by overcoming isolation and forming a future orientation. The study provides guidance for supporting NEET-situated young people through a relational approach to welfare. It also offers a model against which local initiatives provided to a youth group high on the policy agenda can be mapped.
The chapter examines the role of forced displacement in increasing the demand for state intervention and expanding the size of the state bureaucracy in West Germany. It discusses the government elites’ strategies for dealing with the needs of expellees and receiving communities and reviews expellees’ ability to influence government policy. Statistical analysis is used to demonstrate that counties with a greater proportion of expellees to population had more civil servants per capita.
The objective of this paper is to analyse the impact of skill mismatch on labour turnover, unemployment, and informality, in the case of Colombia. We study Colombia because it is a developing country with one of the highest levels of unemployment and informality in Latin America, along with very restrictive institutions, such as the minimum wage. We found that skill mismatch can explain the high turnover of workers in the Colombian labour market, evident in the increase in hirings and also in separations. Additionally, we find a positive significant effect of skill mismatch on the levels of informality, but no significant effect on unemployment. This evidence remains even once we consider the role of labour market institutions such as minimum wage and non-wage labour costs.
Chapter Eleven takes up Rogers’ engagment with the Great Depression of the 1930s, the economic disaster that marked the culmination of his influence as a commentator on American political life. The Oklahoman castigated Wall Street for foolish financial practices and criticized Americans for buying on credit, two practices in the 1920s he believed underlay the economic collapse. With typical good-humored civility, he initially sympathized with Herbert Hoover as a victim of circumstances but soon denounced the president’s refusal to promote relief programs and job-creation initiatives. Rogers became an enthusiastic supporter of Franklin Roosevelt and the New Deal. The humorist became one of the biggest boosters of FDR’s programs as necessary to save the American system. While suspicious of federal government overreach and the encouragement of labor radicalism, he deemed the New Deal largely a success. Throughout the Depression, Rogers maintained his populist outlook, consistently criticizing economic and social elites while laboring to protect and uplife America’s common, working citizens. His acclaim for "the little fellow" further elevated his public stature in America.
This chapter provides a macroeconomic perspective of artificial intelligence’s impacts on labor markets and economic growth – although the analysis remains grounded in microeconomic functions. In this chapter, we provide an economic growth model wherein AI as a possible substitute for human labor is modeled, taking into account the nature of AI as an automation technology. This goes to the heart of the current focus of economists on AI, namely its implications for labor markets, and specifically unemployment and skills requirements. The crucial points that we make here are that economists need to go further than indirectly modeling AI through assumptions on substitution elasticities and need to take the specific nature (narrow focus) of AI into explicit account.
After the Progressive Era of the late 19th century, the unregulated financial markets boomed, encouraging people to go into debt to buy stocks, and when an economic boom went bust, the Great Depression ensued. FDR’s New Deal was a response to the failure of markets to protect people that led to the government taking on the responsibility of preventing, or at least moderating, economic dislocations, regulating the financial and banking systems, providing jobs as an employee of last resort, and establishing a social security system to protect the elderly and disabled Americans. The missing link in these efforts was racial justice, which was largely overlooked for political reasons. While FDR’s critics accused him of betraying capitalism, he in fact saved the market system from destroying itself.
While unemployment is known to increase the risk of suicide, its cumulative effect remains underexplored. This study investigates how unemployment affects suicide mortality and whether the effect varies based on the number of unemployment spells using two years of nationwide data.
Methods
Using the data from the National Statistical Office and Employment Insurance Database for 2018 and 2019, we identified an average of 2365 cases of suicide over two years among 7.76 million workers aged 25–64 years who had been employed within one year before their suicide. The number of unemployment spells was counted using the employment history of the past five years. We calculated crude suicide mortality rates per 100 000 population, age- and sex- standardized mortality rates (SMRs), and proportionate mortality rates (PMRs) for suicide.
Results
Over the two years, the crude suicide rate was 30.0 per 100 000 among the general population and 30.5 among workers. Workers with no unemployment spells in the past five years had a significantly lower SMR (0.44; 0.42–0.46), while those with four or more unemployment spells had a significantly higher SMR (3.13; 2.92–3.35) than the general population. These findings were consistent across all sex and age groups. Additionally, workers with four or more unemployment spells had a significantly higher PMR than the general population.
Conclusion
The impact of unemployment on suicide mortality intensifies as the number of unemployment spells increases. These results underscore the necessity for additional social and psychological support along with economic assistance for individuals facing recurrent unemployment.
Chapter 2 demonstrates how the recognition of the societal value of domestic service affected some aspects of domestic workers’ rights but not others. It analyzes debates around the 1926 law on domestic service and the effects it had on the domestic workers’ ability to resolve conflicts with employers in court or mediation. Domestic workers’ labor rights were limited by the new law to make their labor more accessible to employers: written labor agreements were no longer mandatory and there was no compensation for overtime work. Yet, the state was reluctant to limit domestic workers’ access to their employers housing after termination of contract because female homelessness was closely associated with prostitution. The new law put domestic workers at a disadvantage compared to other workers, which, together with continuing valorization of “productive” labor, made domestics seek employment opportunities outside domestic service. This chapter contributes to our understanding of the effects labor laws have on paid domestic labor and testifies to the importance of government regulations and protection.
This chapter reveals how stories about the past came to cohere around struggles over identity in the final decades of the twentieth century in and around Birmingham. The Second World War was becoming increasingly important across the generations, although it was mainly the children of the inter-war period, now pensioners, who looked back fondly on any part of inter-war life. However, immigration brought in groups with divergent memories of the past, including people whose family experiences of the early twentieth century were of fascism in continental Europe and those who felt that Atlantic slavery, not the struggles of the white working class, was the historical injustice of fundamental importance.
This chapter, looking at the Second World War, foregrounds the concerns about the post-war future that took shape in relation to people’s hopes for the next generation and with their sense of conditions locally at the front of their minds. It first uses a case study of attitudes towards urban reconstruction to probe where people’s ideas about the post-war future came from. The chapter argues that memories of the inter-war period and everyday experiences of wartime were fundamental in shaping these hopes. A second case study, about concerns surrounding post-war employment, highlights the complexity of popular assumptions about what was likely to follow the war, again signalling the importance of place in shaping people’s memories and aspirations.
This paper studies the impact of technological progress on unemployment in a search-matching model with heterogeneous multiworker firms. In the model, some firms continue to reap rewards from new technologies over time and contribute to job creation, while other firms obsolesce and reduce their employment. Thus, the model captures an endogenous change in the aggregate composition of firms (the firm-composition effect). Considering this effect along with the two canonical effects—the capitalization and creative-destruction effects—I examine the importance of each through a simulation. The results show that the firm-composition effect explains almost all the variation in unemployment in the model, mainly through shrinking the number of obsolescing firms relative to surviving firms and increasing the aggregate technology adoption rate when technology progresses rapidly.
Benzodiazepines and related drugs (BZDRs) are widely used in the treatment of anxiety and sleep disorders, but cognitive adverse effects have been reported in long-term use, and these may increase the risk of labor market marginalization (LMM). The aim of this study was to investigate whether the risk of LMM is associated with new long-term BZDR use compared to short-term use.
Methods
This register-based nationwide cohort study from Finland included 37,703 incident BZDR users aged 18–60 years who initiated BZDR use in 2006. During the first year of use, BZDR users were categorized as long-term users (≥180 days) versus short-term users based on PRE2DUP method. The main outcome was LMM, defined as receipt of disability pension, long-term sickness absence (>90 days), or long-term unemployment (>180 days). The risk of outcomes was analyzed with Cox regression models, adjusted with sociodemographic background, somatic and psychiatric morbidity, other types of medication and previous sickness absence.
Results
During 5 years of follow-up, long-term use (34.4%, N = 12,962) was associated with 27% (adjusted Hazard Ratio, aHR 1.27, 95% CI 1.23–1.31) increased risk of LMM compared with short-term use. Long-term use was associated with 42% (aHR 1.42, 95% CI 1.34–1.50) increased risk of disability pension and 26% increased risk of both long-term unemployment and long-term sickness absence.
Conclusions
These results indicate that long-term use of BZDRs is associated with increased risk of dropping out from labor market. This may be partly explained by cognitive adverse effects of prolonged BZDR use, which should be taken into account when prescribing BZDRs.
This article explores the experiences of keyworkers within a third-sector employability programme targeted at people furthest from work. Using semi-structured qualitative interviews, the study investigated keyworker perspectives on effective elements of programme design, and what made the critical difference for those who did move into employment. Echoing previous research, findings confirmed the value of a holistic and personalised approach founded upon a consistent and long-term relationship of trust and support, through which programme participants developed the confidence and self-belief that was critical to progression towards employment. However, critical attention to the keyworker perspective offers novel insights, bringing to light challenges in defining role parameters and maintaining personal-professional boundaries in the interests of keyworkers and programme participants. We contribute to the body of research on employability practitioner perspectives, revealing that the strengths of person-centred support may simultaneously present tensions and wellbeing risks, where role parameters are very broadly defined.
The stigma faced by unemployed Americans places a toll on their wellbeing and decreases their life chances. While all unemployed Americans are subject to stigmatization, the stigma levied on Black Americans may be particularly potent due to racializing stereotypes that associate Blackness with the undeserving poor, including the inability to obtain employment. Given the social and economic challenges Black people face, research elucidating the racial complexities of unemployment stigma is needed. Through in-depth open format face-to-face interviews of unemployed individuals residing in urban and suburban areas, this study produces an alternative perspective on how impression management techniques are connected to both internalization and mitigation of unemployment stigma. This study contributes to employment, race, and stigma literature by providing a theoretical frame that synthesizes Du Boisian and dramaturgical concepts to conceptualize an “unemployed worker-self.” Through this framing, I find variations across race and community type in impression management techniques executed by unemployed people. I conclude with suggestions for future research and potential applications for the theoretical frame developed in this study.
Activation schemes are widely criticised, with the negative experiences of ‘the activated’ featuring prominently in the literature. This article presents the findings of a constructivist grounded theory study concerning the lived experience of long-term unemployment, welfare recipiency and community placement in activation schemes in Ireland, with a focus on the positive effects that participating in such schemes had on participants’ subjective well-being. For the participants in this research, community placement signified change, respite, and recovery that improved their subjective well-being by creating an experience that counteracted the draining experience of long-term unemployment and welfare recipiency. This study brings new elements to the discussion on the role of activation in promoting/diminishing the subjective well-being of the long-term unemployed.
Edited by
Rachel Thomasson, Manchester Centre for Clinical Neurosciences,Elspeth Guthrie, Leeds Institute of Health Sciences,Allan House, Leeds Institute of Health Sciences
Taking a history is an essential part of patient care for all clinicians but there can be a tendency for the social history to be brief, formulaic or even absent. The possible reasons for this and how liaison psychiatry might respond, given that history-taking skills are highly developed in the specialty, are described. The individual in the wider multidisciplinary team who is best placed to take a social history from a patient is considered, reviewing the attitudes of both doctors and nurses alongside evidence from studies where frameworks have been established to take the social history from all patients. The sources of information other than the patient that might be considered are described. Several key aspects of the social history are explored in detail – debt, employment, housing and social isolation. The evidence of impact on physical health and mental health is detailed for each, together with a summary of the evidence of benefit for interventions. Finally, the issue of how the information obtained should be shared and with whom and what can be done to improve patient outcomes is discussed.
This chapter covers: the growing importance of Chicago School of Economics and of School of Public Choice; the work of F. Hayek; individual rights and individual freedom are seen as being more important than community rights and goals; privatization of Public Private Partnerships and of pensions; laziness is associated with unemployment, and social assistance is discouraged; marginal tax rates begin to be reduced; differentiations in compensations for work increases; Gini coefficients begin to rise; welfare beneficiaries are seen as lazy individuals who wish to live at the expense of hard-working and tax paying individuals; free markets are seen as a miracle drug; many conservative economists receive Nobel Prizes; the social landscape experiences a dramatic change in the 1980s in a rightward direction; fiscal stabilization policy loses influence; monetary policy becomes more important; and there is a return to pre-Keynesian times.
In light of ongoing debates about income targeting in the welfare state, this article explores how the design and outcomes of income targeting policies are related to popular targeting preferences. Based on the unique combination of fine-grained opinion and policy indicators in a multilevel analysis, the results show that targeting preferences are indeed empirically related to targeting policies. However, whether these preferences are affected more by the de jure targeting design or the de facto targeting outcome seems to vary between two very different policy domains. In the case of unemployment benefits, the results suggest positive policy feedback: support for high-income targeting increases when unemployment benefits are designed to benefit those with previously higher incomes. For income taxation, by contrast, the results suggest negative policy feedback. In that case, it is not so much the de jure design but rather the de facto outcome that matters: the more taxes effectively work to the advantage of higher-income earners, the less support there is for a tax that levies the same amount on everyone, regardless of income.
Nigeria is home to a significant and growing “youth” population, over a third of it below 24 years of age. The demographic potential for productivity and growth this group represents occurs alongside large-scale unemployment among young people of working age. The “unemployment crisis” has deep historical roots and exists within a wider context of poor governance, insecurity, conflict, and poverty. Policy norms and practices to address youth unemployment in Nigeria largely centre on skill development and job creation, with complementary schemes selectively targeted to specific groups of vulnerable and poor individuals. Measures are typically ad hoc, detached from a coherent programme of sustainable reform. Pre-existing structural factors and capacity constraints also shape the effectiveness of these programmes. While a productivist focus within current policy is potentially empowering in giving young Nigerians “worker” status, it also detracts from attending to deep-rooted structural problems seen to affect young people in disproportionate ways. Securing meaningful choices and lives for Nigerian youth requires reframing youth unemployment beyond labour markets alone, and embedded in ideas of equality and collective action.