The global economic downturn has been associated with increased unemployment in many countries. Insights into the impact of unemployment on specific health conditions remain limited.
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We determined the association between unemployment and prostate cancer mortality in members of the Organisation for Economic Co-operation and Development (OECD). We used multivariate regression analysis to assess the association between changes in unemployment and prostate cancer mortality in OECD member states between 1990 and 2009. Country-specific differences in healthcare infrastructure, population structure, and population size were controlled for and lag analyses conducted. Several robustness checks were also performed.
Time trend analyses were used to predict the number of excess deaths from prostate cancer following the 2008 global recession. Between 1990 and 2009, a 1% rise in unemployment was associated with an increase in prostate cancer mortality. Lag analysis showed a continued increase in mortality years after unemployment rises.
The association between unemployment and prostate cancer mortality remained significant in robustness checks with 46 controls. Eight of the 21 OECD countries for which a time trend analysis was conducted, exhibited an estimated excess of prostate cancer deaths in at least one of 2008, 2009, or 2010, based on 2000-2007 trends. Rises in unemployment are associated with significant increases in prostate cancer mortality. Initiatives that bolster employment may help to minimise prostate cancer mortality during times of economic hardship.
Ecancermedicalscience. 2015 May 14;9:538. doi: 10.3332/ecancer.2015.538. eCollection 2015.
Maruthappu M1, Watkins J2, Taylor A3, Williams C4, Ali R5, Zeltner T6, Atun R7.
1 Faculty of Medicine, Imperial College London, London SW7 2AZ, UK ;
2 Institute for Mathematical and Molecular Biomedicine, King's College London, London SE1 1UL, UK ;
3 Medical Sciences Division, University of Oxford, OX1 2JD, UK.
4 The Economist, 25 St James's Street, London SW1A 1HG, UK.
5 Cancer Epidemiology Unit, University of Oxford, Oxford OX3 7LF, UK ; Faculty of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, United Arab Emirates.
6 Special Envoy for Financing to the Director General of the World Health Organization (WHO), 1211 Geneva 27, Switzerland ; University of Bern, Bern CH 3011, Switzerland.
7 Faculty of Medicine, Imperial College London, London SW7 2AZ, UK ; Harvard School of Public Health, Harvard University, MA 02115, USA.