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This article investigates short-term health effects of unemployment for individuals in Denmark, Norway, and Sweden during an economic downturn (2007–2010) that hit the Scandinavian countries with diverging strength. The longitudinal part of the European Union Statistics on Income and Living Conditions (EU-SILC) data material is analyzed, and results from generalized least squares estimation indicate that Denmark is the only Scandinavian country in which health status deteriorated among the unemployed. The individual-level (and calendar year) fixed-effect results confirm the negative relationship between unemployment and health status in Denmark. This result is robust across different subsamples, model specifications, and changes in both the dependent and independent variable. Health status deterio- rated especially among women and people in prime working age (30–59 years). There is, however, only scant evidence of short-term health effects among the recently unemployed in Norway and Sweden. The empirical findings are discussed in light of: (1) the adequacy of the unemployment insurance system, (2) the likelihood of re-employment for the displaced worker, and (3) selection patterns into and out of employment in the years preceding and during the economic downturn.

Objective: Previous research has established that both ill health and minority status are associated with unemployment. Less is known, however, about the interplay between having ill health and being from minority background. The present study examines whether immigrants and descendants with ill health are particularly prone to unemployment during an economic downturn in Europe. Design: The European Union Statistics on Income and Living Conditions (EU-SILC) cross-sectional data material is utilized, and linear probability models are estimated. The analysis is run for countries in which the two minority samples are acceptably large ( N ≥ 100), resulting in 18 included European countries. The year 2011 is chosen because it is possible to identify both immigrants and descendants in EU-SILC due to a module on intergenerational transfer of disadvantages. Results: The results indicate – as expected – that both ill health and minority status are independently related to higher unemployment likelihood. Immigrants and descendants with ill health, however, are not particularly likely to be unemployed. This finding is robust to a number of sensitivity tests, and the empirical pattern is very similar across the 18 included countries. Conclusion: Both minority status and ill health are associated with high unemployment probability in Europe. However, there does not seem to exist a ' double disadvantage ' for immigrants and descendants with ill health, which is in line with a human capital perspective on how employers evaluate potential employees. Both a non-native-sounding name and bad health status are interpreted as a risk factor, but there is no reason to expect ill health to lower the productivity level more if the applicant is a descendant or immigrant. ; acceptedVersion

To enjoy good health is a fundamental part of human life, as evident by the large number of people who state "my health" when asked what is most important for them. In a similar vein, to take active part in the labor force is essential for individuals, both because it provides income and self-worth, and because it enhances social integration and participation. In fact, having good health and holding a job are two of the most important elements in a person's life. Hence, the interrelationship between health and employment status is of major importance, and this is the overarching topic of the present thesis. Our point of departure is the empirical observation that the unemployed tend to be in significantly worse health than the employed. This is probably the final product of three processes: (i) a lower likelihood of gaining employment if health status is poor, (ii) a higher unemployment probability when health status deteriorates, and (iii) negative health effects due to unemployment. Correspondingly, the current dissertation investigates health selection in hiring and employment (paper 1), health selection to unemployment (papers 2 and 4) and health effects of unemployment (papers 3 and 5). The data material consists of EU-SILC, and both OLS and GLS regressions, individual level fixed effects, and propensity score matching are utilized in the empirical papers. In order to get a deeper understanding of the health—employment status relationship, we need to examine how the association varies over time and/ or geographical space. Accordingly, this dissertation will investigate cross-national differences in hiring, firing, and health. Institutional settings are the main focus in papers 1, 2 and 3, where research context is set to Scandinavia. Denmark, Norway and Sweden are similar on many domains, but differ on the strength of employment protection legislation and on generosity of unemployment benefits, both of which potentially important for the association between health and employment status. Economic conditions, i.e. the level of and trend in the overall unemployment rate, is the focal point in papers 4 and 5. All available European countries are included (N=28, 25), so that we get as much variation in the economic conditions as possible. Paper 1 indicates that people with ill health are more likely to be hired in Denmark, where employment protection is weak, than in Norway and Sweden. This pattern is, however, only evident among higher educated people, which is surprising because it is primarily among 'low skill' employees that employment protection is weak in the Danish 'flexicurity' model. Furthermore, people with ill health are twice as likely (compared to people with good health) to hold temporary work contracts in Denmark. The 'health component' in temporary work are less evident in Sweden, and especially Norway. Paper 2 shows that ill health is associated strongly with unemployment likelihood in Denmark, and there are even signs of this being a causal relationship. Health selection to unemployment is not apparent as a general phenomenon in neither Norway nor Sweden, but there is some evidence that younger individuals (<30 years) with poor health have a high unemployment probability in both countries. Paper 3 examines short-term health effects of unemployment. Sweden have less generous unemployment benefits than Denmark and particularly Norway, perhaps implying larger health effects in Sweden (due to more financial hardship). However, it is apparently only among the unemployed in Denmark that health status tends to deteriorate somewhat. Nonetheless, the findings are quite positive overall for the three Scandinavian countries. Paper 4 investigates possible compositional changes in the unemployment population in 28 European countries experiencing differing economic conditions. The results indicate that people with good health status constitute a larger part of the unemployed population, but only in countries experiencing a severe economic crisis. In the remaining countries, people with bad health are – if anything – overrepresented among the recently unemployed. Paper 5 shows that the unemployment event seems to be harmful for self-rated health regardless of how common the experience is, according to analyses of 25 European countries. Low-unemployment countries stand somewhat out empirically (i.e. more pronounced health effects of unemployment), again suggesting that the composition of the unemployed population is crucial for how 'strong' the unemployment—health relationship is. There are four 'take-home-messages' in this thesis. First, labor market deregulation (weak employment protection and more temporary work contracts) is not beneficial for people with ill health. Second, although people with health problems tend to be among the first to lose their jobs during an economic crisis, stronger employment protection legislation could improve the situation. Third, the Scandinavian welfare states have apparently kept the unemployed in good health, showing the importance of (reasonably) generous unemployment benefits. Fourth, the composition of the unemployed population is of vital importance for why the unemployment—health relationship varies over time and geographical space. ; Det er langt frå tilfeldig at veldig mange personar svarar «helsa mi» på spørsmål om kva som er viktigast for dei. God helsetilstand er ein grunnleggande del av eit lukkeleg liv. Å delta aktivt på arbeidsmarknaden er også essensielt for folk, sidan yrkesdeltaking sikrar både inntekt, sjølvrespekt, og integrering i lokalsamfunnet. Å ha god helse samt eit arbeid å gå til er kanskje to av dei viktigaste elementa i ein person sitt liv. Det å undersøke korleis helse, på den eine sida, og arbeidsmarknadsutfall, på den andre sida, heng saman er derfor både viktig og interessant, og det er nettopp det denne avhandlinga skal sjå nærare på. Utgangspunktet vårt er den empiriske observasjonen at dei arbeidsledige har signifikant dårlegare helsetilstand enn folk som har jobb. Dette er sannsynlegvis eit resultat av minst tre prosessar: (i) lågare sannsyn for å bli tilsett dersom helsa er dårleg, (ii) større sannsyn for å bli arbeidsledig dersom helsa er (eller blir) dårleg, og (iii) negative helseeffektar av arbeidsløyse. Denne avhandlinga skal undersøke desse tre prosessane: tydinga av helsetilstand for tilsetjingar og sysselsetting (artikkel 1), helseseleksjon til arbeidsløyse (artikkel 2 og 4), samt negative helseeffektar av arbeidsløyse (artikkel 3 og 5). Datamaterialet består av EU-SILC, og både OLS/GLS regresjon, individnivå fast effekt, og propensity score matching blir nytta som analyseteknikkar. For at me skal få ei djupare forståing av forholdet mellom helse og sysselsettingsstatus, treng me å undersøka korleis samanhengen varier over tid og geografisk stad. Denne avhandlinga vil derfor analysere skilnadar mellom land i sysselsetting, arbeidsløyse, og helsetilstand. Institusjonelle forhold er hovudfokus i artikkel 1, 2 og 3, der Skandinavia er forskingskonteksten. Danmark, Noreg og Sverige er like på mange områder, men det er viktige skilnadar både med omsyn til styrken på stillingsvernet, samt på kor generøse arbeidsløysetrygdene er. Begge desse institusjonelle faktorane kan ha ei innverknad på samanhengen mellom helse og sysselsettingsstatus. Økonomiske forhold, det vil seie nivå og trend i nasjonal arbeidsløyserate, er fokus i artikkel 4 og 5. Alle tilgjengelege europeiske land vert inkludert (N=28, 25), slik at me får mest mogleg makroøkonomisk variasjon. Artikkel 1 viser at folk med dårleg helse har større sannsyn for å bli tilsett i Danmark, der stillingsvernet er svakt, enn i Noreg og Sverige. Men dette empiriske mønsteret er berre synleg blant folk med høgare utdanning, noko som er merkeleg sidan det primært er blant 'lav-status' yrker at stillingsvernet er svakt i den danske 'flexicurity' modellen. I tillegg er midlertidig stillingskontrakt dobbelt så vanleg blant folk med dårleg helse i Danmark (samanlikna med folk med god helse). Det er mindre skilnadar etter helsetilstand i bruk av midlertidig stilling i Sverige, og spesielt Noreg. Artikkel 2 viser at folk med dårleg helse har stort sannsyn for å vere arbeidsledig i Danmark, og det er ting som tyder på at dette er eit kausalforhold. Helseseleksjon til arbeidsløyse er mykje mindre utstrakt i Noreg og Sverige, men unge personar (<30 år) med dårleg helse er arbeidsledige i nokså stor grad i både land. Artikkel 3 undersøker (korttids-)helseeffektar av arbeidsløyse. Sverige har mindre generøs arbeidsløysetrygd enn nabolanda, noko som kanskje inneberer større negative helseeffektar her (på grunn av meir økonomiske vanskar). Analysane, derimot, visar at det berre er i Danmark at arbeidsløyse vert etterfølgt av forverra helsetilstand. Samla sett så er resultata temmeleg positive for dei tre Skandinavsike landa, med lite teikn på helsesvikt. Artikkel 4 undersøker potensielle endringar i komposisjonen av arbeidsløysebefolkninga i 28 europeiske land med ulik makroøkonomisk utvikling. Resultata tyder på at personar med god helse utgjer ein større del av dei arbeidsledige, men berre i land som opplev ei alvorleg økonomisk krise. I dei resterande landa tenderer folk med dårleg helse mot å vere overrepresentert blant dei 'nye' arbeidsledige i krisetider. Artikkel 5 indikerer at arbeidsløyse er skadeleg for sjølvrapportert helse uavhengig av kor vanleg arbeidsløyseerfaringa er, i følgje analysar av 25 europeiske land. Land med svært låg arbeidsløyserate skil seg, til ei viss grad, ut empirisk (med større negative helseeffektar), noko som igjen tyder på at komposisjonen av dei arbeidsledige er viktig for kor 'sterkt' forholdet er mellom helse og arbeidsløyse. Det er fire hovudbodskap i denne avhandlinga. (1) De-regulering av arbeidsmarknaden (svakare stillingsvern og meir midlertidige stillingar) er ikkje gunstig for folk med dårleg helse. (2) Personar med dårleg helse er blant dei første som mistar jobben under ei økonomisk nedgangstid, men sterkare stillingsvern ser ut til å forbetre situasjonen. (3) Dei Skandinaviske velferdsstatane har tilsynelatande lukkast ganske bra i å bevare helsetilstanden til dei arbeidsledige, noko som indikerer viktigheita av (nokså) generøs arbeidsløysetrygd. (4) Komposisjonen av arbeidsløysebefolkninga ser ut til å vera av avgjerande tyding når me skal forklara kvifor samanhengen mellom arbeidsløyse og helse varier over tid, og mellom land. ; publishedVersion

The economic crisis in Europe since 2008 has led to high unemployment levels in several countries. Previous research suggests that becoming unemployed is a health risk, but is job loss and unemployment easier to cope with when unemployment is widespread? Using EU-SILC panel data (2010-2013), this study examines short-term effects of unemployment on self-rated health (SRH) in 25 European countries with diverging macroeconomic conditions. Ordinary least squares regressions show that the unemployed are in worse health than the employed throughout Europe. The association is reduced considerably, but remains significant in several countries when time-invariant personal characteristics are accounted for using individual-level fixed-effects models. Propensity score kernel matching shows that both being and becoming unemployed are associated with slightly worse SRH. There is a weak tendency towards less health effects of unemployment in countries where the experience is widely shared. In particular, countries with a very low unemployment rate stand out with larger health effects. The results overall suggest that a changed composition of the unemployed population is an important explanation for the weaker unemployment - health association in high-unemployment countries.