Health and mass unemployment events-developing a framework for preparedness and response.

A R Davies,L Homolova,C N B Grey,M A Bellis

doi:10.1093/pubmed/fdy174

Abstract

BackgroundMass unemployment events are not uncommon yet the impact on health is not well recognised. There is a need for a preparedness and response framework, as exists for other events that threaten population health.MethodsFramework informed by a narrative review of the impact of mass unemployment on health (studies published in English from 1990 to 2016), and qualitative data from 23 semi-structured interviews with individuals connected to historical national and international events, addressing gaps in published literature on lessons learnt from past responses.ResultsEconomic and employment shock triggered by mass unemployment events have a detrimental impact on workers, families and communities. We present a public health informed response framework which includes (i) identify areas at risk, (ii) develop an early warning system, (iii) mobilise multi-sector action including health and community, (iv) provision of support across employment, finance and health (v) proportionate to need, (vi) extend support to family members and (vii) communities and (viii) evaluate and learn.ConclusionMass unemployment events have an adverse impact on the health, financial and social circumstances of workers, families, and communities. This is the first framework for action to mitigate and address the detrimental impact of mass unemployment events on population health.

Highlights

IntroductionMajor changes in trade and labour markets because of globalisation and financial crises can result in the loss of a large employer in a localised area
While emergency planning frameworks exist for other external shocks that have a detrimental impact on health, such as flooding, a framework to inform response to reduce the impact of mass unemployment events (MUEs) on population health is lacking
This study aimed to address that gap, by reviewing international literature and drawing on national and international expertise to describe the impact of MUEs on populations, developing a public health informed response to inform future action

Summary

Introduction

Major changes in trade and labour markets because of globalisation and financial crises can result in the loss of a large employer in a localised area. The economic impact of such mass unemployment events (MUEs) can be severe, but the cost to health and social inequalities can be even greater and endure across generations.[1]. During the global recession from 2007–16, the European Globalisation Adjustment Fund provided €600 M (with an additional €427 M match-funded by Member States) to support local responses to 146 significant unemployment events.[5]. Longitudinal studies have demonstrated that MUEs and recession pose risks to health, and that impacts are greatest where the underlying social, health and economic policy is not protective or supportive.[6]. National and international sustainable health development policies recognise the importance of both employment, and supporting resilience to external shocks to achieving good health.[7–10]. While emergency planning frameworks exist for other external shocks that have a detrimental impact on health, such as flooding, a framework to inform response to reduce the impact of MUEs on population health is lacking. There is a need for a preparedness and response framework, as exists for other events that threaten population health

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