Baseline Unemployment Research Articles

Bariatric metabolic surgery eliminates body mass index as a risk factor for unemployment.

The effects of bariatric metabolic surgery (BMS) on health and comorbidities are well-known. Socioeconomic factors have been increasingly in focus in recent investigations. The aim of this study was to analyze the effects of BMS on predictive variables for unemployment. This study as performed in one reference center for BMS. Patients were treated between 2011 and 2017. The study design was a retrospective cohort study. Inclusion criteria were Roux-en-Y gastric bypass surgery, follow-up of 60 months, and complete data on employment rate. Exclusion criteria were secondary BMS, secondary referral, loss of follow-up, or patients aged 60 years and above. Patients were stratified as employed independent of part-time work and as unemployed if the patient had no current employment at the time of the visit. Follow-up visits were performed after 6, 12, 24, 48, and 60 months. This study included 623 patients; prior to BMS, 239 (38.36%) patients were employed and 384 (61.64%) unemployed. Risk factors for baseline unemployment included increased body mass index (BMI) (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.01 to 1.05; P = .010) and increased American Society of Anesthesiology (ASA) score (OR, 3.55; 95% CI, 2.56 to 4.90; P < .001). Unemployment rate dropped to 32.4% after 24 months (P < .001) and increased to 62.8% after 60 months. The BMI continuously decreased. Following BMS, the unemployment rate was no longer associated with BMI (24 months: OR, 0.97; 95% CI, 0.95 to 1.01; P = .220; 60 months: 1.04; 95% CI, 0.97 to 1.11; P = .269). The initial ASA status remained associated with unemployment (OR, 2.20; 95% CI, 1.60 to 3.01; P < .001). BMI showed some association with the unemployment rate prior to BMI. The unemployment rate significantly decreased 24 months after BMS but increased to baseline values after 60 months. Following BMS, BMI was no longer associated with unemployment.

Experience, skill composition, and the persistence of unemployment fluctuations

There is little internal propagation of unemployment in standard search and matching models. When calibrated to the high levels of worker flows observed empirically, unemployment in these models rapidly converges back to its steady state level. We illustrate that even with high worker flows between employment and unemployment, slow movements in the composition of workers across groups with different baseline unemployment rates can generate substantial persistence. To quantitatively assess the importance of these compositional changes, we develop a search model with worker experience and skill loss. When the model is calibrated to match empirical evidence on labor market outcomes that vary with tenure and worker displacement, the model endogenously generates substantial persistence in unemployment.

Do economic recessions “squeeze the middle class”?

AbstractWe examine whether economic downturns are linked to the distribution of population income giving rise to an observed “middle class squeeze.” We test this hypothesis using a novel and unique dataset using the Luxembourg Income Study (LIS) and allowing us to construct alternative definitions of middle class, such as income‐based measures, including labor income based, and perceived measures from the Integrated Values Study (IVS). Our findings suggest that, although recessions are not consistently correlated with middle class squeeze overall, the more unanticipated shocks resulting from the Great Recession show consistently through several definitions, a negative and robust conditional correlation. Furthermore, we find that recessions are positively correlated with the share of the population that regards itself as “middle class.” Estimates are heterogeneous to the baseline unemployment at the time of a recession, country spending on social protection, to middle class measures and definitions.

Trade liberalization and local labor market adjustment in South Africa

Despite a large literature analyzing trade liberalization in developing countries, little evidence exists around its effects in sub-Saharan African economies characterized by high levels of baseline unemployment and weak manufacturing sectors. Using a local labor market approach, we investigate the causal effects of tariff reforms implemented in South Africa between 1994 and 2004 on labor market outcomes at the individual level. More specifically, we construct a district-level measure of exposure to tariff reductions equal to a weighted average of industry tariffs using baseline industry shares as weights, and estimate the effect of this shock on local economies. We find that workers in districts facing larger tariff reductions experience a significant decline in both formal and informal employment in the tradable sector, driven primarily by a decline in manufacturing employment, relative to workers in districts less exposed to these reductions. There is no evidence of any significant effect on wages for those who remain employed. However, displaced workers do not show any evidence of transitions into other sectors, or migration to less affected regions; rather, they are more likely to become discouraged workers or exit the labor force entirely, and show an increased probability of accessing government transfers.

Two-Year Clinical and Functional Outcomes of an Asian Cohort at Ultra-High Risk of Psychosis.

Background: To determine the 2-year clinical and functional outcomes of an Asian cohort at ultra-high risk (UHR) of psychosis.Method: This was a longitudinal study with a follow-up period of 2 years on 255 help-seeking adolescents and young adults at UHR of psychosis managed by a multi-disciplinary mental health team in Singapore. Clients received case management, psychosocial, and pharmacological treatment as appropriate. Data comprising symptom and functional outcomes were collected over the observation period by trained clinicians and psychiatrists.Results: The 2-year psychosis transition rate was 16.9%, with a median time to transition of 168 days. After 2 years, 14.5% of the subjects had persistent at-risk symptoms while 7.5% developed other non-psychotic psychiatric disorders. 38.4% of the cohort had recovered and was discharged from mental health services. The entire cohort's functioning improved as reflected by an increase in the score of the Social and Occupational Functioning Assessment Scale during the follow-up period. Predictors to psychosis transition included low education level, baseline unemployment, a history of violence, and brief limited intermittent psychotic symptoms, while male gender predicted the persistence of UHR state, or the development of non-psychotic disorders.Conclusion: Use of the current UHR criteria allows us to identify individuals who are at imminent risk of developing not just psychosis, but also those who may develop other mental health disorders. Future research should include identifying the needs of those who do not transition to psychosis, while continuing to refine on ways to improve the UHR prediction algorithm for psychosis.

Baptism by fire: did the creative class generate economic growth during the crisis?

Scholars have long argued that creativity drives economic prosperity. Recently, much of this debate has revolved around the creative class. Most of this research, however, has been done during times of strong economic growth. What is the economic effect of the creative class after the financial crisis? Looking at regional unemployment variation in 2007–2011 against baseline unemployment in 2005, we study if specific subgroups within the creative class have different relationships with regional unemployment. Throughout the entire timeframe all of the creative subgroups are associated with lower unemployment. We conclude that creativity matters but the influence of each subsector is dependent on region size. Copyright 2012, Oxford University Press.

Social dysfunction predicts two years clinical outcome in people at ultra high risk for psychosis

The experience of a first psychotic episode is associated with a marked impairment in psychosocial functioning. However, the decline may be already evident in the pre-psychotic phases and play a significant role in the etiopathology of the disease onset. A sample of subjects at ultra high clinical risk for psychosis (“At Risk Mental State”, ARMS, n = 152) was compared with a demographically-matched general population ( n = 98,072) on different measures of psychosocial functioning. The proportion of subjects with an ARMS living in communal establishments or living at home with their parents was significantly higher than that of the local population ( p < 0.001). Subjects with an ARMS showed also higher rates of unemployment as compared to the general population ( p < 0.001). GAF scores at baseline were significantly lower in unemployed ARMS as compared to students and employed ARMS ( p = 0.002). ARMS subjects living in communal establishments presented higher rates of co-morbid psychiatric conditions ( p = 0.007) and lower GAF scores at baseline ( p = 0.017). Finally, baseline unemployment and living in a communal establishment were associated with an increased risk of developing a psychotic episode within the following two years ( p < 0.05). We concluded that the “At Risk Mental State” is a clinical condition which is characterized by marked psychosocial impairment and by an increased vulnerability to psychosis. Unemployment at the first contact with the prodromal service may be a risk factor for the development of a psychotic episode.

Coronary Artery Bypass Graft Surgery

Although the literature is replete with evidence related to physiological predictors and short-term outcomes of coronary artery bypass graft (CABG) surgery, there is still a paucity of data that encompass a broader perspective of risk and outcomes. The primary objective of this prospective cohort study was to explore the physiological and psychosocial dimensions of preoperative status that may be predictive of the short- and longer term outcomes of CABG surgery. Patients (N = 136) scheduled for elective/urgent CABG surgery were followed from the time of placement on the waiting list until 6 months after the surgery. Significant predictors of intensive care unit length of stay (LOS) included the following: age, urgency of operation, and perioperative complications. Hospital LOS was best predicted by baseline unemployment, longer bypass time, and perioperative complications. Baseline unemployment and less optimism regarding surgery outcomes were predictive of postdischarge home care utilization. Lower baseline physical functioning predicted postdischarge emergency room visits. Sex and baseline mental status predicted quality of life/health satisfaction scores at 6 weeks and 6 months after discharge. The ability to predict patient outcomes has implications for program planning, patient education, and policy development. The findings of this study provide rationale for clinicians, educators, and administrators to consider a broader scope of physiological and psychosocial parameters to predict outcomes of CABG surgery. Although the sample size was relatively small, the broader perspective on risk and outcomes provides insight for strategies to optimize overall outcomes for the CABG surgery population. These findings also establish the cornerstone for ongoing CABG surgery outcomes evaluation and research.

A comparison of 1-year substance abuse treatment outcomes in community syringe exchange participants versus other referrals

This longitudinal cohort study of 324 consecutive admissions to methadone maintenance treatment between 08/1994 and 09/1997 compared 1-year outcomes of opioid-dependent patients referred from a syringe exchange program (SEP; n = 81) versus other sources ( n = 243). All participants received stepped-based counseling. The Addiction Severity Index was completed upon admission. Treatment outcomes were assessed using weekly urine testing and days in treatment. GEE regression models were used to evaluate the association between baseline variables and treatment outcomes. SEP referrals were older, included more males and African Americans, reported greater unemployment and heavier heroin, cocaine, and injection drug use at admission. During treatment, SEP referrals used more opioids (OR 2.57; 95% CI 1.86–3.56) and cocaine (OR 2.77; 95% CI 1.93–3.95), and were less likely to complete 1 year (35%) compared to other referrals (56%; hazard ratio 1.88; 95% CI 1.35–2.62). Nevertheless, referral source was not significantly associated with outcome when adjusted for baseline characteristics. Greater baseline frequency of substance and injection drug use, and younger age were positively associated with ongoing opioid and cocaine use. African American race and baseline unemployment were also associated with ongoing cocaine use. Younger age and greater baseline cocaine use were associated with poorer retention at 1 year. The poorer treatment response of SEP referrals is likely due to higher baseline problem severity. Specialized interventions may be required to reduce drug use and improve retention in this population.