Getting Laid-Off May Lead to Early Death -- But There Are Ways to Cushion the Severe Health Impact of Job Loss
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"There is a fair amount of evidence that expecting a major stressor is often worse than the actual occurrence of the stressor," he says. "My understanding is people who lose their jobs and get new ones pretty quickly don't show many of these effects. That's consistent with what we know about stress in general. Generally, the longer the stressor lasts, the greater the risk you are under for various diseases."
Cohen reports there are "two general pathways linking stress to disease-related outcomes. One is the behavioral pathway. We know that under stress, people smoke more, drink more. They don't sleep as well. They don't exercise. They have poorer diets. All of these things can put people at greater risk of disease.
"The other is the physiological pathway. There is considerable evidence that under chronic stress, the immune system does not work the way it should. There's evidence for underresponsivity, where the immune system does not respond adequately to challenges and also for overresponsivitity."
What's the problem with an overly vigilant immune system? In many cases, the body's response to a perceived threat is what causes the symptoms we associate with a disease. "In cold studies, we find people who are under chronic stress, when we expose them to a virus, they're more likely to get sick," Cohen says. "They're producing much more pro-inflammatory cytokine, which is what produces the symptoms of colds."
So expect to hear a lot of sneezing in coming months. But Cohen counters that thought with some good news: The fact job anxiety is so widespread could actually dampen its destructive impact.
"A lot of the experience of stress has to do with challenges to your self-esteem -- that feeling you're not accomplishing what you should be able to accomplish," he says. "Being out of work is a stressful event, irrespective of the reason, but it is buffered a bit by the idea that it's the economy that's at fault -- not the fact I'm incompetent."
Cohen doubts there are any simple public-policy solutions to this particular health facet of the current financial crisis. "There are interventions that can influence aspects of stress in people's lives," he says. "But I'm not sure how effective they're going to be for people who are unemployed. The major stressors that put people at risk are the chronic, enduring problems that are engrained in their lives, and they're the ones least susceptible to interventions."
One obvious response is being considered as part of current the health-care debate in Congress: Finding a way to ensure laid-off workers continue to have health insurance. Under the current system, where most people receive health benefits from their employer, laid-off workers are losing coverage precisely at a time when they are at increased risk of disease.
On the other hand, Strully notes, "Making sure people have health insurance won't negate or undo the health consequences of job loss. In my analysis, it doesn't reduce the effect of job loss that much.
"If people are developing health problems as a result of job loss, being able to continue their health care will certainly impact how well they can manage. So it's definitely a good idea (to find a way to make sure the unemployed are covered). But any intervention is going to have to be more broad and holistic."
Meaning what? "Some combination of income protection and helping people cope with stress in a reasonably healthy way is probably the most practical intervention," she says. "There's a lot of research showing social support -- access to supportive, healthy relationships — is really important in how people cope with stressful events.