Accumulating disadvantage. Longitudinal analyses of unemployment and physical health in representative samples of the swedish population

In the long-standing debate on the association between social stratificatio n and health it has recently been argued that the health differential resul ts from a step-by-step process involving both selection and causation. One factor likely to be important in this process of accumulating disadvantage is unemployment. Entering unemployment is a drastic example of downward soc ial mobility, and one that is likely to have a substantial impact on subseq uent mobility chances. Health may obviously play a role in selection into a nd out of unemployment, yet ill health is also often see as a consequence o f unemployment. Despite a vast number of studies our knowledge of the relat ive importance of these factors is surprisingly limited, in particular when it comes to physical health. In this study analyses of health-based select ion into and out of unemployment are presented, as well as of the effect of unemployment on health. The former shows that ill health increases the ris k of both becoming and remaining unemployed. In addition, the latter analys es, which take into account a number of alternative selection possibilities , provide unequivocal evidence of worsening of health status due to unemplo yment.