A slightly dated article (Dec 2009) but still full of interesting information and links. SV
he Top Moments of the Decade in Social Entrepreneurship
by Nathaniel Whittemore · December 27, 2009
My final list of the year, and this is the big one: the top moments in social entrepreneurship of the decade.
As any list, this is subjective, and reflects my biases. That said, I've tried to look across a pretty wide scope of happenings and chose key moments that reflected larger movements and shifts that have shaped the field. As you'll see, and following the pattern of this blog, I haven't defined the field strictly, and have included events that I think have, are, or will shift the boundaries of how we define ourselves. In true historian form, I haven't even defined the decade in strict terms.
The ordering isn't random, but it reflects an attempt to balance the impact that an event already had to the impact it will have in the coming years. One regret is that the list is largely US-centric. This is a matter of my failings to know the whole world far more than the lack of the world's impact on social entrepreneurship. Finally, there is almost no doubt that I've forgotten important things, and for an incredibly complete history of our field, please download and read this chronology of social enterprise.
Without further ado:
#10: Launch of the Office of Social Innovation (April 2009) - While it is muddled through the messy business of reforming health care and cleaning up foreign wars, this administration has also quietly put into motion the most high level collaboration between social enterprise and government the US has seen. With $50 million in approved funding, the forthcoming Social Innovation Fund provides a chance to live up to the promise of the office. Other notable moments for government collaboration with social entrepreneurs include the Fall 2006 launch of the Louisiana Office of Social Entrepreneurship - the first state level office of it's type, and the UK's May 2006 commissioning of the Cabinet Office of the Third Sector.
#9: First Issue of Stanford Social Innovation Review (Spring 2003) - The 2000s saw a huge number of academic programs based around social entrepreneurship and innovation. Indeed, it's increasingly a prerequisite that MBA programs have significant social innovation offerings. I've chosen the publishing of the first issue of the Stanford Social Innovation Review as the moment to capture this movement because, as any good academic will tell you, every field needs a journal. Since 2003, SSIR has been the place to get into the real research and scholarship behind our field.
#8: Andrew Zolli Joins Pop!Tech (2003) and TED Talks Move Online (June 2006) - As I argued in my #3 Trends Shaping Social Entrepreneurship in 2010 prediction, social innovation is an increasingly bigger bucket and actors and institutions from other fields like design are pushing the boundaries of what it means to be a social entrepreneur. Pop!Tech and TED are perhaps the two most important public faces of this broader world of creative social innovation. Both networks are anchored in conferences that bring together big thinkers from across the spectrum, and both networks have used the incredibly distribution power of the internet to help make the world safe for smart. Although they have their roots in earlier decades, there are a number of identifiable moments in the last ten years that stand out. For Pop!Tech, the emotional and intellectual force of curator Andrew Zolli has taken the network into a new league that continues to evolve at an incredible pace. For TED, the decision in 2006 to begin giving away the talks for free online has allowed anyone with an internet connection to be inspired, and with 100+ million views, that impact can hardly be calculated. I am totally convinced that these communities will continue to bring new people to social entrepreneurship as well as push those of us in the field to think differently about who and what we are and do.
#7: Unilever's Acquisiton of Ben & Jerry's (April 2000) and Cadbury's Shift To Fair Trade (March 2009) - These twin events are something of the Yin and Yang of corporate involvement with social good. Ben & Jerry's sold itself to European conglomerate Unilever in early 2000 with the promise that Unilever would keep its myriad social good programs in tact. Unfortunately, they didn't, and the fallout has had a profound impact on how investors like the folks at Good Capital think about structuring their investments to "bake social good into the DNA" as GoodCap founder Kevin Jones is fond of saying. On the flip side, the Fair Trade movement - a subsection or related cousin of social enterprise, depending on your perspective - has become increasingly mainstream - particularly in Europe. In March of this year, famous UK Chocolate maker Cadbury announced that its entire Dairymilk line would subsequently be produced with exclusively Fair Trade certified chocolate. A few months later, as Kraft circled for a Cadbury acquisition, many wondered if it would be Ben & Jerry's all over again. Exits for social enterprise will be a major factor in determining how far the field advances in the next decade.
#6: The Launch of the iPhone (June 2007) - Bear with me. Regardless of how you feel about Apple or social media, it is pretty inarguable that the iPhone is the first consumer electronic device to truly put the power of the computer in your pocket. It is truly the modern Swiss Army Knife, with 100,000+ applications that allow you to do everything from find parks that kids can play in to post status updates on Facebook to perform microtasks that help give work to refugees in Kenya. The iPhone is the first device that actualized the potential of the social communication revolution wrought on by instant messaging, Twitter, Facebook, and now geolocation services like Foursquare and Gowalla. In doing so, it is accelerating the shift in how we self organize, and I believe that we're only seeing the beginning of how the devices we carry in our pockets will allow us to shift how we act collectively and individually for the common good. The iPhone may eventually be disrupted itself, but its importance as the device that launched the revolution will stick.
#5: Teach For America's 2009 Recruitment Class Numbers (May 2009) - Who turned down more than 30,000 top college graduates last year? Who received applications from a full 11% of graduating Ivy League seniors, including 16% of Yale's class? Who was the top employer of graduating seniors from Brown, Georgetown, Trinity College, the University of Chicago, Marquette, and about a dozen other schools? Not Goldman Sachs. Not McKinsey, Deloitte or any other consulting firm. It was Teach For America. In a field predicated on the idea that social innovation can be scaled to achieve widespread change, we have precious few examples of organizations that have actually begun to achieve it. While TFA isn't where it wants to be - still facing often contentious relationships with teachers unions that limit placements, for example - it has achieved a scale, particularly in the hearts of the vital next generation of change leaders - that demonstrates the potential of the field.
#4: Bankruptcy of Lehman Brothers (September 2008) and launch of the Social Capital Markets Conference (October 2008) - Even in the few years that I've been actively involved with the field, social entrepreneurship has increasingly shifted away from an exoneration of heroic individuals to understand itself instead as a full market apparatus with institutions for funding, operations, and support, and increasingly robust pipelines for information and financing. The first Social Capital Markets conference in San Francisco, held in October 2008, was notable in that it was explicitly about this emerging market structure, and brought together a hugely diverse cross-section of the actors involved. Only a month before, Lehman Brothers crashed in the largest bankruptcy in US history and sent shivers through the mainstream financial world. The events feel tied to me because at its core, the attendees and planners of the first (and subsequent) SoCap are fundamentally engaged with the question NOT of identifying high potential entrepreneurs, but of fundamentally reshaping capitalism. They have a lot of building to do, but the shift is significant and is already shaping what "social entrepreneurship" will mean in the coming decade.
#3: Muhammad Yunus And Grameen Bank Win Nobel Peace Prize (October 2006) and Kiva.org Founded (March 2005) - Every field needs its shining exemplars. Perhaps nothing has done more to make people take note of the idea that markets can be used for good than the Nobel Peace Prize committee recognizing Muhammad Yunus and the Grameen Bank he founded in Bangladesh in the 1970s. Since then, Yunus has become an increasingly household name, and as he has told the story of microfinance, he has opened the door to the conversation about "social business," as he calls it in a book of the same title, more broadly. Of course, the action engine that made Yunus' increasing reknown so powerful for our field is Kiva.org, the microlending site that just passed $100 million in loans and that has given millions of average citizens the chance to be a part of microfinance. While no one would argue that donating $25 (or even a bunch more than that) constitutes a full engagement with the field of social entrepreneurship, I would imagine that Kiva has been the gateway drug for more Moms, Cousins, and Grandparents than just about anything else, and has opened up the gates for a whole new crop of organizations like Vittana, Samasource, and Change.org to create new ways to engage online.
#2: David Bornstein Publishes "How To Change The World" (February 2004) - Before I knew what social entrepreneurship was, exactly, I knew about David Bornstein's "How To Change The World: Social Entrepreneurs And The Power Of New Ideas." That was the case for most of the undergrads I knew getting into the field. Bornstein's collection of stories of some of the world's best performing and least known social innovators was the book that brought together a seemingly interesting idea and made it real, tangible, and tasteable. Although there have been a lot of great books about the field put out since then, Bornstein's remains at the top of the list for those who want the overview and inspiration. In terms of building the field, it's hard to calculate how important this book has been and will be to the new generation of young people clamoring to create or help grow the innovative institutions of tomorrow. Like every field needs a journal, every young movement needs a book to tip it from niche to popular. More than any other, David's book has done that for social entrepreneurship.
#1: eBay Goes Public (September 1998) - Barron's recently published a list of the Top 25 best philanthropists. Right on the top of the list at #1 and #2 respectively were Pierre Omidyar and Jeff Skoll, the founder and first employee of online auction site eBay. In September 1998, when eBay went public and Omidyar and Skoll became worth 9+ figures, it created the wealth and the opportunity that have done arguably the most to build social entrepreneurship into a recognizable field over the last ten years. Omidyar's Omidyar.net has functioned as a venture capital/philanthropic investment firm, making grants and investments in groups working in microfinance, digital access, and social entrepreneurs working on a host of other issues. What's more, the Omidyar.net/group online community was one of the earliest and most important conversation groups to discuss social innovation in the early part of the decade. Skoll barely needs a writeup. I argued a few days ago that he should have been on Inc's top entrepreneurs of the decade list. He has pumped more than $1b of eBay stock into his Skoll Foundation for Social Entrepreneurship, launched the "Davos of Social Entrepreneurship," the Skoll World Forum, started a major Hollywood studio - Participant Media - dedicate to films for good like "An Inconvenient Truth," and most recently launched a new "Urgent Threats Fund" to deal with issues like the Israeli-Palestinian conflict. While I've chosen a moment that happened at the end of the last decade, the real impact of the eBay bros belongs entirely to the 2000s, and we're much the better for it.
Honorable Mention #1: Al Gore Debuts "An Inconvenient Truth" at Skoll World Forum (March 2006) - I purposefully didn't include anything explicitly about the mainstreaming of environmental justice and climate change as a part of social entrepreneurship, for the reason that I believe that it is truly its own beast. That said, environmental impact is a core part of the triple bottom line equation sought for by social entrepreneurs, and in trying to think of moments that best highlight the connection between these spaces, I came to the premier of Al Gore's Academy Award winning "An Inconvenient Truth," which happened at the Skoll World Forum 2006.
Honorable Mention #2: Two organizations that deserve to be recognized but for which I couldn't think of one particular moment to mention. Echoing Green and Ashoka - both of which have roots in the 1980s - have consistent drivers of the field, Ashoka has been a constant public advocate for worldwide changemakers and the idea of social entrepreneurship, and Echoing Green has become one of the most important funders and aspirational models for young social innovators. Both have been permanent and vital parts of this field throughout the 2000s.
So there you have it. Fire away with comments, critiques, and your own ideas.
Saturday, 30 April 2011
Sex ratio, patriarchy, and ethics (From The Hindu newspaper)
Patriarchal societies are part of the problem of altered sex ratios, female infanticide and foeticide. This needs to be acknowledged and changed.
India's sex ratio, among children aged 0-6 years, is alarming. The ratio has declined from 976 females (for every 1000 males) in 1961 to 914 in 2011. Every national census has documented a decline in the ratio, signalling a ubiquitous trend. Preliminary data from the 2011 census have recorded many districts with sex ratios of less than 850. The ratio in urban areas is significantly lower than those in rural parts of the country. Reports suggest evidence of violence and trafficking of poor women and forced polyandry in some regions with markedly skewed ratios. The overall steep and consistent decline in the ratio mandates serious review.
Sex selection and technology: Medical technology (like amniocentesis and ultrasonography), employed in the prenatal period to diagnose genetic abnormalities, are being misused in India for detecting the sex of the unborn child and subsequently for sex-selection. Female foetuses, thus identified, are aborted.
A large, nationally representative investigation of married women living in 1.1 million households documented markedly reduced sex ratios of 759 and 719 for second and third births when the preceding children were girls. By contrast, sex ratios for second or third births, if one or both of the previous children were boys, were 1102 and 1176 respectively. A systematic study in Haryana documented the inverse relationship between the number of ultrasound machines in an area and the decline in sex ratios. Studies have also documented correlations of low sex ratios at birth with higher education, social class and economic status. Many studies have concluded that prenatal sex determination, followed by abortion of female foetuses, is the most plausible explanation for the low sex ratio at birth in India.
The steady decline in the sex ratio suggests that marked improvements in the economy and literacy rates do not seem to have had any impact on this index. In fact, the availability of new technology and its easy access for the urban, wealthy and the educated have worsened the trend and harmed the status of women in Indian society.
Sex selection and statutes: A prolonged campaign by women's groups and civil society organisations all over the country, in the wake of the skewed child sex ratio in the 1991 census, led to the enactment of the Pre-Natal Diagnostic Techniques Act in 1994. However, this statute was not effectively implemented, leading to further skewing of the sex ratios as recorded in the 2001 census. Social and financial pressures for smaller families intensified the misuse of such technologies to ensure the birth of sons. Such misuse cut across barriers of caste, class, religion and geography. The Act was amended in 2003, to include the more recent pre-conception sex selection techniques within its ambit, with the aim of tightening regulation to provide more teeth to the law to prevent the practice. It mandated the regulation of sale of technology, the registration of diagnostic centres, the monitoring of medical personnel, procedures and protocols. It has procedures for complaints and appeals and regulation by local authorities.
And yet, the problems of implementation are ubiquitous. Violations go unpunished with very few cases being booked and a zero conviction rate. The collusion between people, the medical fraternity and the administration has resulted in the worsening of the sex ratio and failure of the Act to make a difference.
Patriarchy and prejudice: The social system of patriarchy, with males as the primary authority figures, is central to the organisation of much of Indian society. The system upholds the institutions of male rule and privilege and mandates female subordination. Patriarchy manifests itself in social, religious, legal, political and economic organisation of society. It continues to strongly influence Indian society, despite the Constitution's attempt to bring about an egalitarian social order.
Patriarchal societies in most parts of India have translated their prejudice and bigotry into a compulsive preference for boys and discrimination against the girl child. They have also spawned practices such as female infanticide, dowry, bride-burning and sati. They have led to the neglect of nutrition, health care, education, and employment for girls. Women's work is also socially devalued with limited autonomy in decision-making. The intersections of caste, class and gender worsen the situation. Despite its social construction, patriarchal culture, reinforced by the major religions in the country, maintains its stranglehold on gender inequality. The prevalent patriarchal framework places an ideological bar on the discussion of alternative approaches to achieve gender justice.
Ethical blindness: The declining sex ratio cannot be simply viewed as a medical or legal issue. It is embedded within the social construction of patriarchy and is reinforced by tradition, culture and religion. Female foeticide and infanticide are just the tip of the iceberg; there is a whole set of subtle and blatant discriminatory practices against girls and women under various pretexts. It is this large base of discrimination against women that supports the declining sex ratio.
Many approach the problem superficially and focus on the declining sex ratio and its medical and legal solutions. But those who seriously engage with the issues have found that much unethical conduct that goes on, whether in one's social or work life, happens because people are fooling themselves. Men, the dominant figures, and older women, who have lost the battle and have joined hands to form the ruling coalition, overlook many transgressions because it is in their interest to maintain the patriarchal culture. With such focus on patriarchal goals, the ethical implications of important decisions fade away. Such ethical fading results in engaging in or condoning behaviour that one would condemn if one were consciously aware of it. It results in ethical lapses in our social world, which are pervasive and intractable.
While viewing the girl child from only the narrow and bigoted, or financial perspectives, one fails to notice that many decisions have an ethical component. Consequently, one is able to behave unethically in relation to girls and women, while maintaining a positive self-image. Ethical fading also causes one to condone the unethical behaviour of others. Such “motivated blindness” tends to disregard issues that work against patriarchy. With the acceptance of patriarchal standards, based on religion or culture, even the most honest people have difficulty being objective. Those who overtly or covertly accept and defend patriarchy have a conflict of interest which biases their decisions against girls and women, in contexts both big and small. It is the everyday casual and hurtful misogyny — gendered language, sexist innuendo, stereotyping and jokes, small institutional inequities, sexualisation of society encouraged by advertising, media and capitalism that actually undergird violence of all types against women.
Need for gender justice: Viewing the sex ratio as an individual or medical issue and suggesting medical or legal interventions to end the practice reflect poor understanding. While strict implementation of the law will help reduce female foeticide and infanticide, it will not eliminate the problems. Simply exhorting the general population and the medical profession to desist from such practice without attempting to change patriarchy will prove futile.
The major barrier to mainstreaming gender justice and scaling up effective interventions is gender inequality based on socio-cultural issues. The systematic discrimination of girls and women needs to be tackled if interventions have to work. Although medical intervention (of sex determination and selective abortion of female foetuses) in the sex ratio stands out as causal, it is the more hazy but ubiquitous and dominant relationship between gender and patriarchy that has a major impact on the outcome. The failure to recognise this relationship and the refusal to tackle these issues result in the declining sex ratio. Debates on gender equality should not be reduced to talking about culture, tradition and religion. The prevalent patriarchal framework needs to be acknowledged as causal, interrogated and laid bare. Discussions on alternative approaches to achieving gender justice are mandatory.
While women are guaranteed equality under the Constitution, legal protection has little effect in the face of the prevailing patriarchal culture. India needs to confront its gender bias openly. It would appear that nothing short of a social revolution would bring about an improvement in the health and status of women in the country. Irony and hypocrisy are the two words that come to mind when patriarchal societies talk about justice for their women. Surely, the disappearance of millions of girls in India is reason enough to question the acceptance of patriarchy and search for an egalitarian social order.
(Professor K.S. Jacob is on the faculty of the Christian Medical College, Vellore.)
India's sex ratio, among children aged 0-6 years, is alarming. The ratio has declined from 976 females (for every 1000 males) in 1961 to 914 in 2011. Every national census has documented a decline in the ratio, signalling a ubiquitous trend. Preliminary data from the 2011 census have recorded many districts with sex ratios of less than 850. The ratio in urban areas is significantly lower than those in rural parts of the country. Reports suggest evidence of violence and trafficking of poor women and forced polyandry in some regions with markedly skewed ratios. The overall steep and consistent decline in the ratio mandates serious review.
Sex selection and technology: Medical technology (like amniocentesis and ultrasonography), employed in the prenatal period to diagnose genetic abnormalities, are being misused in India for detecting the sex of the unborn child and subsequently for sex-selection. Female foetuses, thus identified, are aborted.
A large, nationally representative investigation of married women living in 1.1 million households documented markedly reduced sex ratios of 759 and 719 for second and third births when the preceding children were girls. By contrast, sex ratios for second or third births, if one or both of the previous children were boys, were 1102 and 1176 respectively. A systematic study in Haryana documented the inverse relationship between the number of ultrasound machines in an area and the decline in sex ratios. Studies have also documented correlations of low sex ratios at birth with higher education, social class and economic status. Many studies have concluded that prenatal sex determination, followed by abortion of female foetuses, is the most plausible explanation for the low sex ratio at birth in India.
The steady decline in the sex ratio suggests that marked improvements in the economy and literacy rates do not seem to have had any impact on this index. In fact, the availability of new technology and its easy access for the urban, wealthy and the educated have worsened the trend and harmed the status of women in Indian society.
Sex selection and statutes: A prolonged campaign by women's groups and civil society organisations all over the country, in the wake of the skewed child sex ratio in the 1991 census, led to the enactment of the Pre-Natal Diagnostic Techniques Act in 1994. However, this statute was not effectively implemented, leading to further skewing of the sex ratios as recorded in the 2001 census. Social and financial pressures for smaller families intensified the misuse of such technologies to ensure the birth of sons. Such misuse cut across barriers of caste, class, religion and geography. The Act was amended in 2003, to include the more recent pre-conception sex selection techniques within its ambit, with the aim of tightening regulation to provide more teeth to the law to prevent the practice. It mandated the regulation of sale of technology, the registration of diagnostic centres, the monitoring of medical personnel, procedures and protocols. It has procedures for complaints and appeals and regulation by local authorities.
And yet, the problems of implementation are ubiquitous. Violations go unpunished with very few cases being booked and a zero conviction rate. The collusion between people, the medical fraternity and the administration has resulted in the worsening of the sex ratio and failure of the Act to make a difference.
Patriarchy and prejudice: The social system of patriarchy, with males as the primary authority figures, is central to the organisation of much of Indian society. The system upholds the institutions of male rule and privilege and mandates female subordination. Patriarchy manifests itself in social, religious, legal, political and economic organisation of society. It continues to strongly influence Indian society, despite the Constitution's attempt to bring about an egalitarian social order.
Patriarchal societies in most parts of India have translated their prejudice and bigotry into a compulsive preference for boys and discrimination against the girl child. They have also spawned practices such as female infanticide, dowry, bride-burning and sati. They have led to the neglect of nutrition, health care, education, and employment for girls. Women's work is also socially devalued with limited autonomy in decision-making. The intersections of caste, class and gender worsen the situation. Despite its social construction, patriarchal culture, reinforced by the major religions in the country, maintains its stranglehold on gender inequality. The prevalent patriarchal framework places an ideological bar on the discussion of alternative approaches to achieve gender justice.
Ethical blindness: The declining sex ratio cannot be simply viewed as a medical or legal issue. It is embedded within the social construction of patriarchy and is reinforced by tradition, culture and religion. Female foeticide and infanticide are just the tip of the iceberg; there is a whole set of subtle and blatant discriminatory practices against girls and women under various pretexts. It is this large base of discrimination against women that supports the declining sex ratio.
Many approach the problem superficially and focus on the declining sex ratio and its medical and legal solutions. But those who seriously engage with the issues have found that much unethical conduct that goes on, whether in one's social or work life, happens because people are fooling themselves. Men, the dominant figures, and older women, who have lost the battle and have joined hands to form the ruling coalition, overlook many transgressions because it is in their interest to maintain the patriarchal culture. With such focus on patriarchal goals, the ethical implications of important decisions fade away. Such ethical fading results in engaging in or condoning behaviour that one would condemn if one were consciously aware of it. It results in ethical lapses in our social world, which are pervasive and intractable.
While viewing the girl child from only the narrow and bigoted, or financial perspectives, one fails to notice that many decisions have an ethical component. Consequently, one is able to behave unethically in relation to girls and women, while maintaining a positive self-image. Ethical fading also causes one to condone the unethical behaviour of others. Such “motivated blindness” tends to disregard issues that work against patriarchy. With the acceptance of patriarchal standards, based on religion or culture, even the most honest people have difficulty being objective. Those who overtly or covertly accept and defend patriarchy have a conflict of interest which biases their decisions against girls and women, in contexts both big and small. It is the everyday casual and hurtful misogyny — gendered language, sexist innuendo, stereotyping and jokes, small institutional inequities, sexualisation of society encouraged by advertising, media and capitalism that actually undergird violence of all types against women.
Need for gender justice: Viewing the sex ratio as an individual or medical issue and suggesting medical or legal interventions to end the practice reflect poor understanding. While strict implementation of the law will help reduce female foeticide and infanticide, it will not eliminate the problems. Simply exhorting the general population and the medical profession to desist from such practice without attempting to change patriarchy will prove futile.
The major barrier to mainstreaming gender justice and scaling up effective interventions is gender inequality based on socio-cultural issues. The systematic discrimination of girls and women needs to be tackled if interventions have to work. Although medical intervention (of sex determination and selective abortion of female foetuses) in the sex ratio stands out as causal, it is the more hazy but ubiquitous and dominant relationship between gender and patriarchy that has a major impact on the outcome. The failure to recognise this relationship and the refusal to tackle these issues result in the declining sex ratio. Debates on gender equality should not be reduced to talking about culture, tradition and religion. The prevalent patriarchal framework needs to be acknowledged as causal, interrogated and laid bare. Discussions on alternative approaches to achieving gender justice are mandatory.
While women are guaranteed equality under the Constitution, legal protection has little effect in the face of the prevailing patriarchal culture. India needs to confront its gender bias openly. It would appear that nothing short of a social revolution would bring about an improvement in the health and status of women in the country. Irony and hypocrisy are the two words that come to mind when patriarchal societies talk about justice for their women. Surely, the disappearance of millions of girls in India is reason enough to question the acceptance of patriarchy and search for an egalitarian social order.
(Professor K.S. Jacob is on the faculty of the Christian Medical College, Vellore.)
Tuesday, 12 April 2011
Unemployment and mortality - clear relationship shown
This is very important research that is bound to create significant reactions. When governments tolerate certain levels of unemployment, they are also in effect tolerating certain levels of mortality in particular groups of citizens.
Social Science & Medicine
Volume 72, Issue 6, March 2011, Pages 840-854
doi:10.1016/j.socscimed.2011.01.005 | How to Cite or Link Using DOI
Copyright © 2011 Elsevier Ltd All rights reserved.
Permissions & Reprints
Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality
David J. Roelfsa, , , Eran Shorb, Karina W. Davidsonc and Joseph E. Schwartzd
a Department of Sociology, Stony Brook University, S-401 SBS Building, Stony Brook, NY 11794-4356, USA
b Department of Sociology, McGill University, Montreal, Quebec, Canada
c Department of Medicine and Psychiatry, Columbia University, New York, NY, USA
d Department of Psychiatry and Behavioral Medicine, Stony Brook University, Stony Brook, NY, USA
Available online 27 January 2011.
Abstract
Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a random effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late career. The risk of death was highest during the first 10 years of follow-up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors.
Highlights
► The risk of death for unemployed persons was 63% higher than the risk of death for employed persons. ► The relative mortality risk associated with unemployment was 37% higher for men than for women. ► The relative mortality risk associated with unemployment was significantly lower for workers approaching retirement age (50-65 years of age). ► The relative mortality risk associated with unemployment remained elevated among studies with lengthy follow-up periods, suggesting that becoming unemployed induces a long-term change in the underlying mortaity risk.
Keywords: Unemployment; All-cause mortality; Meta-analysis; Meta-regression; Systematic review; Psychosocial stress; Health behaviors
Article Outline
Mediating and confounding health factors in unemployment research
The latent sickness hypothesis
The coping hypothesis
Methods
Search strategy and coding procedures
Statistical methods and inclusion criteria
Results
sub-group meta-analyses and meta-regression analyses
Sensitivity analysis
Discussion
Limitations
Discussion
Conclusion
Acknowledgements
Appendix. Appendix
Section 1: Full search algorithms for Medline.
Section 2: Coding procedures and variables for which data were sought.
Section 3: Additional information on the conversion of odds ratios and relative risks to hazard ratios.
Section 4: Additional information on the estimation of death rates and standard errors.
Section 5: Additional information on method for adjusting inverse variance weights.
References
Social Science & Medicine
Volume 72, Issue 6, March 2011, Pages 840-854
doi:10.1016/j.socscimed.2011.01.005 | How to Cite or Link Using DOI
Copyright © 2011 Elsevier Ltd All rights reserved.
Permissions & Reprints
Losing life and livelihood: A systematic review and meta-analysis of unemployment and all-cause mortality
David J. Roelfsa, , , Eran Shorb, Karina W. Davidsonc and Joseph E. Schwartzd
a Department of Sociology, Stony Brook University, S-401 SBS Building, Stony Brook, NY 11794-4356, USA
b Department of Sociology, McGill University, Montreal, Quebec, Canada
c Department of Medicine and Psychiatry, Columbia University, New York, NY, USA
d Department of Psychiatry and Behavioral Medicine, Stony Brook University, Stony Brook, NY, USA
Available online 27 January 2011.
Abstract
Unemployment rates in the United States remain near a 25-year high and global unemployment is rising. Previous studies have shown that unemployed persons have an increased risk of death, but the magnitude of the risk and moderating factors have not been explored. The study is a random effects meta-analysis and meta-regression designed to assess the association between unemployment and all-cause mortality among working-age persons. We extracted 235 mortality risk estimates from 42 studies, providing data on more than 20 million persons. The mean hazard ratio (HR) for mortality was 1.63 among HRs adjusted for age and additional covariates. The mean effect was higher for men than for women. Unemployment was associated with an increased mortality risk for those in their early and middle careers, but less for those in their late career. The risk of death was highest during the first 10 years of follow-up, but decreased subsequently. The mean HR was 24% lower among the subset of studies controlling for health-related behaviors. Public health initiatives could target unemployed persons for more aggressive cardiovascular screening and interventions aimed at reducing risk-taking behaviors.
Highlights
► The risk of death for unemployed persons was 63% higher than the risk of death for employed persons. ► The relative mortality risk associated with unemployment was 37% higher for men than for women. ► The relative mortality risk associated with unemployment was significantly lower for workers approaching retirement age (50-65 years of age). ► The relative mortality risk associated with unemployment remained elevated among studies with lengthy follow-up periods, suggesting that becoming unemployed induces a long-term change in the underlying mortaity risk.
Keywords: Unemployment; All-cause mortality; Meta-analysis; Meta-regression; Systematic review; Psychosocial stress; Health behaviors
Article Outline
Mediating and confounding health factors in unemployment research
The latent sickness hypothesis
The coping hypothesis
Methods
Search strategy and coding procedures
Statistical methods and inclusion criteria
Results
sub-group meta-analyses and meta-regression analyses
Sensitivity analysis
Discussion
Limitations
Discussion
Conclusion
Acknowledgements
Appendix. Appendix
Section 1: Full search algorithms for Medline.
Section 2: Coding procedures and variables for which data were sought.
Section 3: Additional information on the conversion of odds ratios and relative risks to hazard ratios.
Section 4: Additional information on the estimation of death rates and standard errors.
Section 5: Additional information on method for adjusting inverse variance weights.
References
Monday, 4 April 2011
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