Alcoholics and workaholics

Sammanfattning: From the recent mortality trends in Central and Eastern Europe, it is clear that in the former socialist countries the economic transition had a different effect on male and female mortality: premature death became much more frequent among males, and the gender mortality gap increased as a result. The psycho-social stress hypothesis (Cornia and Paniccia, 2001) explains the Eastern European experience, suggesting that an increase in the gender gap may be a sign of economic and social crisis, as male mortality sometimes reacts to economic uncertainties more strongly. To my knowledge, no previous studies have examined if there is a similar relationship between economic crisis and gender gap elsewhere. The present study focuses on the economic crisis – gender mortality gap relationship in a broader context. While the starting point is the Eastern European experience, the focus is on looking at other examples, outside of the Soviet bloc, where high unemployment and economic uncertainty may have caused similar mortality reactions. Firstly, I review a large number of studies which report some information on gender-specific mortality during crisis. Secondly, to examine the unemployment - gender mortality gap relationship, I have prepared five case studies, for countries where there has been an economic crisis recently: Russia, Germany, South Korea, Argentina and Spain. For each country I have calculated gender mortality rate ratios by cause before and during crisis and correlations of differenced unemployment and gender gap time series. Thirdly, I look at the effect of Great Depression on mortality on individual level, using the Utah Population Database. I check if there was any difference in the mortality reactions of males and females using interactions in a Cox model. The results make it likely that the increase in premature male mortality is not a usual consequence of economic crisis. In none of the countries I have examined could I link statistically the movements of the gender mortality gap to fluctuations in unemployment. Although there was a smaller increase in the relative risk of dying among the middle aged during 1930 in Utah, there were no significant sex differences in the increase of relative risk. On the other hand the literature review and the case studies show, that behavioural differences and changes (like changes in the relative prevalence of smoking and drinking) are much more important in shaping the gender mortality gap than psychosocial stress even in the short run.