Online Program

Understanding the associations between unemployment, Medicaid, social welfare programs, and suicides, 1999-2009

Tuesday, November 5, 2013 : 10:30 a.m. - 10:50 a.m.

Lawrence Pellegrini, MSW, MPA, PhD candidate, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
Rosa Rodriguez-Monguio, PhD, MS, Health Policy and Management, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA
Background: During economic contractions, unemployed individuals experience a heightened risk for worsening mental health disorders and increased risk of suicide. This study sought to examine the relationship between unemployment, suicide, social welfare programs, and Medicaid provisions.

Data and Methods: Data were collected for 50 states and the District of Columbia from 1999-2009. Unemployment data obtained from the Bureau of Labor Statistics. Suicide and mental distress data derived from the Center for Disease Control. Health insurance data collected from the Centers for Medicare and Medicaid Services and the Census Bureau. Temporary Assistance for Needy Families (TANF) and State Unemployment Insurance (SUI) data obtained from the Departments of Health and Human Services, and Labor. State fixed effects regression models were used to examine the associations between unemployment, mental distress, suicide, and social welfare and Medicaid provisions. Statistical tests were based on a two-sided α significance level of p<.05. Analyses were performed with STATA.

Results: White non-Hispanic unemployment was associated with increased mental distress (p<.05), suicide (p<.001), uninsured (p<.001), Medicaid recipients (p<.001), and SUI beneficiaries (p<.001), and decreased TANF recipients (p<.01). Improved TANF (p<.001) and SUI (p<.05) coverage was associated with lower White non-Hispanic suicide, whereas increasing numbers of uninsured and Medicaid beneficiaries had the opposite association. Medicaid mental health spending did not have a statistically significant relationship with White non-Hispanic suicide.

Conclusion: As unemployment increases so does mental distress and suicides. Budget cuts on social welfare programs and Medicaid mental health services could lead to increases in suicides during economic downturns.

Learning Areas:

Biostatistics, economics
Public health or related public policy
Public health or related research

Learning Objectives:
Explain the association between unemployment, social welfare and Medicaid programs, mental distress, and suicide rates for working age individuals in the US. Analyze the relationship between social welfare and Medicaid provisions, incidence of mental distress, and suicide deaths. Discuss implications of the relationship between unemployment, social welfare and Medicaid programs for mental distress and suicide deaths.

Keyword(s): Suicide, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: This study was conducted under the supervision of a Ph.D. with a background in health economics. The study examines the labor market’s impact on population health. My experience in this area includes seven years working as an economist at the Bureau of Labor Statistics, and four years working as a licensed clinical social worker in both mental health and hospital settings. I am currently working towards completion of a Ph.D. in Health Policy and Management.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.