LAUSR

AIM To test if exposure to unemployment in young adulthood is associated with an increased risk of later alcohol-related morbidity. DESIGN A nationwide register-linked longitudinal population-based study. SETTING Sweden. PARTICIPANTS A total of 16 490 individuals born between 1967 and 1978, who had participated in the Labour Force Survey between the ages of 16-24 during the years of 1990-1995. MEASUREMENT Information on the outcome of alcohol-related morbidity was obtained from the National Hospital Discharge Register. The Swedish index of alcohol-related inpatient care was used to define the outcome. Information on sex, age, and country of birth, as well as parents' level of education, socioeconomic status, and alcohol-related health problems, were also obtained. Average follow-up time was 22 years. Cox regression analysis was used to obtain Hazard ratios (HR) with 95% confidence intervals (CI). FINDINGS Compared with full-time students, individuals who experienced short- and long-term unemployment spells at a young age were at an increased risk of later alcohol-related morbidity; <3 months (HR: 2.04; 95% CI 1.35 to 3.09), 3 to 6 months (2.20; 1.29 to 3.75) and >6 months (1.99; 1.06 to 3.71) of unemployment, after adjusting for several important individual and family level covariates. CONCLUSION In Sweden, a nationwide registered based study with a 22-year follow-up suggests that being unemployed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.