The great recession, youth unemployment and inequalities in psychological health complaints in adolescents: a multilevel study in 31 countries

Int J Public Health. 2016 Sep;61(7):809-19. doi: 10.1007/s00038-016-0866-0. Epub 2016 Aug 8.


Objectives: Little is known about the impact of recessions on young people's socioeconomic inequalities in health. This study investigates the impact of the economic recession in terms of youth unemployment on socioeconomic inequalities in psychological health complaints among adolescents across Europe and North America.

Methods: Data from the WHO collaborative 'Health Behaviour in School-aged Children' (HBSC) study were collected in 2005/06 (N = 160,830) and 2009/10 (N = 166,590) in 31 European and North American countries. Logistic multilevel models were used to assess the contribution of youth unemployment in 2009/10 (enduring recession) and the change in youth unemployment (2005-2010) to adolescent psychological health complaints and socioeconomic inequalities in complaints in 2009/10.

Results: Youth unemployment during the recession is positively related to psychological health complaints, but not to inequalities in complaints. Changes in youth unemployment (2005-2010) were not associated with adolescents' psychological health complaints, whereas greater inequalities in complaints were found in countries with greater increases in youth unemployment.

Conclusions: This study highlights the need to tackle the impact of increasing unemployment on adolescent health and health inequalities during economic recessions.

Keywords: Adolescence; Health inequalities; Multilevel analysis; Recession; Subjective health; Youth unemployment.

MeSH terms

  • Adolescent
  • Age Distribution
  • Child
  • Economic Recession / statistics & numerical data*
  • Europe / epidemiology
  • Female
  • Guanosine Diphosphate
  • Health Status Disparities*
  • Humans
  • Male
  • Mental Health / statistics & numerical data*
  • Multilevel Analysis
  • North America / epidemiology
  • Sex Distribution
  • Socioeconomic Factors
  • Unemployment / psychology*
  • Unemployment / statistics & numerical data*


  • Guanosine Diphosphate