Background Job loss is a well-established social determinant of health. Recent research has taken an ‘institutional turn’, asking whether unemployment support could buffer the health consequences of job loss. Here, we exploit a quasi-natural experiment based on the Fornero reforms in Italy, which increased wage replacement rates from 60% to 75% on 1 January 2013. Methods We employed difference-in-difference models using longitudinal data covering 202 incidents of job loss from the EU-Survey on Income and Living Conditions to quantify the impact of job loss on changes in self-reported health prior to and after the Fornero reforms (2011–14). Results Job loss pre-Fornero was associated with health declines −0.342 [95% confidence interval (CI): −0.588 to −0.096] but did not significantly influence health post-Fornero 0.031 (95% CI: −0.101 to 0.164). The difference-in-difference estimate was 0.373 (95% CI: 0.107–0.639), or a −0.51 standard deviation in self-reported health, consistent with the buffering hypothesis. To put the magnitude of this estimate in perspective, the incidence of a chronic illness, such as diabetes, results in a similar magnitude decline in self-reported health. Conclusions Our analysis contributes to a growing body of evidence that the impact of job loss on health depends critically on the strength of social protection systems and, in some cases, could be eliminated completely.

中文翻译：

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他们跌得越软：一项自然实验检查了意大利福内罗失业救济金改革前后失业对健康的影响

背景 失业是一个公认的健康的社会决定因素。最近的研究采取了“制度转向”，询问失业支持是否可以缓冲失业带来的健康后果。在这里，我们利用基于意大利 Fornero 改革的准自然实验，该实验在 2013 年 1 月 1 日将工资替代率从 60% 提高到 75%。 方法 我们使用差异中的差异模型，使用涵盖 202 起工作事件的纵向数据来自欧盟收入和生活条件调查的损失，以量化失业对 Fornero 改革前后自我报告的健康变化的影响（2011-14 年）。结果 Fornero 之前的失业与健康下降有关 -0.342 [95% 置信区间 (CI): -0.588 到 -0.096]，但对 Fornero 之后的健康没有显着影响 0.031 (95% CI: -0.101 到 0.164)。差异估计值为 0.373（95% CI：0.107–0.639），或自我报告健康的标准差为 -0.51，与缓冲假设一致。从这个估计的幅度来看，糖尿病等慢性疾病的发病率会导致自我报告的健康状况出现类似幅度的下降。结论 我们的分析提供了越来越多的证据，即失业对健康的影响在很大程度上取决于社会保护体系的强度，并且在某些情况下可以完全消除。导致自我报告的健康状况出现类似幅度的下降。结论 我们的分析提供了越来越多的证据，即失业对健康的影响在很大程度上取决于社会保护体系的强度，并且在某些情况下可以完全消除。导致自我报告的健康状况出现类似幅度的下降。结论 我们的分析提供了越来越多的证据，即失业对健康的影响在很大程度上取决于社会保护体系的强度，并且在某些情况下可以完全消除。