Quantifying the burden of depressive symptoms in older Americans that is attributable to involuntary job loss: a counterfactual approach

量化美国老年人因非自愿失业而产生的抑郁症状负担：反事实方法

• 批准号: 10302605
• 负责人: Sally Picciotto
• 金额: $ 8.03万
• 依托单位: UNIVERSITY OF CALIFORNIA BERKELEY
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10302605
• 关键词: Affect; Age; Aging; American; Centers for Disease Control and Prevention (U.S.); Characteristics; Complex; Data; Data Analyses; Economic Conditions; Economics; Elderly; Employment; Employment Terminations; Financial Hardship; Foundations; Goals; Health; Health Insurance; Health and Retirement Study; Industry; Intervention; Job loss; Left; Mental Depression; Mental Health; Mission; Modification; Occupations; Outcome; Participant; Policies; Population; Probability; Public Health; Publishing; Quality of life; Recording of previous events; Research; Research Personnel; Retirement; Risk; Side; Social support; Surveys; Symptoms; Testing; Time; Unemployment; United States National Institutes of Health; Work; Workplace; age group; cohort; depressive symptoms; disability; experience; family structure; follow-up; improved; innovation; social; suicidal risk; suicide rate

The burden of depressive symptoms among older Americans over the period 1992-2018 that is attributable to involuntary job loss, and the extent to which intervening on various mechanisms could mitigate it, have not been estimated. The long-term goal is to identify key mechanisms (e.g., loss of health insurance, unemployment, inadequate reemployment, financial hardship, etc.) that affect depressive symptoms over time in older Americans after job loss, in order to guide policy and interventions. As the first step toward this long-term goal, the objective of this application is to quantify the burden of depressive symptoms among older Americans that is attributable to job loss, adjusting for time-varying confounding, and to evaluate time to reemployment as one mechanism. The central hypothesis is that involuntary job loss increases the burden of depressive symptoms among older Americans of limited means and that unemployment is one of the key mechanisms by which this occurs. The rationale for this project is that no one has yet analyzed data from the Health and Retirement Study (HRS) using a counterfactual framework or leveraging the full richness of the longitudinal data, and doing so will be essential for identifying mechanisms and thus interventions to alleviate depressive symptoms among older adults. The hypothesis will be tested by pursuing two specific aims: 1) Compare depressive symptoms burden in HRS under the observed employment histories to what would have happened if no one had ever suffered an involuntary job loss during follow-up. 2) Compare depressive symptoms burden in HRS under the observed employment histories to what would have happened if everyone who experienced a job loss during follow-up had soon been reemployed. For both aims, the parametric g-formula will be applied to estimate counterfactual outcomes under hypothetical interventions while controlling for time-varying confounding. The proposed research is innovative because, instead of comparing those who lost a job to those who did not, it frames the question in terms of hypothetical interventions on employment to estimate changes in the burden of depressive symptoms that would have been observed in the whole population under those interventions. The proposed research is significant because more than half of Americans in this age group will experience an involuntary job loss; the rigorous analysis proposed will provide estimates of both the corresponding burden of depressive symptoms and the extent to which these symptoms can be mitigated by reemployment, ultimately helping to set priorities for interventions.

1992年至2018年期间，美国老年人的抑郁症状负担 由于非自愿失业，以及在何种程度上干预各种机制， 可以减轻它，还没有估计。长期目标是确定关键机制（例如， 失去健康保险、失业、再就业不足、经济困难等）的 影响失业后美国老年人的抑郁症状，以指导政策 和干预措施。作为实现这一长期目标的第一步，本申请的目标是 量化美国老年人中归因于工作的抑郁症状负担 损失，调整随时间变化的混杂因素，并将重新就业的时间作为一个 机制中心假设是，非自愿失业增加了抑郁症的负担。 经济能力有限的美国老年人的症状，失业是关键之一， 这种情况发生的机制。这个项目的基本原理是，还没有人分析 健康与退休研究（HRS）数据使用反事实框架或杠杆 充分丰富的纵向数据，这样做对于确定机制至关重要 从而采取干预措施来缓解老年人的抑郁症状。假设将 通过追求两个具体目标进行测试：1）比较HRS中的抑郁症状负担， 观察到的就业历史，如果没有人曾经遭受过 在随访期间非自愿失业。2)比较HRS患者在不同治疗方案下的抑郁症状负担 观察就业历史，如果每个有工作经历的人 随访期间的损失很快被重新雇用。对于这两个目标，参数g公式将是 应用于估计假设干预下的反事实结果，同时控制 时变混杂这项研究是创新的，因为它不是比较 那些谁失去了工作，那些谁没有，它框架的问题，在假设方面， 对就业的干预，以估计抑郁症状负担的变化， 在这些干预措施下，在整个人口中都会观察到这种情况。拟议 这项研究意义重大，因为在这个年龄段的美国人中，超过一半的人会经历 非自愿失业;拟议的严格分析将提供对 抑郁症状的相应负担以及这些症状可能被 通过再就业缓解，最终帮助确定干预的优先事项。