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Doctoral defence of Rand Jarroch, MSc, 26 May 2023: The 1990s recession in Finland was followed by an increased incidence of non-communicable diseases

The doctoral dissertation in the field of Public Health / Epidemiology will be examined at the Faculty of Health Sciences at Kuopio campus.

What is the topic of your doctoral research? Why is it important to study the topic?

Very little is known worldwide about the impact of economic recessions on the later incidence of non-communicable diseases. Non-communicable diseases are the leading cause of death, morbidity and disability in the world, as well as in Finland. It is well-established that socioeconomic factors play an important role in their development. Few countries, including Finland, have succeeded in narrowing health inequalities between various socioeconomic groups, however, the challenge grows still in times of macroeconomic crises such as the severe economic recession that hit Finland in the early 1990s and had a remarkable and long-lasting impact on the country for many years after. Past examples tell us how poorly prepared most countries are in those situations, with inadequate preparedness strategies and action plans. Public health catastrophes of various sorts and magnitudes are commonly seen to accompany and follow economic crises. The present PhD project is of special interest as the world is currently facing an unprecedented economic recession and public health crisis with enormous economic effects. Yet, studies on the given topic are still very limited and health protection policies from recurrent financial crises are absent.

What are the key findings or observations of your doctoral research?

Socioeconomic hardships experienced during the 1990s recession were associated with higher risk of incident cardiovascular morbidity among middle-age and older Finnish women during 18-years of follow-up (Study I).

Among men, those who had experienced socioeconomic hardships in recession were at an increased risk of developing prostate-genital cancer within 20-years of follow-up. No association between socioeconomic hardships and cancer of any type was observed in women (Study II).

The recession-related hardships were associated with a long-term risk of psychiatric disorders and alcohol-related diseases among middle-age and older Finnish men, but again not among women. Even in men, the increased risks seemed to appear only during a lengthy 20-years of follow-up but could not be observed in the additional retrospective analysis of the first 4−10 post-recession years (Study III).

The majority of studies on recessions and health have investigated the physical and mental health only among those who have become unemployed during recessions. The outcomes were usually measured as mortality rates. These studies have mostly used short follow-ups during the actual recession period, while in fact, many harmful health effects of recessions might take several years to become evident.

In our research, we used a new approach to more comprehensively estimate the hardships caused by the recession through the overall impact on individuals and their families, financially and psychologically. Moreover, we investigated the association of the 1990s recession with the incidence of four major non-communicable disease categories in Finland, rather than only mortality, and during a long-term follow-up of 20 years rather than during the recession period only. It is wise to keep in mind that recession hardships might carry their toll for decades to come, even after the actual recession was passed to the history a long time ago. Economic shocks can negatively affect any group within the society, from working-age population to retirees, from children of parents who lost homes or jobs to wealthy business people, anyone...

How can the results of your doctoral research be utilized in practice?

Our findings emphasize the importance of effective social and health policies. These include social security and other forms of social support, equal opportunities of education, decent jobs and employment conditions with fair and equal pay, sufficient health care services not forgetting mental health, universal and unsegregated access to health care at need, secure housing, and more. Governments often tend to deal with financial crises by prioritizing reductions in spending, including cuts on health expenditure. Policy makers should provide alternative policies that alleviate socioeconomic hardships in recessions.

What are the key research methods and materials used in your doctoral research?

The study subjects were a random sub-sample of 920 women and 854 men between 53−73 years of age from Eastern Finland. They participated at the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD), a prospective population-based follow-up study, between 1998−2001. Socioeconomic hardships experienced during the recession were inquired with a series of questions a few years after the recession. At that point, extensive baseline examinations were also conducted. Subsequent changes in health were then monitored through linkage with national health registries over the average follow-up time of 18−20 years. The relationship between recession-induced socioeconomic hardships and later incidence of four non-communicable diseases (cardiovascular diseases, cancer, psychiatric disorders and alcohol-related diseases) were examined by using Cox proportional hazards models, with adjustments for multiple potential confounding variables.

The doctoral dissertation of Rand Jarroch, MSc, entitled Economic Recession and Non-Communicable Diseases will be examined at the Faculty of Health Sciences. The Opponent in the public examination will be Professor Sakari Karvonen of the Finnish Institute for Health and Welfare (THL), and the Custos will be Professor Jussi Kauhanen of the University of Eastern Finland.

Doctoral defence



For further information, please contact:

Rand Jarroch, MSc, randj(a), 0408584382