Socioeconomic Stress and Drug Consumption: Unemployment as an Adverse Health Factor in Croatia

Aim: To explore to what degree unemployment was related to health problems expressed in terms of consumption of prescription drugs in Croatian citizens. Methods: Based on the Croatian Institute for Health Insurance data for 2003, the number of prescriptions per insured individual (NPI) was calculated for employed and unemployed persons, as well as for different subsets according to the region (Zagreb, Split, Rijeka, Osijek), age, gender, and prescribed drug category. Results: During 2003, a total of 1 003 547 drugs were prescribed to 949 746 health-insured persons aged 18-69 years. NPI was 32% higher for unemployed than for employed citizens; it averaged 0.995 among the employed, and 1.317 among the unemployed. Differences in NPI (∆NPI) between the employed and the unemployed varied within the subsets; the largest difference was observed in the Zagreb region (ΔNPI = 0.522), in the 30-39 age group (ΔNPI = 0.563), in men (ΔNPI = 0.565), and for anxiolytic/antidepressant drugs (ΔNPI = 0.184). Conclusion: Our findings indicate that unemployed Croatian citizens used more drugs, which calls for the implementation of health care measures to reduce or prevent their medical problems, particularly those affecting mental health. Medical problems associated with unemployment present a specific burden for family medicine and the health care system