For most people, employment is the foundation to a stable life, enabling us to maintain our sense of purpose and shape our daily life. Beyond the apparent financial strain , unemployment can lead to a change in a person’s time structure, their social relationships and in their identity [2, 3]. The non-financial costs of unemployment often have a stronger association with well-being during this time . Overall, the negative relationship between unemployment and health is widely reported in the literature [5,6,7,8,9,10]. However, what if a whole group of society faces unemployment simultaneously, as seen currently during the COVID-19 crisis?
The set-point theory posits that in the short-term subjective well-being fluctuates following major life events and in the long-term values return to a predetermined ‘set point’ [11,12,13]. In regards to unemployment, an improvement in health is generally seen after reemployment (e.g., ). However, Clark et al.  examined the long-term effect of job loss and reemployment on life satisfaction and found that some people did not return to their baseline values many years after the end of their unemployment.
The effects of unemployment on different aspects of health are often used interchangeably. Unemployed individuals have reported significantly lower mental health, subjective physical health and marital, family and life satisfaction compared to their employed counterparts [3, 14], but a non-significant relationship with objective physical health  or psychiatric caseness  is seen. To address these differential effects of job loss, the present study draws on the World Health Organization’s  holistic definition of health – i.e. physical, mental, and social well-being as opposed to the mere dichotomy of ill versus healthy – and examines two different aspects of general health status: self-rated health (a one-item proxy for subjective health) and life satisfaction (cognitive aspect of well-being).
Short- versus long-term unemployment
Another aspect to consider is short-term as opposed to long-term unemployment, where the latter is largely associated with worse health [3, 6, 16,17,18]. While individuals who had experienced repeated unemployment compared to those who had never been unemployed reported significantly worse mental health and lower life satisfaction , individuals who had experienced single unemployment compared to the other groups (i.e., repeated unemployment or no experience at all) only significantly differed in their satisfaction with income and employment . One can infer that short-term unemployment may impact directly on related matters like finances, while a broader impact on life manifests following longer or repeated experience of unemployment.
Long-term unemployment has often been defined as short as six months  or one year or more . While the length of unemployment worsens the effects of job loss on health, this effect does not appear to remain constant. Within the first year of unemployment mental health scores continually fluctuate between deterioration and recovery , while after a few years an habituation effect is seen and the increase in health risks plateau . These findings suggest that six to 12 months is not sufficient to adjust to unemployment and for its effect to become fully evident. Therefore, in the current study we defined long-term unemployment as being registered unemployed in two consecutive years.
Lastly, McKee-Ryan et al.’  meta-analysis showed that the effect of longer unemployment on subjective physical health was stronger than on life satisfaction. So we propose the following:
Returning to the overarching research interest: how does mass unemployment affect the well-being in a population? Data from previous occurrences of mass unemployment, help draw parallels to similar circumstances: like the global financial crisis in 2009, the European refugee crisis in 2015 or the current COVID-19 crisis . The present study examines unemployment immediately following the German reunification in 1989/1990. This data is particularly useful in the investigation of unemployment, because in this period East Germans were confronted with a major change in economic policies and their employment system. The government of the former socialist East Germany emphasized the importance of the work force and it had been every citizen’s basic right but also their obligation to take up employment . After reunification, most East Germans faced involuntary retraining from the job centre, a change in workplace or unemployment. The 1991 annual unemployment statistic by the German Federal Employment Agency recorded levels of 10.3% in East Germany and so nearly double to the 6.3% in West Germany . In Struck et al.’  study, 33% of East Germans reported a change in their job role shortly after reunification and 69% reported a change in their workplace, while Mayer  reported that 40% had experienced job loss by 1995. In contrast, in West Germany a stable rate of unemployment was present and affected the same groups continuously .
In sum, following the reunification unemployment presented differently in East versus West Germany: in the former, unemployment was unexpected and forced on a large scale (e.g., through plant closures), while the latter group grew accustomed to unemployment and the low prospects of reemployment. Then, especially in the West German group the reciprocal relationship between unemployment and health should not be highlighted. Analyses with panel data have shown that unemployed individuals already reported lower health levels prior to becoming unemployed  and may have become unemployed as a result of their lower health. In the East German sample, it is less likely that the relationship between unemployment and health would have been reciprocal, because first, unemployment did not exist in former East Germany and so was a novel experience, and second, it presented itself on a large scale and was unpredictable.
High regional unemployment has also been found to be associated with significantly more functional somatic symptoms , psychological symptoms , and lower subjective well-being . Turner  for instance found that in communities with medium to high unemployment rates, current unemployment was associated with higher levels of depression and physical illness. However high regional unemployment in general is associated with lower health in both employed and unemployed individuals living in the region [3, 35] and instead it may be the prospect of reemployment that plays a greater role . Thus we propose that:
Gender and unemployment
In former East Germany the discrepancy in income and employment rates between men and women was low  and women were encouraged and supported to easily combine their roles as mother, wife and worker . In contrast, in West Germany, in the end 1980s, only 50% of women were in employment  and instead most were housewives. After reunification, East German women faced grave discrimination in the more traditionally gender-role oriented West German employment system  and faced twice as much job insecurity compared to their male counterparts(female: 31.4%, male: 13.1% ).
In general, men assign greater importance to work, which can be explained by traditional gender roles: men are the breadwinners of the family and bear the responsibility of providing for them, while women care for the children and run the household. So along these lines it would be ‘easier’ for women to become unemployed, because, first, they would likely not be the main source of income, and, second, they could transition to the role of housewife, instead of a vacuum of ‘no employment’. By comparison, men would experience the effects of no longer fulfilling their traditional roles. Van der Meer  found that while men gain most of their status from their job, women attain their status from several sources. Forret et al.  further showed that men with children are more likely to see unemployment as a defeat, while women perceive it as an opportunity.
While women’s participation in the labour market even now is significantly lower than men’s , traditional gender roles are changing. Strandh et al.  purported that the associations between unemployment, gender and psychological distress are dependent on the social context and compared samples from Ireland and Sweden. They found that compared to Irish men, women reported lower distress following unemployment, whereas Swedish, unemployed women reported greater distress than their male counterparts. The authors explained that Sweden has a large female labour force and the society is strongly defamilised, whereas the opposite is the case in Ireland, which follows more traditional gender roles. Hammarström et al.  also studied unemployment in a Swedish sample and similarly found no gender effect. As East German women after reunification similarly did not embody traditional gender roles and had a high participation in the labour market, this group is comparable to the Swedish samples. In this vein we propose that: