Objectives This study examined the relationship between long term unemployment (>100 days) during a recession among young men and women, both immigrants and native Swedes, and future unemployment, sickness absence, disability pension and death.

Methods A register-based cohort study with data from national databases. The study population comprised all foreign-born individuals 20–24 years 1992 (N=32 808) and a random sample of Swedish-born individuals of the same age (n=186 352). The cohort was followed 1993–2007. The results were adjusted for age, income and geographical origin and analysed separately for men and women and educational background in three classes.

Results Unemployed individuals at baseline (1992) had a higher risk (measured as OR) of future long-term unemployment, sickness absence and disability pension during follow-up compared to those employed. The length of the unemployment period 1992 was associated with the length of future unemployment periods and sickness absence periods. Unemployed also run an elevated risk of death compared to employed but the numbers were low in this young cohort. The higher the education level for the unemployed the lower the risk of future unemployment. There were no consistent differences between men and women or immigrants and native Swedes for the studied outcomes.

Conclusions Unemployment in young ages led to increased OR for absence from work due to unemployment, sickness and disability pension during a 15-year follow-up period. To enrol young persons in working life seems to be very important both for the individual and the society.