The study also finds that women and those from lower socioeconomic backgrounds are particularly sensitive to higher unemployment. The percentage of respondents who state that they have reduced health care use is 27% in the United States, 12% in France, 10% in Germany, 8% in the United Kingdom and 6% in Canada. The authors conclude that the level of out-of-pocket (OOP) costs combined with a drop in wealth is a major determinant in the fall in health care use during the crisis. A recent paper from the United States suggests that prescribing patterns for mental health drugs rise during times of adverse economic conditions, although this finding is only significant for the North Eastern parts of the country.