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Islam MK, Kjerstad E, Rydland HT. The chronically ill in the labour market - are they hierarchically sorted by education? Int J Equity Health 2024; 23:66. [PMID: 38528545 DOI: 10.1186/s12939-024-02148-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/13/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The chronically ill as a group has on average lower probability of employment compared to the general population, a situation that has persisted over time in many countries. Previous studies have shown that the prevalence of chronic diseases is higher among those with lower levels of education. We aim to quantify the double burden of low education and chronic illness comparing the differential probabilities of employment between the chronically ill with lower, medium, and high levels of education and how their employment rates develop over time. METHODS Using merged Norwegian administrative data over a 11-year period (2008-2018), our estimations are based on multivariable regression with labour market and time fixed effects. To reduce bias due to patients' heterogeneity, we included a series of covariates that may influence the association between labour market participation and level of education. To explicitly explore the 'shielding effect' of education over time, the models include the interaction effects between chronic illness and level of education and year. RESULTS The employment probabilities are highest for the high educated and lowest for chronically ill individuals with lower education, as expected. The differences between educational groups are changing over time, though, driven by a revealing development among the lower-educated chronically ill. That group has a significant reduction in employment probabilities both in absolute terms and relative to the other groups. The mean predicted employment probabilities for the high educated chronic patient is not changing over time indicating that the high educated as a group is able to maintain labour market participation over time. Additionally, we find remarkable differences in employment probabilities depending on diagnoses. CONCLUSION For the chronically ill as a group, a high level of education seems to "shield" against labour market consequences. The magnitude of the shielding effect is increasing over time leaving chronically ill individuals with lower education behind. However, the shielding effect varies in size between types of chronic diseases. While musculoskeletal, cardiovascular and partly cancer patients are "sorted" hierarchically according to level of education, diabetes, respiratory and mental patients are not.
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Affiliation(s)
- M Kamrul Islam
- NORCE Health and Society, Nygårdsgaten 112, Bergen, 5008, Norway
| | - Egil Kjerstad
- NORCE Health and Society, Nygårdsgaten 112, Bergen, 5008, Norway.
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Sánchez-Peña JF, Jáñez-Álvarez M, Álvarez-Cotoli PG, García-Laredo E. Dual diagnosis in immigrant patients with alcohol use disorder: 2-years of follow-up treatment. ACTAS ESPANOLAS DE PSIQUIATRIA 2022; 50:276-286. [PMID: 36622715 PMCID: PMC10803857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 01/10/2023]
Abstract
There is a high prevalence of comorbid psychiatric disorders in alcohol abuse disorder. The presence of dual diagnosis in patients decreases the maintenance of abstinence and increases the likelihood of relapse, which makes treatment more complicated.
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El Haddad R, Lemogne C, Matta J, Wiernik E, Goldberg M, Melchior M, Roquelaure Y, Limosin F, Zins M, Airagnes G. The association of substance use with attaining employment among unemployed job seeking adults: Prospective findings from the French CONSTANCES cohort. Prev Med 2022; 163:107196. [PMID: 35961621 DOI: 10.1016/j.ypmed.2022.107196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/28/2022] [Accepted: 08/07/2022] [Indexed: 10/15/2022]
Abstract
This study aimed to examine the prospective association between tobacco, alcohol and cannabis use with attaining employment among unemployed job seekers. Data from the French population-based CONSTANCES cohort on 5114 unemployed job seeking adults enrolled from 2012 to 2018 were analyzed. Binary logistic regressions were computed. Odds ratio (OR) and 95%CI of remaining unemployed at one-year of follow-up (versus attaining employment) according to substance use at baseline were obtained. The following independent variables were introduced into separate models: tobacco use (non-smoker, former smoker, light (<10cig/day), moderate (10-19cig/day) and heavy smoker (>19cig/day)), alcohol use according to the Alcohol Use Disorder Identification Test (non-users (0), low (<7), moderate (7-15) and high or very high-risk (>15)) and cannabis use (never used, no use in the previous 12 months, less than once a month, at least once a month but less than once per week, once per week or more). Analyses were adjusted for age, gender and education. At follow-up, 2490 participants (49.7%) were still unemployed. Compared to non-smokers, moderate and heavy smokers were more likely to remain unemployed, with ORs (95%CI) of 1.33 (1.08-1.64) and 1.42 (1.04-1.93), respectively. Compared to low-risk alcohol users, no alcohol users and high or very high-risk alcohol users were more likely to remain unemployed, with ORs (95% CI) of 1.40 (1.03-1.83) and 2.10 (1.53-2.87), respectively. Compared to participants who never used cannabis, participants who use cannabis once a week or more were more likely to remain unemployed, OR (95%CI) of 1.63 (1.33-2.01). Substance use may play an important role in difficulty attaining employment.
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Affiliation(s)
- Rita El Haddad
- Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.
| | - Cédric Lemogne
- Université Paris Cité, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Joane Matta
- Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Emmanuel Wiernik
- Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marcel Goldberg
- Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Maria Melchior
- Sorbonne Université, INSERM UMR_S 1136, Institut Pierre Louis d'Épidémiologie et de Santé Publique IPLESP, Paris, France
| | - Yves Roquelaure
- Université d'Angers, CHU Angers, Université de Rennes, INSERM, EHESP, Irset (Institut de recherche en santé, environnement et travail), UMR_S 1085, F-49000 Angers, France
| | - Frédéric Limosin
- Université Paris Cité, Centre Ressource Régional de Psychiatrie du Sujet Âgé (CRRPSA), Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, DMU Psychiatrie et Addictologie, AP-HP, Centre-Université Paris Cité, France, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France
| | - Marie Zins
- Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Guillaume Airagnes
- Université Paris Cité, AP-HP, Hôpital Européen Georges Pompidou, DMU Psychiatrie et Addictologie, Centre Ambulatoire d'Addictologie, INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
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Hall J, Goranitis I, Kigozi J, Guariglia A. New evidence on the impact of the Great Recession on health-compromising behaviours. ECONOMICS AND HUMAN BIOLOGY 2021; 41:100980. [PMID: 33571870 DOI: 10.1016/j.ehb.2021.100980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 06/12/2023]
Abstract
Using data from the English Longitudinal Study of Ageing over the period 2004-2017, this paper explores the effects of the Great Recession and its aftermath upon health-compromising behaviours in adults aged 50 and over. We introduce new techniques into this area of research, namely dynamic random-effects logit estimators which control for initial conditions and correlated individual effects. We observe a lack of crisis effect upon the probabilities of smoking and being physically inactive, as well as of transitioning in and out of these behaviours. In line with other recent literature, this suggests that the relationship between economic recessions and smoking and physical inactivity may have broken down. Alternatively, the over 50s may have been protected from the crisis and subsequent austerity measures. Nonetheless, both the crisis and post-crisis period were associated with a lower probability of drinking frequently.
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Affiliation(s)
- James Hall
- Institute for Primary Care & Health Sciences, David Weatherall Building, Keele University, Newcastle-under-Lyme, ST5 5BG, United Kingdom.
| | - Ilias Goranitis
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Jesse Kigozi
- Health Economics Unit, Institute of Applied Health Research, University of Birmingham, Edgbaston, B15 2TT, United Kingdom.
| | - Alessandra Guariglia
- Department of Economics, University of Birmingham, University House, Edgbaston, Birmingham, B15 2TY, United Kingdom.
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Leinonen T, Viikari-Juntura E, Räisänen H, Sundvall S, Kauhanen A, Solovieva S. Does Work Disability Contribute to Trajectories of Work Participation before and after Vocational Labour Market Training for Job Seekers? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1347. [PMID: 33540863 PMCID: PMC7908399 DOI: 10.3390/ijerph18031347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/28/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022]
Abstract
The contribution of ill-health to labour market participation in relation to vocational training is unclear. Using nationally representative Finnish register data on 42,691 vocational labour market trainees in 2008-2010, we constructed latent trajectory groups of work participation in the open labour market three years before and after training, identifying groups called "High-High", "High-Low", "Low-High", and "Low-Low". We plotted further patterns of labour market participation within these trajectory groups and, using multinomial logistic regression, examined assignment to these groups focusing on previous work disability status. Those with compared to those without previous work disability had previous employment more often and spent less time in economic inactivity within the two trajectory groups with low pre-training levels of work participation. Having a previous work disability was associated with assignment to the "High-Low" trajectory group of work participation instead of the "High-High" comparison group. The associations of other background factors with the assignment to the different trajectory groups were relatively similar amongst those with and without previous work disability. However, some of these associations were weaker amongst the former. Along with other key background factors, previous work disability should be accounted for when assessing the effects of vocational training.
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Affiliation(s)
- Taina Leinonen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
| | - Eira Viikari-Juntura
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
| | - Heikki Räisänen
- Ministry of Economic Affairs and Employment, 00023 Helsinki, Finland; (H.R.); (S.S.)
| | - Santtu Sundvall
- Ministry of Economic Affairs and Employment, 00023 Helsinki, Finland; (H.R.); (S.S.)
| | | | - Svetlana Solovieva
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (E.V.-J.); (S.S.)
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The association between unemployment and depression-Results from the population-based LIFE-adult-study. J Affect Disord 2018; 235:399-406. [PMID: 29677604 DOI: 10.1016/j.jad.2018.04.073] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 03/13/2018] [Accepted: 04/07/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND Unemployment is a risk factor for impaired mental health. Based on a large population-based sample, in this study we therefore sought to provide detailed information on the association between unemployment and depression including information on (i) differences between men and women, (ii) differences between different types of unemployment, and (iii) on the impact of material and social resources on the association. METHODS We studied 4,842 participants (18-65 years) of the population-based LIFE-Adult-Study. Depression was assessed using the Center for Epidemiological Studies Depression Scale. Employment status was divided into three groups: being employed, being unemployed receiving entitlement-based benefits, being unemployed receiving means-tested benefits. Multivariate logistic regression models were applied to assess the association between employment status and depression. RESULTS Statistically significantly increased depression risk was solely found for unemployed persons receiving means-tested benefits. Adjusting for differences in sociodemographic factors, net personal income and risk of social isolation, comparable associations of being unemployed and receiving means-tested benefits with elevated depression risk were found for men (Odds Ratio/OR = 2.17, 95%-CI = 1.03-4.55) and women (OR = 1.98, 95%-CI:1.22-3.20). LIMITATIONS No conclusions regarding causality can be drawn due to the cross-sectional study design. It was not possible to assess length of unemployment spells. CONCLUSION Unemployed persons receiving means-tested benefits in Germany constitute a risk group for depression that needs specific attention in the health care and social security system. The negative impact of unemployment on depression risk cannot be explained solely by differences in material and social resources. Contrasting earlier results, women are equally affected as men.
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Jakobsen ELT, Biering K, Kærgaard A, Andersen JH. Neck-Shoulder Pain and Work Status among Former Sewing Machine Operators: A 14-year Follow-up Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:80-88. [PMID: 28260173 DOI: 10.1007/s10926-017-9702-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Purpose A total of 243 Danish female sewing machine operators lost their jobs in 1996 because of outsourcing. The aim was to investigate the employment status during follow-up from 1996 to 2008, and to estimate to what extent former neck-shoulder pain had an impact on later work participation. Methods Assessment of neck-shoulder pain was based on questionnaires completed in 1994. The Danish Register-Based Evaluation of Marginalization (DREAM) register was used to describe employment status during the follow-up period. Register data were explored by sequence analyses and graphics, and the association between neck-shoulder pain and work participation was analyzed by logistic regression analysis. Results In all, 987 working years were lost during follow-up, and a sequence index plot revealed interrupted and heterogeneous courses of incomes. The odds ratio between neck and shoulder pain and a work participation score less than 75% was 1.49 (95% CI 0.84-2.67). Conclusions After outsourcing of the textile industry, the former sewing machine operators had decreased work participation and frequent transitions between different income types. Previous neck-shoulder pain tended to be associated with poor work participation. The results suggest that increased attention should be to given to dismissed workers from other industries that become outsourced, especially unskilled workers with similar work-related health limitations. Additionally, we concluded that time-to-event measures in research involving employment status are insufficient because of the many transitions that take place in working life.
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Affiliation(s)
- Emma Lise Thorlund Jakobsen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark.
| | - Karin Biering
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Anette Kærgaard
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine, Danish Ramazzini Centre, Regional Hospital West Jutland - University Research Clinic, Gl. Landevej 61, 7400, Herning, Denmark
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Effects of Lifetime Unemployment Experience and Job Insecurity on Two-Year Risk of Physician-Diagnosed Incident Depression in the German Working Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14080904. [PMID: 28800069 PMCID: PMC5580607 DOI: 10.3390/ijerph14080904] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 01/20/2023]
Abstract
Unemployment and job insecurity have been reported to be associated with a higher risk of depression. The purpose of this study was to evaluate the separate and combined effects of lifetime unemployment experience and job insecurity on the incidence of depression in an unselected working population in Germany. Data from the German Socio-Economic Panel (GSOEP) study were used, as was a final sample of those currently employed, with complete data at baseline (2009) and follow-up (2011) restricted to those free of depression in 2009 (n = 7073). Poisson regression analysis was applied to test the prospective associations between unemployment, job insecurity, and a two-year incident of depression. Results showed that the experience of unemployment and perceived job insecurity were significantly associated with a higher risk of depression during the two-year follow-up (risk ratios 1.64; 95% confidence intervals (1.16, 2.31) and risk ratios 1.48; 95% confidence intervals (1.13, 1.92), respectively). Notably, the strongest risk was observed among participants with insecure jobs and past long-term unemployment (risk ratios 2.15; 95% confidence intervals (1.32; 3.52)). In conclusion, even during employment, the experience of lifetime unemployment led to a higher risk of depression. The combination of previous unemployment experience and anticipated job insecurity increased the risk of developing depression. Results support health promotion with special emphasis on unemployment and precarious working conditions.
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Bosque-Prous M, Kunst AE, Brugal MT, Espelt A. Changes in alcohol consumption in the 50- to 64-year-old European economically active population during an economic crisis. Eur J Public Health 2017; 27:711-716. [PMID: 28472296 PMCID: PMC5881701 DOI: 10.1093/eurpub/ckx044] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The aim was to compare alcohol drinking patterns in economically active people aged 50-64 years before the last economic crisis (2006) and during the crisis (2013). Methods Cross-sectional study with data from 25 479 economically active people aged 50-64 years resident in 11 European countries who participated in wave 2 or wave 5 of the SHARE project (2006 and 2013). The outcome variables were hazardous drinking, abstention in previous 3 months and the weekly average number of drinks per drinker. The prevalence ratios of hazardous drinking and abstention, comparing the prevalence in 2013 vs. 2006, were estimated with Poisson regression models with robust variance, and the changes in the number of drinks per week with Poisson regression models. Results The prevalence of hazardous drinking decreased among both men (PR = 0.75; 95%CI = 0.63-0.92) and women (PR = 0.91; 95%CI = 0.72-1.15), although the latter decrease was smaller and not statistically significant. The proportion of abstainers increased among both men (PR = 1.11; 95%CI = 0.99-1.29) and women (PR = 1.18; 95%CI = 1.07-1.30), although the former increase was smaller and not statistically significant. The weekly average number of drinks per drinker decreased in men and women. The decreases in consumption were larger in Italy and Spain. Conclusion From 2006 to 2013, the amount of alcohol consumed by late working age drinkers decreased in Europe, with more pronounced declines in the countries hardest hit by the economic crisis.
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Affiliation(s)
- Marina Bosque-Prous
- Agencia de Salut Pública de Barcelona, Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anton E. Kunst
- Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - M. Teresa Brugal
- Agencia de Salut Pública de Barcelona, Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
| | - Albert Espelt
- Agencia de Salut Pública de Barcelona, Barcelona, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau), Barcelona, Spain
- Centros de Investigación Biomédica en Red. Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Departament de Psicobiologia i Metodologia en Ciències de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Spain
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Leinonen T, Mäki N, Martikainen P. Trajectories of Antidepressant Medication before and after the Onset of Unemployment by Subsequent Employment Experience. PLoS One 2017; 12:e0169652. [PMID: 28056083 PMCID: PMC5215907 DOI: 10.1371/journal.pone.0169652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/20/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The unemployed more often suffer from depression than the employed. We examined whether mental health deterioration occurs already before unemployment implicating health selection, or whether it mostly occurs after becoming exposed to the experience rendering causal explanations more likely. METHODS We used nationally representative Finnish register data to examine changes in depressive morbidity as measured by antidepressant medication in 1995-2009 over four years before and since a new onset of unemployment (N = 28 000) at the age of 30-60 compared to the employed (N = 124 136). We examined separately those who became continuously long-term unemployed, intermittently unemployed and unemployed with eventual re-employment in the second, third or fourth year since the year of onset. Annual repeated measurements were analysed using generalised estimation equations. RESULTS Among the employed antidepressant medication increased slowly but steadily over the study period and it was mainly at a lower level than among the unemployed. In the four years leading to unemployment there was excess increase in medication that was generally stronger among those with longer duration of the eventual unemployment experience. During unemployment medication decreased in all groups except among the intermittently unemployed. By the first year of re-employment antidepressant medication reached a level similar to that among the employed and afterwards followed no consistent trend. CONCLUSIONS The associations of unemployment and re-employment with depressive morbidity appear to be largely driven by health selection. The question of potential causal associations remains unresolved for intermittent unemployment in particular.
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Affiliation(s)
- Taina Leinonen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- * E-mail:
| | - Netta Mäki
- City of Helsinki Urban Facts, Helsinki, Finland
| | - Pekka Martikainen
- Population Research Unit, Department of Social Research, University of Helsinki, Helsinki, Finland
- Centre for Health Equity Studies (CHESS), Stockholm University and Karolinska Institutet, Stockholm, Sweden
- Max Planck Institute for Demographic Research, Rostock, Germany
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Svane-Petersen AC, Dencker-Larsen S. The impact of self-reported health and register-based prescription medicine purchases on re-employment chances: A prospective study. SSM Popul Health 2016; 2:580-586. [PMID: 29349173 PMCID: PMC5757886 DOI: 10.1016/j.ssmph.2016.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 11/03/2022] Open
Abstract
In this paper, we investigate the influence of self-reported health and register-based prescription medicine purchases on re-employment chances, and whether these health indicators measure similar aspects of health in this analysis. Data came from a 2006 Danish unemployment survey among a random sample of unemployed individuals enriched with register data (2006–2008, N=1806). The survey participants all received unemployment benefits from the welfare system and had been unemployed for more than 20 weeks at the time of the interview in 2006. We combined these data with longitudinal register data on individual prescription medicine purchases for somatic illnesses and prescription medicine purchases for mental illnesses, information on re-employment and various socio-demographic variables. We conducted binary logistic regression analyses to investigate the impact of self-reported health and prescription medicine purchases measured in 2006 on re-employment chances in 2007 and 2008. Our analyses show that unemployed workers with poor self-reported health and workers who had prescription medicine purchases for mental illnesses were less likely to be re-employed in 2007 and 2008. Furthermore, the impact of both prescription medicine purchases for somatic illnesses and for mental illnesses increased when adding self-reported health to the model although prescription purchases for somatic illnesses became statistically insignificant. The impact of prescription medicine purchases for somatic illnesses was mediated by self-reported health, whilst prescription medicine purchases for mental illnesses was only partly mediated. Finally, SRH seemed a much stronger prediction than prescription medicines. From these results, we propose, when possible, the inclusion of both an indicator of self-reported health and an indicator of mental health in studies on re-employment. Poor health negatively affects re-employment chances of unemployed workers. Self-reported health indicates somatic health over prescription medicine purchases. Both self-reported health and mental health are relevant to re-employment chances.
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Affiliation(s)
- Annemette Coop Svane-Petersen
- SFI - The Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-1052 Copenhagen K, Denmark.,Department of Sociology, University of Copenhagen, Øster Farimagsgade 5, Building 16, DK-1014 Copenhagen K, Denmark
| | - Sofie Dencker-Larsen
- SFI - The Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-1052 Copenhagen K, Denmark.,Department of Sociology, University of Copenhagen, Øster Farimagsgade 5, Building 16, DK-1014 Copenhagen K, Denmark
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12
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Nwaru CA, Nygård CH, Virtanen P. Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study. BMC Public Health 2016; 16:531. [PMID: 27392125 PMCID: PMC4938954 DOI: 10.1186/s12889-016-3200-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 06/08/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. METHODS Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. RESULTS Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. CONCLUSIONS Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed.
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Affiliation(s)
- Chioma A. Nwaru
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Clas-Håkan Nygård
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
| | - Pekka Virtanen
- School of Health Sciences, University of Tampere, FI-33014 Tampere, Finland
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Job Loss, Unemployment and the Incidence of Hazardous Drinking during the Late 2000s Recession in Europe among Adults Aged 50-64 Years. PLoS One 2015; 10:e0140017. [PMID: 26445239 PMCID: PMC4596847 DOI: 10.1371/journal.pone.0140017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 09/19/2015] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND To estimate the incidence of hazardous drinking in middle-aged people during an economic recession and ascertain whether individual job loss and contextual changes in unemployment influence the incidence rate in that period. METHODS Longitudinal study based on two waves of the SHARE project (Survey of Health, Ageing and Retirement in Europe). Individuals aged 50-64 years from 11 European countries, who were not hazardous drinkers at baseline (n = 7,615), were selected for this study. We estimated the cumulative incidence of hazardous drinking (≥40g and ≥20g of pure alcohol on average in men and women, respectively) between 2006 and 2012. Furthermore, in the statistical analysis, multilevel Poisson regression models with robust variance were fitted and obtained Risk Ratios (RR) and their 95% Confidence Intervals (95%CI). RESULTS Over a 6-year period, 505 subjects became hazardous drinkers, with cumulative incidence of 6.6 per 100 persons between 2006 and 2012 (95%CI:6.1-7.2). Age [RR = 1.02 (95%CI:1.00-1.04)] and becoming unemployed [RR = 1.55 (95%CI:1.08-2.23)] were independently associated with higher risk of becoming a hazardous drinker. Conversely, having poorer self-perceived health was associated with lower risk of becoming a hazardous drinker [RR = 0.75 (95%CI:0.60-0.95)]. At country-level, an increase in the unemployment rate during the study period [RR = 1.32 (95%CI:1.17-1.50)] and greater increases in the household disposable income [RR = 0.97 (95%CI:0.95-0.99)] were associated with risk of becoming a hazardous drinker. CONCLUSIONS Job loss among middle-aged individuals during the economic recession was positively associated with becoming a hazardous drinker. Changes in country-level variables were also related to this drinking pattern.
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Tøge AG, Blekesaune M. Unemployment transitions and self-rated health in Europe: A longitudinal analysis of EU-SILC from 2008 to 2011. Soc Sci Med 2015; 143:171-8. [PMID: 26360419 DOI: 10.1016/j.socscimed.2015.08.040] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 08/20/2015] [Accepted: 08/23/2015] [Indexed: 12/27/2022]
Abstract
The Great Recession of 2008 has led to elevated unemployment in Europe and thereby revitalised the question of causal health effects of unemployment. This article applies fixed effects regression models to longitudinal panel data drawn from the European Union Statistics on Income and Living Conditions for 28 European countries from 2008 to 2011, in order to investigate changes in self-rated health around the event of becoming unemployed. The results show that the correlation between unemployment and health is partly due to a decrease in self-rated health as people enter unemployment. Such health changes vary by country of domicile, and by individual age; older workers have a steeper decline than younger workers. Health changes after the unemployment spell reveal no indication of adverse health effects of unemployment duration. Overall, this study indicates some adverse health effects of unemployment in Europe--predominantly among older workers.
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Affiliation(s)
- Anne Grete Tøge
- Department of Social Work, Child Welfare and Social Policy, Faculty of Social Sciences, Oslo and Akershus University College of Applied Sciences, P.O. Box 4, St. Olavs plass, NO-0130 Oslo, Norway.
| | - Morten Blekesaune
- Department of Sociology and Social Work, University of Agder, P.O. Box 422, 4604 Kristiansand, Norway.
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Carlier BE, Schuring M, van Lenthe FJ, Burdorf A. Influence of health on job-search behavior and re-employment: the role of job-search cognitions and coping resources. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:670-9. [PMID: 24510518 DOI: 10.1007/s10926-014-9499-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
PURPOSE To investigate the influence of poor health on job-search behavior and re-employment, and the mediating role of job-search cognitions and coping resources. METHODS A prospective study was conducted among unemployed persons receiving social security benefits in the Netherlands (n = 510). Self-rated health, self-esteem, mastery, job-search cognitions, and the intention to search for a job were measured at baseline. Logistic regression analysis was used to investigate determinants of job-search behavior during a follow-up period of 6 months. Cox proportional hazards analysis was used to investigate the influence of health, job-search cognitions and coping resources on re-employment during a mean follow-up period of 23 months. RESULTS Persons with poor health were less likely to search for paid employment (OR 0.58, 95 % CI 0.39-0.85) and were also less likely to find paid employment (HR 0.58, 95 % CI 0.39-0.89). Persons with a positive attitude toward job-search, high perceived social pressure to look for a job, high job-search self-efficacy and high job-search intention were more likely to search actively and also to actually find paid employment. Adjustment for job-search cognitions and coping reduced the influence of health on active search behavior by 50 % and on re-employment by 33 %. CONCLUSIONS Health-related differences in job-search behavior and re-employment can be partly explained by differences in coping, job-search attitude, self-efficacy, and subjective norms towards job-search behavior. Measures to reduce the negative impact of poor health on re-employment should address the interplay of health with job-search cognitions and coping resources.
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Affiliation(s)
- B E Carlier
- Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA, Rotterdam, The Netherlands,
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