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Martínez-Medina A, Morales-Calvo S, Rodríguez-Martín V, Meseguer-Sánchez V, Molina-Moreno V. Sixteen Years since the Convention on the Rights of Persons with Disabilities: What Have We Learned since Then? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11646. [PMID: 36141926 PMCID: PMC9517366 DOI: 10.3390/ijerph191811646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
Persons with disabilities have historically been subjected to discrimination and exclusion, placing them in dangerous situations of social vulnerability. The Convention on the Rights of Persons with Disabilities, passed on the 13th of December 2006, was an important legislative landmark for valuing the rights of this population group. This study involved a bibliometric analysis of 1024 research articles published in Scopus on the social, workplace, educational, and financial inclusion of persons with disabilities since the Convention. The results show an increase in scientific production, and there is also a great deal of multi-disciplinarity, which has led to important breakthroughs for the all-encompassing inclusion of this section of the population. The most productive journals, authors, institutions, and countries, as well as the international cooperation networks, are presented here. The review concludes by setting out the main themes and trends in the research.
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Affiliation(s)
- Andrés Martínez-Medina
- Health Sciences PhD Program, Catholic University of Murcia, Campus de los Jerónimos nº135, Guadalupe, 30107 Murcia, Spain
| | - Sonia Morales-Calvo
- Department of Research and Diagnostic Methods in Education, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Vicenta Rodríguez-Martín
- Department of Social Work and Social Services, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
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Work and Family Transitions Throughout Adulthood and the Impact on Health: A Systematic Review. JOURNAL OF POPULATION AGEING 2022. [DOI: 10.1007/s12062-022-09382-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Davidescu AA, Apostu SA, Marin A. Forecasting the Romanian Unemployment Rate in Time of Health Crisis-A Univariate vs. Multivariate Time Series Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11165. [PMID: 34769684 PMCID: PMC8583511 DOI: 10.3390/ijerph182111165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/17/2022]
Abstract
Economic crises cause significant shortages in disposable income and a sharp decline in the living conditions, affecting healthcare sector, hitting the profitability and sustainability of companies leading to raises in unemployment. At micro level, these sharp decreases in earnings associated with unemployment and furthermore with the lack of social protection will impact the quality of life and finally the health of individuals. In time of crisis, it becomes vital to support not only the critical sectors of the economy, the assets, technology, and infrastructure, but to protect jobs and workers. This health crisis has hit hard the jobs dynamics through unemployment and underemployment, the quality of work (through wages, or access to social protection), and through the effects on specific groups, with a higher degree of vulnerability to unfavorable labor market outcomes. In this context, providing forecasts as recent as possible for the unemployment rate, a core indicator of the Romanian labor market that could include the effects of the market shocks it becomes fundamental. Thus, the paper aims to offer valuable forecasts for the Romanian unemployment rate using univariate vs. multivariate time series models for the period 2021-2022, highlighting the main patterns of evolution. Based on the univariate time series models, the paper predict the future values of unemployment rate based on its own past using self-forecasting and implementing ARFIMA and SETAR models using monthly data for the period January 2000-April 2021. From the perspective of multivariate time series models, the paper uses VAR/VECM models, analyzing the temporal interdependencies between variables using quarterly data for the period 2000Q1-2020Q4. The empirical results pointed out that both SETAR and VECM provide very similar results in terms of accuracy replicating very well the pre-pandemic period, 2018Q2-2020Q1, reaching the value of 4.1% at the beginning of 2020, with a decreasing trend reaching the value of 3.9%, respectively, 3.6% at the end of 2022.
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Affiliation(s)
- Adriana AnaMaria Davidescu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, 010552 Bucharest, Romania;
- Department of Education, Training and Labour Market, National Scientific, Research Institute for Labour and Social Protection, 010643 Bucharest, Romania
| | - Simona-Andreea Apostu
- Department of Statistics and Econometrics, Bucharest University of Economic Studies, 010552 Bucharest, Romania;
- Institute of National Economy, 050711 Bucharest, Romania
| | - Aurel Marin
- Department of Physical Education and Sports, National University of Physical Education and Sports, 060057 Bucharest, Romania;
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Pinto AD, Hassen N, Craig-Neil A. Employment Interventions in Health Settings: A Systematic Review and Synthesis. Ann Fam Med 2018; 16:447-460. [PMID: 30201643 PMCID: PMC6130994 DOI: 10.1370/afm.2286] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 04/30/2018] [Accepted: 05/10/2018] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Employment is a key social determinant of health. People who are unemployed typically have worse health than those employed. Illness and disability can result in unemployment and be a barrier to regaining employment. We combined a systematic review and knowledge synthesis to identify both studies of employment interventions in health care settings and common characteristics of successful interventions. METHODS We searched the peer-reviewed literature (1995-2017), and titles and abstracts were screened for inclusion and exclusion criteria by 2 independent reviewers. We extracted data on the study setting, participants, intervention, methods, and findings. We also conducted a narrative synthesis and iteratively developed a conceptual model to inform future primary care interventions. RESULTS Of 6,729 unique citations, 88 articles met our criteria. Most articles (89%) focused on people with mental illness. The majority of articles (74%) tested interventions that succeeded in helping participants gain employment. We identified 5 key features of successful interventions: (1) a multidisciplinary team that communicates regularly and collaborates, (2) a comprehensive package of services, (3) one-on-one and tailored components, (4) a holistic view of health and social needs, and (5) prospective engagement with employers. CONCLUSIONS Our findings can inform new interventions that focus on employment as a social determinant of health. Although hiring a dedicated employment specialist may not be feasible for most primary care organizations, pathways using existing resources with links to external agencies can be created. As precarious work becomes more common, helping patients engage in safe and productive employment could improve health, access to health care, and well-being.
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Affiliation(s)
- Andrew D Pinto
- The Upstream Lab, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada .,Department of Family and Community Medicine, St Michael's Hospital, Toronto, Ontario, Canada.,Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Nadha Hassen
- The Upstream Lab, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
| | - Amy Craig-Neil
- The Upstream Lab, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada
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Mæhlisen MH, Pasgaard AA, Mortensen RN, Vardinghus-Nielsen H, Torp-Pedersen C, Bøggild H. Perceived stress as a risk factor of unemployment: a register-based cohort study. BMC Public Health 2018; 18:728. [PMID: 29895286 PMCID: PMC5998595 DOI: 10.1186/s12889-018-5618-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 05/28/2018] [Indexed: 11/18/2022] Open
Abstract
Background Although unemployment and high levels of perceived stress have been associated in cross-sectional studies, the direction of causation is unknown. We prospectively examined if high levels of perceived everyday life stress increased the risk of subsequent unemployment and further if differences existed between socioeconomic status-groups. Methods We included 9335 18–64-year-old employed respondents of a health survey (North Denmark Health Profile 2010) in which Cohen’s Perceived Stress Scale was used to assess the level of perceived stress. Data were linked individually to national administrative registers. Cox proportional hazards model was used to investigate the association between perceived stress quintiles and risk of unemployment during 98 weeks of follow-up. Analyses were further performed in subgroups defined by education and income. Results In total, 224 people (10.4%) of the high stress group became unemployed during follow-up, which was higher than the lower stress groups. After adjusting for gender, age, education and income, the risk of unemployment was 1.64 (95% CI: 1.28;2.11) in the high stress group compared to the low stress group. After adjusting for gender and age, a similar trend was observed across different education levels and among the lower income groups, but no higher risk of unemployment due to perceived stress was found among the higher income groups. However, there was no statistically significant interaction between perceived stress and income level (p = 0.841) or perceived stress and education level (p = 0.587). Conclusion Perceived everyday life stress nearly doubled the risk of subsequent unemployment in a working population. No statistically significant interactions between SES and perceived stress were found. This indicates that stress prevention among the working population should not solely focus on stress in the workplace but also include stress from everyday life. Electronic supplementary material The online version of this article (10.1186/s12889-018-5618-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maiken Holm Mæhlisen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark.
| | - Alexander Arndt Pasgaard
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark
| | - Rikke Nørmark Mortensen
- Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark
| | - Henrik Vardinghus-Nielsen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark
| | - Christian Torp-Pedersen
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark
| | - Henrik Bøggild
- Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg Øst, Denmark.,Unit of Epidemiology and Biostatistics, Aalborg University Hospital, Sdr. Skovvej 15, 9000, Aalborg, Denmark
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Meneton P, Plessz M, Courtin E, Ribet C, Goldberg M, Zins M. L’impact du chômage sur la santé. Med Sci (Paris) 2017; 33:785-789. [DOI: 10.1051/medsci/20173308025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vahid Shahidi F, Siddiqi A, Muntaner C. Does social policy moderate the impact of unemployment on health? A multilevel analysis of 23 welfare states. Eur J Public Health 2016; 26:1017-1022. [PMID: 27060593 DOI: 10.1093/eurpub/ckw050] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The magnitude of observable health inequalities between the unemployed and their employed counterparts differs considerably across countries. Few attempts have been made to test theoretical explanations for this cross-national variation. Moreover, existing studies suffer from important theoretical and methodological limitations. This study addresses these limitations and investigates whether differences in the generosity of social protection policies and in public attitudes towards those policies explain why unemployment-related health inequalities are steeper in some societies than in others. METHODS Multilevel logistic modelling was used to link contextual-level variables on social protection policies and public attitudes in 23 European countries to individual-level data on self-rated health from the 2012 wave of the European Social Survey. RESULTS The magnitude of inequalities in self-rated health between the unemployed and their employed counterparts varies significantly across countries as a function of cross-national differences in the level of social protection awarded to the unemployed and the level of public support for the welfare state. CONCLUSIONS The results provide empirical support for the claim that governments can play a more active role in mitigating unemployment-related health inequalities by expanding the generosity and scope of social protection policies. Whether such an expansion of social protection will take place in the current climate of fiscal austerity is a political question whose implications merit the attention of population health scholars.
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Affiliation(s)
- Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Bloomberg School of Nursing, University of Toronto, Toronto, Ontario, Canada.,Department of Public Health Sciences, Korea University, Seoul, South Korea
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Meneton P, Kesse-Guyot E, Méjean C, Fezeu L, Galan P, Hercberg S, Ménard J. Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals. Int Arch Occup Environ Health 2014; 88:707-16. [PMID: 25385250 DOI: 10.1007/s00420-014-0997-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 10/30/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess prospectively the association between employment status and cardiovascular health outcomes in socially privileged individuals. METHODS The incidence of fatal and non-fatal cardiovascular events and all-cause mortality rate were monitored during 12 years in a national sample of 5,852 French volunteers, aged 45-64 years, who were free of cardiovascular disease or other overt disease at baseline. The association between health outcomes and employment status was tested using Cox proportional modelling with adjustment for confounding factors. RESULTS Compared to randomly selected individuals, these volunteers were characterized by higher education level and socio-economic status and lower cardiovascular risk and mortality rate. A total of 242 cardiovascular events (3.5 events per 1,000 person-years) and 152 deaths from all causes (2.2 deaths per 1,000 person-years) occurred during follow-up. After adjustment for age and gender, both cardiovascular event risk [HR (95% CI) 1.84 (1.15-2.83), p = 0.01] and all-cause mortality [2.79 (1.66-4.47), p = 0.0002] were increased in unemployed individuals compared to workers. These poor health outcomes were observed to the same extent after further adjustment for clinical, behavioural and socio-demographic characteristics of individuals at baseline [HR (95% CI) 1.74 (1.07-2.72), p = 0.03 and 2.89 (1.70-4.69), p = 0.0002, respectively]. In contrast, neither cardiovascular event risk nor all-cause mortality was significantly increased in retired individuals compared to workers after adjustment for confounding factors. CONCLUSIONS These results support the existence of a link between unemployment and poor cardiovascular health and suggest that this link is not mediated by conventional risk factors in middle-aged socially privileged individuals.
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Affiliation(s)
- Pierre Meneton
- INSERM U1142 LIMICS, UMR_S 1142 Sorbonne Universités, UPMC Université Paris 06, Université Paris 13, Campus des Cordeliers, 15 rue de l'Ecole de Médecine, 75006, Paris, France,
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Vahid Shahidi F, Muntaner C, Siddiqi A. Economic crisis, unemployment and health: conceptual and methodological issues in the modelling of national contexts. J Epidemiol Community Health 2014; 69:101-2. [DOI: 10.1136/jech-2014-204487] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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10
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Gowan MA. Moving from job loss to career management: The past, present, and future of involuntary job loss research. HUMAN RESOURCE MANAGEMENT REVIEW 2014. [DOI: 10.1016/j.hrmr.2014.03.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Lötters F, Carlier B, Bakker B, Borgers N, Schuring M, Burdorf A. The influence of perceived health on labour participation among long term unemployed. JOURNAL OF OCCUPATIONAL REHABILITATION 2013; 23:300-8. [PMID: 23143748 DOI: 10.1007/s10926-012-9398-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUNDS Few studies have addressed the specific contribution of health in relation to socio-demographic and motivational aspects to re-entering paid employment. The purpose of this study among beneficiaries of unemployment benefits is to evaluate the detrimental effects of poor health and a lack of motivation on the likelihood of getting a job and to develop a decision support model that predicts remaining unemployment after 12 months. METHODS A longitudinal cohort study was conducted among people on unemployment benefit (UB) or social insurance benefit (SIB). The time-window of the study was 18 months. Written questionnaires were filled out 3 months post-benefit assessment, 6, 12 and 18 months. Multivariate logistic regression analysis was used to identify the barriers of re-entering paid employment. Subsequently, a predictive model was constructed to estimate the probability for every combination of determinants for a person to remain unemployed in the next 12 months. RESULTS Older age (≥55 years), a poor perceived health, and a lack of willingness to accept a job were the most prominent predictive factors for remaining unemployed after 12 months in both UB and SIB groups. Lower education in the UB group and being married or living together and poor self-reliance in the SIB group were additional risk factors for long-term unemployment. CONCLUSION Vocational rehabilitation of people on long-term social benefit should address perceived health, socio-demographic, and motivational aspects as key factors that determine prolonged unemployment. A predictive flow chart can be used to detect most vulnerable persons at risk for remaining long-term unemployment.
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Affiliation(s)
- Freek Lötters
- Department of Health Economics, Institute of Health Policy & Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
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Helgesson M, Johansson B, Nordqvist T, Lundberg I, Vingård E. Unemployment at a young age and later sickness absence, disability pension and death in native Swedes and immigrants. Eur J Public Health 2012; 23:606-10. [PMID: 22930745 PMCID: PMC3719474 DOI: 10.1093/eurpub/cks099] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background: Youth unemployment is an increasing problem for societies around the world. Research has revealed negative health effects of unemployment, and this longitudinal register-based cohort study examined the relationship between unemployment and later sickness absence, disability pension and death among youth in Sweden. Method: The study group of 199 623 individuals comprised all immigrants born between 1968 and 1972 who immigrated before 1990 (25 607) and a random sample of native Swedes in the same age-range (174 016). The baseline year was 1992, and the follow-up period was from 1993 to 2007. Subjects with unemployment benefit in 1990–91, disability pension in 1990–92, severe disorders leading to hospitalization in 1990–92 and subjects who emigrated during follow-up were excluded. Results: Those who were unemployed in 1992 had elevated risk of ≥60 days of sickness absence (OR 1.02–1.49), disability pension (HR 1.08–1.62) and all except native Swedish women had elevated risk of death (HR 1.01–1.65) during follow-up compared with non-unemployed individuals. The risk of future sickness absence increased with the length of unemployment in 1992 (OR 1.06–1.54), and the risk of sickness absence increased over time. A larger part of the immigrant cohort was unemployed at baseline than native Swedes. Selection to unemployment by less healthy subjects may explain part of the association between unemployment and the studied outcomes. Conclusion: Unemployment at an early age may influence the future health of the individual. To a society it may lead to increased burdens on the welfare system and productivity loss for many years.
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Affiliation(s)
- Magnus Helgesson
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
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Zhang W. The impact of public employment on health and health inequalities: evidence from China. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2011; 41:647-78. [PMID: 22053527 DOI: 10.2190/hs.41.4.c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.
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Affiliation(s)
- Wei Zhang
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
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Abstract
This review describes advances over the past decade in what is known about the individual experience of unemployment, predictors of reemployment, and interventions to speed employment. Research on the impact of unemployment has increased in sophistication, strengthening the causal conclusion that unemployment leads to declines in psychological and physical health and an increased incidence of suicide. This work has elucidated the risk factors and mechanisms associated with experiencing poor psychological health during unemployment; less so for physical health and suicide. Psychologists have begun to contribute to the study of factors associated with reemployment speed and quality. The past decade has especially illuminated the role of social networks and job search intensity in facilitating reemployment. Evidence suggests some individuals, especially members of minority groups, may face discrimination during their job search. Although more work in this arena is needed, several intervention-based programs have been shown to help individuals get back to work sooner.
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Affiliation(s)
- Connie R Wanberg
- Carlson School of Management, University of Minnesota, Minneapolis, 55455, USA.
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Puig-Barrachina V, Malmusi D, Martínez JM, Benach J. Monitoring Social Determinants of Health Inequalities: The Impact of Unemployment among Vulnerable Groups. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2011; 41:459-82. [DOI: 10.2190/hs.41.3.d] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Surveillance of social determinants of health inequalities is an essential but still underdeveloped issue in public health. Existing research has identified unemployment as an important social determinant of health inequalities. This cross-sectional study investigates the impact of unemployment on mental health outcomes among vulnerable groups, using the 2006 Catalonian Health Survey (N = 8,591). The authors estimate the prevalence ratios and differences (excess of prevalence) for poor mental health in the unemployed and employed, with 95 percent confidence intervals. After taking into account the interactions among social mechanisms of inequality and related factors, the authors identified seven vulnerable groups to monitor. Primary findings indicate that unemployment has a greater adverse effect on the mental health of male manual workers, single mothers, main-earner women, and manual workers without unemployment benefits for both sexes. Findings support the need to devote more research to the surveillance of unemployment as a social determinant of health inequalities, to identify additional unemployment indicators, and to consider how various social mechanisms of inequality interact with each other to produce health inequalities among vulnerable groups.
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Benach J, Solar O, Vergara M, Vanroelen C, Santana V, Castedo A, Ramos J, Muntaner C. Six Employment Conditions and Health Inequalities: A Descriptive Overview. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2010; 40:269-80. [DOI: 10.2190/hs.40.2.g] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Standard full-time permanent employment—providing a minimal degree of stability, income sustainability, workers' empowerment, and social protection—has declined in the high-income countries, while it was never the norm in the rest of the world. Consequently, work is increasingly affecting population health and health inequalities, not only as a consequence of harmful working conditions, but also because of employment conditions. Nevertheless, the health consequences of employment conditions are largely neglected in research. The authors describe five types of employment conditions that deviate from standard full-time permanent employment—precarious employment, unemployment, informal employment, forced employment or slavery, and child labor—and their health consequences, from a worldwide perspective. Despite obvious problems of measurement and international comparability, the findings show that, certainly in the low-income countries, these conditions are largely situated in informality, denying any possible standard of safety, protection, sustainability, and workers' rights. Considerable numbers of the world's working people are affected in geographically and socioeconomically unequal ways. This clearly relates nonstandard employment conditions to health equity consequences. In the future, governments and health agencies should establish more adequate surveillance systems, research programs, and policy awareness regarding the health effects of these nonstandard employment conditions.
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Harris E, Harris MF. Reducing the impact of unemployment on health: revisiting the agenda for primary health care. Med J Aust 2009; 191:119-22. [PMID: 19619102 DOI: 10.5694/j.1326-5377.2009.tb02709.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Accepted: 05/26/2009] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify potentially effective strategies to be used in the primary health care (PHC) setting to prevent, detect and manage the health problems of unemployed people. DESIGN A narrative review of articles on PHC-based interventions for unemployed people that were published during the period January 1985 to February 2009. RESULTS Seven articles with a focus on improving the health of unemployed people through assessment, management and referral within PHC settings were identified. Four were based in Australia, and the others were from Canada and Europe. Most described interventions that incorporated strategies aimed at increasing general practitioners' awareness of the health problems of unemployed people and providing guidance on the management of these problems. One article included an evaluation of the impact of the intervention on health and social outcomes, but no impact was shown. CONCLUSIONS There have been few formal scientific investigations into the effectiveness of PHC-based interventions for unemployed people. GPs and other community health workers have a central role in preventing, and providing early management of, the health problems of unemployed people, and supporting return to work. People who are unemployed have poorer physical and mental health than those who are employed. Research should move from describing these health problems to developing interventions that are subject to rigorous evaluation.
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Affiliation(s)
- Elizabeth Harris
- Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia.
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