Long‐term effects of poor health on employment: the significance of life stage and educational level

Wel, Kjetil A. van der

doi:10.1111/j.1467-9566.2011.01346.x

Cited by 13 publications

(15 citation statements)

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“…In addition to gender differences, both selection and causation effects are likely to vary by age, time and place [ 11 , 56 ]. In respect of age, there is evidence that health selection mechanisms are more likely at younger ages, around the stage of labour market entry, than in middle age [ 39 , 40 , 55 , 93 ]. Our findings showed health selection mechanisms at this stage of life for mental but not physical health.…”

Section: Discussionmentioning

confidence: 99%

“…Studies from Europe [ 29 , 30 ] and the US [ 31 , 32 ] highlight associations between poor health in childhood or adolescence and reduced educational attainment, temporary and non-employment. Intra-generational health selection is demonstrated by studies conducted in the UK [ 33 ], elsewhere in Europe [ 34 – 38 ] and the US [ 39 ] showing the importance of health for mobility in and out of employment, particularly among younger workers [ 39 , 40 ]. Among the steadily employed, health may also affect promotional chances [ 41 , 42 ].…”

Section: Introductionmentioning

confidence: 99%

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The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort

et al. 2015

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BackgroundEvidence is inconsistent as to whether or not there are health inequalities in adolescence according to socio-economic position (SEP) and whether or when they emerge in early adulthood. Despite the large health inequalities literature, few studies have simultaneously compared the relative importance of ‘health selection’ versus ‘social causation’ at this life-stage. This study followed a cohort through the youth-adult transition to: (1) determine whether, and if so, when, health inequalities became evident according to both class of origin and current SEP; (2) compare the importance of health selection and social causation mechanisms; and (3) investigate whether these phenomena vary by gender.MethodsData are from a West-of-Scotland cohort, surveyed five times between age 15 (in 1987, N=1,515, response=85%) and 36. Self-reported physical and mental health were obtained at each survey. SEP was based on parental occupational class at 15, a combination of own education or occupational status at 18 and own occupational class (with an additional non-employment category) at older ages. In respect of when inequalities emerged, we used the relative index of inequality to examine associations between both parental and own current SEP and health at each age. In respect of mechanisms, path models, including SEP and health at each age, investigated both inter and intra-generational paths from SEP to health (‘causation’) and from health to SEP (‘selection’). Analyses were conducted separately for physical and mental health, and stratified by gender.ResultsAssociations between both physical and mental health and parental SEP were non-significant at every age. Inequalities according to own SEP emerged for physical health at 24 and for mental health at 30. There was no evidence of selection based on physical health, but some evidence of associations between mental health in early adulthood and later SEP (intra-generational selection). Paths indicated intra-generational (males) and inter-generational (females) social causation of physical health inequalities, and intra-generational (males and females) and inter-generational (females) social causation of mental health inequalities.ConclusionsThe results suggest complex and reciprocal relationships between SEP and health and highlight adolescence and early adulthood as a sensitive period for this process, impacting on future life-chances and health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2674-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort

et al. 2015

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“…Other studies support this picture (13)(14)(15). Longitudinal studies have found similar associations (16)(17)(18). But how are these associations affected by the welfare state?…”

Section: The Welfare State and Sickness: Disincentives Or Social Invementioning

confidence: 74%

Social Inequalities in “Sickness”: Does Welfare State Regime Type Make a Difference? A Multilevel Analysis of Men and Women in 26 European Countries

Wel¹,

Dahl²,

Thielen³

2012

Int J Health Serv

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In comparative studies of health inequalities, public health researchers have usually studied only disease and illness. Recent studies have also examined the sickness dimension of health, that is, the extent to which ill health is accompanied by joblessness, and how this association varies by education within different welfare contexts. This research has used either a limited number of countries or quantitative welfare state measures in studies of many countries. In this study, the authors expand on this knowledge by investigating whether a regime approach to the welfare state produces consistent results. They analyze data from the European Union Statistics on Income and Living Conditions (EU-SILC); health was measured by limiting longstanding illness (LLSI). Results show that for both men and women reporting LLSI in combination with low educational level, the probabilities of non-employment were particularly high in the Anglo-Saxon and Eastern welfare regimes, and lowest in the Scandinavian regime. For men, absolute and relative social inequalities in sickness were lowest in the Southern regime; for women, inequalities were lowest in the Scandinavian regime. The authors conclude that the Scandinavian welfare regime is more able than other regimes to protect against non-employment in the face of illness, especially for individuals with low educational level.

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“…Further, studies have shown social differentials in health-related employment consequences in that certain groups, such as manual workers and women with LLSI are more susceptible to loss of employment [7-11]. Moreover, poor health striking in young adulthood seems to result in more adverse employment consequences compared to a similar situation later in life, particularly among people with low educational attainment [12]. …”

Section: Introductionmentioning

confidence: 99%

Trends in poverty risks among people with and without limiting-longstanding illness by employment status in Sweden, Denmark, and the United Kingdom during the current economic recession – a comparative study

et al. 2013

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BackgroundPrevious studies have found higher employment rates and lower risk of relative poverty among people with chronic illness in the Nordic countries than in the rest of Europe. However, Nordic countries have not been immune to the general rise in poverty in many welfare states in recent decades. This study analysed the trends in poverty risks among a particularly vulnerable group in the labour market: people with limiting-longstanding illness (LLSI), examining the experience of those with and without employment, and compared to healthy people in employment in Sweden, Denmark and the United Kingdom.MethodsCross-sectional survey data from EU-SILC (European Union Statistics on Income and Living Conditions) on people aged 25–64 years in Sweden, Denmark and the United Kingdom (UK) were analysed between 2005 and 2010. Age-standardised rates of poverty risks (<60% of national median equalised disposable income) were calculated. Odds ratios (ORs) of poverty risks were estimated using logistic regression.ResultsIn all three countries, non-employed people with LLSI had considerably higher prevalence of poverty risk than employed people with or without LLSI. Rates of poverty risk in the UK for non-employed people with LLSI were higher than in Sweden and Denmark. Over time, the rates of poverty risk for Swedish non-employed people with LLSI in 2005 (13.8% CI=9.7-17.8) had almost doubled by 2010 (26.5% CI=19.9-33.1). For both sexes, the inequalities in poverty risks between non-employed people with LLSI and healthy employed people were much higher in the UK than in Sweden and Denmark. Over time, however, the odds of poverty risk among British non-employed men and women with LLSI compared with their healthy employed counterparts declined. The opposite trend was seen for Swedish men: the odds of poverty risk for non-employed men with LLSI compared with healthy employed men increased from OR 2.8 (CIs=1.6-4.7) in 2005 to OR 5.3 (CIs=3.2-8.9) in 2010.ConclusionsThe increasing poverty risks among the non-employed people with LLSI in Sweden over time are of concern from a health equity perspective. The role of recent Swedish social policy changes should be further investigated.

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Long‐term effects of poor health on employment: the significance of life stage and educational level

Cited by 13 publications

References 38 publications

The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort

The emergence of health inequalities in early adulthood: evidence on timing and mechanisms from a West of Scotland cohort

Social Inequalities in “Sickness”: Does Welfare State Regime Type Make a Difference? A Multilevel Analysis of Men and Women in 26 European Countries

Trends in poverty risks among people with and without limiting-longstanding illness by employment status in Sweden, Denmark, and the United Kingdom during the current economic recession – a comparative study

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