Trends across forty years show that those with poor health are now less likely to find and keep a job – compared to those who enjoy good health – than they were in previous years.
The research looked at whether people of working age were working (in employment), job seeking (unemployed), or weren’t in the labour market (economically inactive). It compared this with their current or most recent occupation, and whether they considered themselves to have a limiting long-term illness (LLTI).
The researchers found that the difference in employment rates of people with a LLTI compared to similar people without a LLTI – the ‘employment penalty’ for being of poorer health – has become larger over time.
They also found that the employment penalty for being of poorer health for people with backgrounds in unskilled and semi-skilled manual work has grown much more than for people in office jobs.
The results of the study, “Research: Health, employment and economic change, 1973 – 2009: repeated cross-sectional study”, are published in the British Medical Journal this week.
The authors, from the Universities of York and Sheffield, looked at whether relationships between social class, health and economic inactivity between 1973 and 1993 were the same between 1994 and 2009, despite improvements in general economic climate. Economic inactivity was defined as both being unemployed and not actively looking for employment. The male and female participants were between the ages of 20 and 59.
The study concluded that between 1973 and 2009, the relationship between good health and securing and sustaining employment has strengthened for both men and women. For men, this has been due to employment rates decreasing and economic inactivity rates increasing among men with poor health.
For women, this has largely been due to a general trend of increased employment and reduced economic inactivity occurring among healthier women, but not in women of poorer health. There is some evidence that, since 2005, the relationship between health, employment and economic inactivity for women in the top two occupational groups has become more like that for males, with poor health becoming associated with reducing employment rates.
This study follows an article published in the British Medical Journal in 1996 which set out to understand why falls in unemployment were not accompanied by equal increases in employment. This new paper assesses the long-term consequences of the recession of the 1980s, 1990s and the possible effect of the 2008 recession.
The study shows that between 1973 and 2009, rates in employment decreased for males but increased for females. However, the low rate of employment associated with limiting long-term illnesses (LLTIs) increased substantially over time for both sexes. In particular, employment rates for women with an LLTI saw a sharp decline.
The study also found that employment rates were associated with particular occupational groups: economic inactivity rates (being unemployed / not looking for employment) were lowest for men in the high occupational groups (professional and non-manual) and highest for those in the lowest occupational groups (skilled manual and unskilled manual). In men, employment rates fell while economic inactivity rose and for women, both employment rates and economic inactivity rates were static.
The research was carried out by Dr Jon Minton during his PhD studies at the University of York.
Dr Minton, now a Research Associate in the School of Health and Related Research at the University of Sheffield, said:
The fact the employment penalty for having a limiting long-term illness seems so much worse for people with backgrounds in manual labour could be because of the nature of the work, which makes it harder to make reasonable adjustments to the workplace than for non-manual work.
It could also be because the market for these jobs is a lot tougher after decades of industrial decline, meaning there’s now more competition for each vacancy, and so having a LLTI becomes even more of a disadvantage in terms of getting and staying in employment.
Co-author, Professor Kate Pickett, from the Department of Health Sciences at the University of York, contributed to the analysis plan and interpretation of data.
Clinicians have a vital role in ensuring that the health needs of people reporting poor health are recognised and addressed. It is important to ensure that people in poor and worsening health are supported to remain working. This can be done by ensuring there are sufficient opportunities for retraining manual workers with poor health.