Academic journal article Scandinavian Journal of Work, Environment & Health

The Effect of Ill Health and Socioeconomic Status on Labor Force Exit and Re-Employment: A Prospective Study with Ten Years Follow-Up in the Netherlands

Academic journal article Scandinavian Journal of Work, Environment & Health

The Effect of Ill Health and Socioeconomic Status on Labor Force Exit and Re-Employment: A Prospective Study with Ten Years Follow-Up in the Netherlands

Article excerpt

Objectives The aim of this study was to investigate the effect of ill health and socioeconomic status on labor force exit due to unemployment, early retirement, disability pension, or becoming economically inactive. A secondary objective was to investigate the effect of ill health and socioeconomic status on return to work.

Methods A representative sample of the Dutch working population (N=15 152) was selected for a prospective study with ten years follow-up (93 917 person-years). Perceived health and individual and household characteristics were measured at baseline with the Permanent Quality of Life Survey (POLS) during 1999-2002. Statistics Netherlands ascertained employment status monthly from January 1999 to December 2008. Cox proportional hazards analyses were used to determine the factors that predicted labor force exit and return to work.

Results Ill health increased the likelihood of labor force exit into unemployment [hazard ratio (HR) 1.89], disability pension (HR 6.39), and early retirement (HR 1.20), but was not a determinant of becoming economically inactive (HR 1.07). Workers with low socioeconomic status were, even after adjusting for ill health, more likely to leave the labor force due to unemployment, disability pension, and economic inactivity. Workers with ill health at baseline were less likely to return to work after unemployment (HR 0.75) or disability pension (HR 0.62). Socioeconomic status did not influence re-employment.

Conclusions Ill health is an important determinant for entering and maintaining paid employment. Workers with lower education were at increased risk for health-based selection out of paid employment. Policies to improve labor force participation, especially among low socioeconomic level workers, should protect workers with health problems against exclusion from the labor force.

Key terms disability pension; early retirement; return to work; unemployment.

In many industrialized countries, the population is ageing due to increasing life expectancy and falling birth rates (1). These demographic changes are bringing about a shift in the ratio of workers to retirees that will lead to a relative shortage of active workers (2). As a consequence, it is important to increase labor force participation. In the Netherlands, policies are developed to promote re-employment of non-employed persons. In addition, measures are undertaken to encourage older workers to remain in the labor force longer. Clearly, the success of these policies will depend on having a better understanding of the particular role of health on entering and remaining in paid employment.

There is ample evidence that ill health may cause exit from the labor force (3-7). The association between health and employment may not be similar across all socioeconomic groups (8). Although life expectancy is increasing, it is not equally distributed in society. Persons with a lower level of education, a lower occupational class, or a lower level of income tend to die at a younger age and have, within their shorter lives, a higher prevalence of all kinds of health problems. This leads to large differences between socioeconomic groups in the number of years a person can expect to live in good health. As a result, individuals with a low socioeconomic status are more likely to be faced with health problems before the retirement age. In addition, there may be differences between socioeconomic groups with respect to the pathway that a person with health problems takes out of the workforce. Workers may leave the workforce due to unemployment, early retirement, disability pension, or by becoming economically inactive.

Among those employed, the risk of exclusion from working life as a result of disability pension varies considerably by education, occupation, and income. A low level of education, occupational status, and income seem to be strong determinants of disability in both genders (9-14). A recent Norwegian study (15) showed that there was a socioeconomic gradient in disability pension corresponding to socioeconomic gradients in health. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.