Worklessness, population health and health inequalities

Frank PophamMRC SPHSU, Glasgow

Outline

• Worklessness and health and its spatial, temporal and socio-economic distribution

• Its potential role in population health and health inequalities

Source Beatty et al. Environment and Planning C: Government and Policy 2009, volume 27, pages 958 -974

Source: Beatty and Fothergill. 2011. Cambridge Journal of Regions, Economy and Society

Source: Holland et al. 2011 International Journal of Health Services 41 (3): 415-430

Source Akinwale B, Lynch K, Wiggins R, et al. J Epidemiol Community Health (2010). doi:10.1136/jech.2009.099325

Mortality rate for men aged 55-64 followed up for 5 years after each census

Mortality rate for working age men and women on sickness benefit in New Zealand

Shaw et al. 2011 Mortality among the working age population receiving incapacity benefits in New Zealand, 1981-2004 Social Science and Medicine 73 , 568-575

Education gradient for working age men in not good health before and after adjustment for labour market status (2001 census)

Source: Bambra and Popham Health and Place 2010, 16: 1014-1021

Prevalence difference in not good health for working age men over time

Source: Popham et al BMJ Open 2012;2:e001342

Source: Tarkiainen et al. 2013 JECH: 67 21-27

Mortality ratio by income quintile Finnish working age men 2004-2007

Source: Marshall and Norman 2013: Geographies of the impact of retirement on health in the United Kingdom. Health and Place 20: 1-12

Source: Marshall and Norman 2013: Geographies of the impact of retirement on health in the United Kingdom. Health and Place 20: 1-12

Conclusion• Worklessness related to ill health risen in many countries over

time but uneven by SES– Even amongst women whose labour market participation has often

risen– Open questions about role of national policy on between country

variation• Worklessness associated with poor health and heightened

mortality risk• Potentially important factor in population health and health

inequalities. Further longitudinal & quasi-experimental evidence needed.

• How much is a labour market / health issue?