Chronic diseases and multimorbidity among unemployed and employed persons in the Netherlands: a register-based cross-sectional study

Yildiz, Berivan; Schuring, Merel; Knoef, Marike; Burdorf, Alex

doi:10.1136/bmjopen-2019-035037

Cited by 22 publications

(24 citation statements)

References 26 publications

(29 reference statements)

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“…Many studies have shown that chronic diseases, such as psychological disorders, cardiovascular diseases and diabetes, are typically more common among unemployed individuals ( 4 – 7 ) and are associated with a higher risk of being unemployed ( 8 ). However, most studies address loss of paid employment in the workforce rather than health as a barrier for (re)entering paid employment ( 9 ).…”

mentioning

confidence: 99%

The influence of chronic diseases and multimorbidity on entering paid employment among unemployed persons – a longitudinal register-based study

Yildiz¹,

Burdorf²,

Schuring³

2020

Scand J Work Environ Health

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Objectives: This study aimed to investigate the influence of chronic diseases and multimorbidity on entering paid employment among unemployed persons. A secondary objective was to estimate the proportion of persons not entering paid employment that can be attributed to specific chronic diseases across different age groups. Methods: Data linkage of longitudinal nationwide registries on employment status, medication use and sociodemographic characteristics was applied. Unemployed Dutch persons (N=619 968) were selected for a three-year prospective study. Cox proportional hazards analyses with hazard ratios (HR) were used to investigate the influence of six common chronic diseases on entering paid employment, stratified by age. The population attributable fraction (PAF) was calculated as the proportion of all persons who did not enter paid employment that can be attributed to a chronic disease. Results: Persons with chronic diseases were less likely to enter paid employment among all age groups. The impact of a chronic disease on maintaining unemployment at population level was largest for common mental disorders (PAF 0.20), due to a high prevalence of common mental disorders (6%), and for psychotic disorders (PAF 0.19), due to a high likelihood of not entering paid employment (HR 0.21), among persons aged 45–55 years. Multimorbidity increased with age, and the impact of having multiple chronic diseases on remaining unemployed increased especially among persons aged ≥45 years. Conclusion: Chronic diseases and multimorbidity are important factors that reduce employment chances among all age groups. Our results provide directions for policy measures to target specific age and disease groups of unemployed persons in order to improve employment opportunities.

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confidence: 99%

The influence of chronic diseases and multimorbidity on entering paid employment among unemployed persons – a longitudinal register-based study

Yildiz¹,

Burdorf²,

Schuring³

2020

Scand J Work Environ Health

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“…Therefore, 31 studies can be considered largely atheoretical, without any emphasis on pathways through which socioeconomic disadvantage leads to multimorbidity. In the 33 studies applying a theory, the following theories were referred to: behavioural,10 34 35 37 38 40–42 46 51–53 59 71 72 79–82 materialist38 41 42 45 46 48 50 52 71 72 74 79 82–85 and psychosocial 34 42 51 52 57 72 73 82 84–86. In addition, four studies applied a theoretical construct called ‘sense of coherence’, which indicates an individual’s coping capacity to deal with life and stressful events,87 and is an indicator of self-efficacy and psychosocial well-being (consistent with psychosocial explanations),73 and also encompasses social capital51 and social support,57 which are widely considered as psychosocial assets (table 3).…”

Section: Resultsmentioning

confidence: 99%

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

et al. 2022

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ObjectiveTo document socioepidemiological theories used to explain the relationship between socioeconomic disadvantage and multimorbidity.DesignScoping review.MethodsA search strategy was developed and then applied to multiple electronic databases including Medline, Embase, PsychInfo, Web of Science, Scielo, Applied Social Sciences, ERIC, Humanities Index and Sociological Abstracts. After the selection of studies, data were extracted using a data charting plan. The last search was performed on the 28 September 2021. Extracted data included: study design, country, population subgroups, measures of socioeconomic inequality, assessment of multimorbidity and conclusion on the association between socioeconomic variables and multimorbidity. Included studies were further assessed on their use of theory, type of theories used and context of application. Finally, we conducted a meta-narrative synthesis to summarise the results.ResultsA total of 64 studies were included in the review. Of these, 33 papers included theories as explanations for the association between socioeconomic position and multimorbidity. Within this group, 16 explicitly stated those theories and five tested at least one theory. Behavioural theories (health behaviours) were the most frequently used, followed by materialist (access to health resources) and psychosocial (stress pathways) theories. Most studies used theories as post hoc explanations for their findings or for study rationale. Supportive evidence was found for the role of material, behavioural and life course theories in explaining the relationship between social inequalities and multimorbidity.ConclusionGiven the widely reported social inequalities in multimorbidity and its increasing public health burden, there is a critical gap in evidence on pathways from socioeconomic disadvantage to multimorbidity. Generating evidence of these pathways will guide the development of intervention and public policies to prevent multimorbidity among people living in social disadvantage. Material, behavioural and life course pathways can be targeted to reduce the negative effect of low socioeconomic position on multimorbidity.

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“…Dispensed medicines are classified into anatomic, therapeutic, chemical (ATC) classification codes, according to the WHO (World Health Organization) drug classification system of 2010 ( 16 ). Previous research has used these ATC codes to identify specific chronic diseases and estimate the prevalence among the working population ( 17 , 18 ). Following these definitions, six chronic diseases were identified: cardiovascular diseases, respiratory diseases, inflammatory diseases, diabetes, mental disorders (depressive, anxiety and sleep disorders) and psychotic disorders.…”

Section: Methodsmentioning

confidence: 99%

Effects of changes in early retirement policies on labor force participation: the differential effects for vulnerable groups

Hengel¹,

Riumallo-Herl²,

Schram³

et al. 2021

Scand J Work Environ Health

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Objectives: This study investigated the effects of a national early retirement reform, which was implemented in 2006 and penalized early retirement, on paid employment and different exit pathways and examined whether these effects differ by gender, income level and health status. Methods: This study included all Dutch individuals in paid employment born six months before (control group) and six months after (intervention group) the cut-off date of the reform (1 January 1950) that fiscally penalized early retirement. A regression discontinuity design combined with restricted mean survival time analysis was applied to evaluate the effect of penalizing early retirement on labor force participation from age 60 until workers reached the retirement age of 65 years, while accounting for secular trends around the threshold. Results: The intervention group postponed early retirement by 7.41 months [95% confidence interval (CI) 6.11–8.72], and partly replaced this by remaining 4.87 months (95% CI 3.60–6.24) longer in paid employment. Workers born after the threshold, annually earning €25 000–40 000, spent 1.24 months (95% CI 0.31–2.18) more in economic inactivity than those born before. The working months lost to unemployment increased by 1.50 months (95% CI 0.30–2.71) for female workers and 1.99 months (95% CI 0.06–3.92) for workers reporting multiple chronic diseases. Conclusions: The national reform successfully prolonged working lives of older workers. However, workers with a middle income, female workers, and workers with chronic diseases were more vulnerable to premature exit from the labor market through unemployment or being without any income or benefit.

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Chronic diseases and multimorbidity among unemployed and employed persons in the Netherlands: a register-based cross-sectional study

Cited by 22 publications

References 26 publications

The influence of chronic diseases and multimorbidity on entering paid employment among unemployed persons – a longitudinal register-based study

The influence of chronic diseases and multimorbidity on entering paid employment among unemployed persons – a longitudinal register-based study

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

Effects of changes in early retirement policies on labor force participation: the differential effects for vulnerable groups

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