The contribution of health to educational inequalities in exit from paid employment in five European regions

Abstract

In all European regions, lower-educated workers have higher risks of leaving paid employment due to disability benefits and unemployment than those with higher education. This disadvantaged position of lower-educated persons is primarily due to a higher prevalence of poor health. Given the presence of health problems, the risk of exit from paid employment is comparable across educational levels.Objectives The primary aim of this study was to investigate educational inequalities in health-related exit from paid employment through different pathways in five European regions. A secondary objective was to estimate the proportion of different routes out of paid employment that can be attributed to poor health across educational groups in five European regions. MethodsLongitudinal data from 2005 up to 2014 were obtained from the four-year rotating panel of the European Union Statistics on Income and Living Conditions (EU-SILC), including 337 444 persons with 1 056 779 observations from 25 countries. Cox proportional hazards models with censoring for competing events were used to examine associations between health problems and exit from paid employment. The population attributable fraction was calculated to quantify the impact of health problems on labor force exit. ResultsIn all European regions, lower-educated workers had higher risks of leaving paid employment due to disability benefits [relative inequality (RI) 3.3-6.2] and unemployment (RI 1.9-4.5) than those with higher education. The fraction of exit from paid employment that could be attributed to poor health varied between the five European regions among lower-educated persons from 0.06-0.21 and among higher-educated workers from 0.03-0.09. The disadvantaged position of lower-educated persons on the labor market was primarily due to a higher prevalence of poor health. ConclusionIn all European regions, educational inequalities exist in health-related exclusion from paid employment. Policy measures are needed to reduce educational inequalities in exit from paid employment due to poor health.

Educational differences in the influence of health on early work exit among older workers

“…Empirical evidence suggests that people with low levels of education tend to exit the workforce earlier. [15][16][17] Research on the differential influence of health on early work exit across educational levels is limited and results are inconsistent. Some studies concluded that the association between poor health and work exit is stronger in the lower educated, 18 19 while others found opposite results, with stronger health effects in higher educated workers, 20 or no educational differences.…”

Educational differences in duration of working life and loss of paid employment: working life expectancy in The Netherlands

“…Particularly workers with a low educational level are at risk for labor force exit and health-related labor force exit (2,3). Educational inequalities in health-related exit from paid employment are substantial in all European countries (4), and it may be hypothesized that, with increasing retirement age, these disparities will increase, especially in the last years of working life (5). Although educational inequalities in labor force exit and re-employment are well-established, studies on the influence of socioeconomic position and poor health on displacement from the labor market do not present a clear insight into the cumulative loss of work capacity during working life.…”

How can we break the vicious circle between poor health and exit from paid employment?

“…While this problem affects large parts of the population, especially during economic downturns, it may particularly affect those with a weak initial labor market position, such as those with low socioeconomic status (SES). This unequal burden has been documented in an interesting paper in this issue of the Scandinavian Journal of Work, Environment & Health (1). The authors report findings from five European regions showing that lower-educated persons had increased risks of exit from paid employment due to health problems compared to those with higher education levels.…”

“…Hence, one might argue that interventions within the occupational setting have the potential to prevent or break the vicious circle between poor health and non-employment. Successful interventions may directly improve health by effects of the intervention itself but also decrease the risk of exit from employment (1), which subsequently leaves healthenhancing effects of employment active for a longer period of time (5).…”