The impact on health of employment and welfare transitions for those receiving out-of-work disability benefits in the UK

Abstract

Employment status has a dynamic relationship with health and disability. There has been a striking increase in the working age population receiving out-of-work disability benefits in many countries, including the UK. In response, recent UK welfare reforms have tightened eligibility criteria and introduced new conditions for benefit receipt linked to participation in return-to-work activities. Positive and negative impacts have been suggested but there is a lack of high quality evidence of the health impact when those receiving disability benefits move towards labour market participation. Using four waves of the UK’s Understanding Society panel survey (2009–2013) three different types of employment and welfare transition were analysed in order to identify their impact on health. A difference-in-difference approach was used to compare change between treatment and control groups in mental and physical health using the SF-12. To strengthen causal inference, sensitivity checks for common trends used pre-baseline data and propensity score matching. Transitions from disability benefits to employment (n = 124) were associated on average with an improvement in the SF12 mental health score of 5.94 points (95% CI = 3.52–8.36), and an improvement in the physical health score of 2.83 points (95% CI = 0.85–4.81) compared with those remaining on disability benefits (n = 1545). Transitions to unemployed status (n = 153) were associated with a significant improvement in mental health (3.14, 95% CI = 1.17–5.11) but not physical health. No health differences were detected for those who moved on to the new out-of-work disability benefit. It remains rare for disability benefit recipients to return to the labour market, but our results indicate that for those that do, such transitions may improve health, particularly mental health. Understanding the mechanisms behind this relationship will be important for informing policies to ensure both work and welfare are ‘good for health’ for this group.

Prioritizing barriers and solutions to improve employment for persons with developmental disabilities

“…Persons with disabilities are at a higher risk of exposure to challenging living and working conditions associated with poorer health outcomes such as lower income and greater employment insecurity [1][2][3]. Employment provides an opportunity for financial autonomy and plays a key role in the well-being and quality of life of persons with disabilities [4].…”

The association between employment status and health among British adults with and without intellectual impairments: cross-sectional analyses of a cohort study

“…People with disabilities are one such group [ 23 ]. While it is clear that people with disabilities have significantly reduced access to employment, [ 24 , 25 ] little is known about the association between employment status and health for people with disabilities [ 19 , 26 ]. Results from the sparse literature that does exist suggests: (1) people with disabilities who were unemployed or economically inactive have poorer mental health when compared with people with disabilities who were employed; [ 26 ] and (2) people with poor health or disabilities are much more vulnerable to job loss and less likely to enter paid employment than those with good health [ 27 ].…”

Employment and attendance in day care centres for people with mild intellectual disabilities – do age, gender, functional level or hospital admissions matter?

“…Individuals with mild ID are often able and willing to work (Parmenter and Knox 1991;Li 2004;Katz and Lazcano-Ponce 2008), and employment for people with IDs may entail better opportunities for independent living, meaningful social participation and enhanced self-confidence (Dixon and Reddacliff 2001;Kober and Eggleton 2005;Li et al 2006;Jahoda et al 2008;Lysaght et al 2012). Unemployment is associated with poor mental and physical health (Bartley et al 2006;van der Noordt, IJzelenberg, Droomers & Proper, 2014;Heggebø 2016), but little is known whether this is actually the case for people with IDs (Milner et al 2014;Curnock et al 2016).…”