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International Archives of Occupational and Environmental Health

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Open Access 01-08-2009 | Original Article

Ethnic differences in unemployment and ill health

Authors: Merel Schuring, Alex Burdorf, Anton Kunst, Toon Voorham, Johan Mackenbach

Published in: International Archives of Occupational and Environmental Health | Issue 8/2009

Abstract

Objective

The aim of the study is to evaluate whether health inequalities associated with unemployment are comparable across different ethnic groups.

Method

A random sample of inhabitants of the city of Rotterdam filled out a questionnaire on health and its determinants, with a response of 55.4% (n = 2,057). In a cross-sectional design the associations of unemployment, ethnicity, and individual characteristics with a perceived poor health were investigated with logistic regression analysis. The associations of these determinants with physical and mental health, measured by the Short Form 36 Health Survey, were evaluated with linear regression analyses. Interactions between ethnicity and unemployment were investigated to determine whether associations of unemployment and health differed across ethnic groups.

Results

Ill health was more common among unemployed persons [odds ratio (OR) 2.6; 95% CI 1.7–3.8] than workers in paid employment. Health inequalities between employed and unemployed persons were largest among native Dutch persons (OR = 3.2) and Surinamese/Antillean persons (OR = 2.6), and smaller in Turkish/Moroccan persons (OR = 1.6) and overseas refugees (OR = 1.6). The proportions of persons with poor health that could be attributed to unemployment were 14, 26, 14, and 13%, respectively.

Conclusions

Differences in ill health between employed and unemployed persons were less profound in ethnic groups compared to the majority population, but the prevalence of unemployment was much higher in ethnic groups. The population attributable fractions varied between 14 and 28%, supporting the argument that policies for health equity should pay more attention to measures that include persons in the labour market and that prevent workers with ill health from dropping out of the workforce.

Agyemang C, Denktas S, Bruijnzeels M, Foets M (2006) Validity of the single-item question on self-rated health status in first generation Turkish and Moroccans versus native Dutch in the Netherlands. Public Health 120:543–550. doi:10.1016/j.puhe.2006.03.002 PubMedCrossRef

Alavinia SM, Burdorf A (2008) Unemployment and retirement and ill-health: a cross-sectional analysis across European countries. Int Arch Occup Environ Health 82:39–45. doi:10.1007/s00420-008-0304-6 PubMedCrossRef

Bartley M, Sacker A, Clarke P (2004) Employment status, employment conditions, and limiting illness: prospective evidence from the British household panel survey 1991–2001. J Epidemiol Community Health 58:501–506. doi:10.1136/jech.2003.009878 PubMedCrossRef

Boot CR, Heijmans M, van der Gulden JW, Rijken M (2008) The role of illness perceptions in labor participation of the chronically ill. Int Arch Occup Environ Health 82:13–20. doi:10.1007/s00420-007-0298-5 PubMedCrossRef

Bos V, Kunst AE, Keij-Deerenberg IM, Garssen J, Mackenbach JP (2004) Ethnic inequalities in age- and cause-specific mortality in The Netherlands. Int J Epidemiol 33:1112–1119. doi:10.1093/ije/dyh189 PubMedCrossRef

CBS (2003) Herkomst van personen; allochtonen en migratie [Country of origin of persons; migrants and migration]. Centraal Bureau voor de Statistiek, Voorburg/Heerlen, Netherlands

Chandola T (2001) Ethnic and class differences in health in relation to British South Asians: using the new National Statistics Socio-Economic Classification. Soc Sci Med 52:1285–1296. doi:10.1016/S0277-9536(00)00231-8 PubMedCrossRef

Claussen B (1999) Health and re-employment in a five-year follow-up of long-term unemployed. Scand J Public Health 27:94–100PubMed

Dunn JR, Dyck I (2000) Social determinants of health in Canada’s immigrant population: results from the National Population Health Survey. Soc Sci Med 51:1573–1593. doi:10.1016/S0277-9536(00)00053-8 PubMedCrossRef

Elkeles T, Seifert W (1996) Immigrants and health: unemployment and health-risks of labour migrants in the Federal Republic of Germany, 1984–1992. Soc Sci Med 43:1035–1147. doi:10.1016/0277-9536(96)00048-2 PubMedCrossRef

Fayers PM, Sprangers MA (2002) Understanding self-rated health. Lancet 359:187–188. doi:10.1016/S0140-6736(02)07466-4 PubMedCrossRef

Graetz B (1993) Health consequences of employment and unemployment: longitudinal evidence for young men and women. Soc Sci Med 36:715–724. doi:10.1016/0277-9536(93)90032-Y PubMedCrossRef

Janlert U (1997) Unemployment as a disease and diseases of the unemployed. Scand J Work Environ Health 23(Suppl 3):79–83PubMed

Kuilman M, van Dijk AP, van der Lee G, Schrijvers CTM (2005) Resultaten gezondheidsenquete Rotterdam 2003 [Results health questionnaire Rotterdam 2003]. GGD Rotterdam, Rotterdam

Last JM (2001) A dictionary of epidemiology, 4th edn. Oxford University Press, New York

Marmot MG, Smith GD, Stansfeld S, Patel C, North F, Head J et al (1991) Health inequalities among British civil servants: the Whitehall II study. Lancet 337:1387–1393. doi:10.1016/0140-6736(91)93068-K PubMedCrossRef

Morris JK, Cook DG, Shaper AG (1994) Loss of employment and mortality. BMJ 308:1135–1139PubMed

Nazroo JY (2003) The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. Am J Public Health 93:277–284. doi:10.2105/AJPH.93.2.277 PubMedCrossRef

Schuring M, Burdorf A, Kunst AE, Mackenbach JP (2007) The effect of ill health on entering and maintaining paid employment: evidence in European countries. J Epidemiol Community Health 61:597–604. doi:10.1136/jech.2006.047456 PubMedCrossRef

Smith GD (2000) Learning to live with complexity: ethnicity, socioeconomic position, and health in Britain and the United States. Am J Public Health 90:1694–1698. doi:10.2105/AJPH.90.11.1694 PubMedCrossRef

Smith GD, Chaturvedi N, Harding S, NazRoo J, Williams R (2000) Ethnic inequalities in health: a review of UK epidemiological evidence. Crit Public Health 10:375–408. doi:10.1080/09581590010005331 CrossRef

Sundquist J (1995) Ethnicity, social class and health. A population-based study on the influence of social factors on self-reported illness in 223 Latin American refugees, 333 Finnish and 126 south European labour migrants and 841 Swedish controls. Soc Sci Med 40:777–787. doi:10.1016/0277-9536(94)00146-K PubMedCrossRef

Uniken Venema HP, Garretsen HF, van der Maas PJ (1995) Health of migrants and migrant health policy, The Netherlands as an example. Soc Sci Med 41:809–818. doi:10.1016/0277-9536(95)00065-F PubMedCrossRef

Ware JE Jr, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483. doi:10.1097/00005650-199206000-00002 PubMedCrossRef

Wiking E, Johansson SE, Sundquist J (2004) Ethnicity, acculturation, and self reported health. A population based study among immigrants from Poland, Turkey, and Iran in Sweden. J Epidemiol Community Health 58:574–582. doi:10.1136/jech.2003.011387 PubMedCrossRef

Title: Ethnic differences in unemployment and ill health
Authors: Merel Schuring
Alex Burdorf
Anton Kunst
Toon Voorham
Johan Mackenbach
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: International Archives of Occupational and Environmental Health / Issue 8/2009
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-009-0408-7

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Springer Medicine

Ethnic differences in unemployment and ill health

Abstract

Objective

Method

Results

Conclusions

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Springer Medicine

Abstract

Objective

Method

Results

Conclusions

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