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Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Factors associated with differences in perceived health among German long-term unemployed

Authors: Heribert Limm, Mechthild Heinmüller, Katrin Liel, Karin Seeger, Harald Gündel, Ahmet Kimil, Peter Angerer

Published in: BMC Public Health | Issue 1/2012

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Abstract

Background

Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons.

Methods

Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health.

Results

The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models.

Conclusions

Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market setting and some of the socio-demographic and health behavior variables. Further research is needed to determine risk factors leading to reduced perceived health in the unemployed. The strong association between mental health and perceived health suggests interventions targeting mental health are urgently needed to positively influence perceived health, a key determinant of individuals’ chances to successfully return to work.
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Literature
1.
go back to reference Jahoda M, Lazarsfeld PF, Zeisel H: Die Arbeitslosen von Marienthal: Ein soziographischer Versuch über die Wirkungen langandauernder Arbeitslosigkeit. 1933, Hirzel, Leipzig Jahoda M, Lazarsfeld PF, Zeisel H: Die Arbeitslosen von Marienthal: Ein soziographischer Versuch über die Wirkungen langandauernder Arbeitslosigkeit. 1933, Hirzel, Leipzig
2.
go back to reference Bartley M, Sacker A, Clarke P: Employment status, employment conditions, and limiting illness: Prospective evidence from the British household panel survey 1991–2001. J Epidemiol Community Health. 2004, 58 (6): 501-506. 10.1136/jech.2003.009878.CrossRefPubMedPubMedCentral Bartley M, Sacker A, Clarke P: Employment status, employment conditions, and limiting illness: Prospective evidence from the British household panel survey 1991–2001. J Epidemiol Community Health. 2004, 58 (6): 501-506. 10.1136/jech.2003.009878.CrossRefPubMedPubMedCentral
3.
go back to reference Feather NT: The psychological impact of unemployment. 1989, Springer, New York Feather NT: The psychological impact of unemployment. 1989, Springer, New York
4.
go back to reference McKee-Ryan FM, Song ZL, Wanberg CR, Kinicki AJ: Psychological and physical well-being during unemployment: A meta-analytic study. J Appl Psychol. 2005, 90 (1): 53-76.CrossRefPubMed McKee-Ryan FM, Song ZL, Wanberg CR, Kinicki AJ: Psychological and physical well-being during unemployment: A meta-analytic study. J Appl Psychol. 2005, 90 (1): 53-76.CrossRefPubMed
5.
go back to reference Murphy GC, Athanasou JA: The effect of unemployment on mental health. J Occup Organ Psychol. 1999, 72 (1): 83-99. 10.1348/096317999166518.CrossRef Murphy GC, Athanasou JA: The effect of unemployment on mental health. J Occup Organ Psychol. 1999, 72 (1): 83-99. 10.1348/096317999166518.CrossRef
6.
go back to reference Winefield AH: Unemployment: Its psychological costs. Int Rev Indust Organizat Psych. Volume 10. Edited by: Cooper CL, Robertson IT. 1995, Wiley, Chichester, 169-212. Winefield AH: Unemployment: Its psychological costs. Int Rev Indust Organizat Psych. Volume 10. Edited by: Cooper CL, Robertson IT. 1995, Wiley, Chichester, 169-212.
7.
go back to reference Winefield AH: The psychology of unemployment. Psychology at the turn of the millennium, Volume 2: Social, developmental, and clinical perspectives. Edited by: Baeckman L, Hofsten Cv. 2002, Psychological Press, UK, 393-408. Winefield AH: The psychology of unemployment. Psychology at the turn of the millennium, Volume 2: Social, developmental, and clinical perspectives. Edited by: Baeckman L, Hofsten Cv. 2002, Psychological Press, UK, 393-408.
8.
go back to reference Dooley D, Fielding J, Levi L: Health and unemployment. Annu Rev Public Health. 1996, 17: 449-465. 10.1146/annurev.pu.17.050196.002313.CrossRefPubMed Dooley D, Fielding J, Levi L: Health and unemployment. Annu Rev Public Health. 1996, 17: 449-465. 10.1146/annurev.pu.17.050196.002313.CrossRefPubMed
9.
go back to reference Geyer S, Peter R: Hospital admissions after transition into unemployment. Soz Praventivmed. 2003, 48 (2): 105-114.PubMed Geyer S, Peter R: Hospital admissions after transition into unemployment. Soz Praventivmed. 2003, 48 (2): 105-114.PubMed
10.
go back to reference Hanisch KA: Job loss and unemployment research from 1994 to 1998: A review and recommendations for research and intervention. J Vocat Behav. 1999, 55 (2): 188-220. 10.1006/jvbe.1999.1722.CrossRef Hanisch KA: Job loss and unemployment research from 1994 to 1998: A review and recommendations for research and intervention. J Vocat Behav. 1999, 55 (2): 188-220. 10.1006/jvbe.1999.1722.CrossRef
11.
go back to reference Grobe TG, Schwartz FW: Arbeitslosigkeit und Gesundheit. Gesundheitsberichterstattung des Bundes. Heft 13. 2003, Westdeutscher Verlag, Opladen, 75-92. Grobe TG, Schwartz FW: Arbeitslosigkeit und Gesundheit. Gesundheitsberichterstattung des Bundes. Heft 13. 2003, Westdeutscher Verlag, Opladen, 75-92.
12.
go back to reference Artazcoz L, Benach J, Borrell C, Cortes I: Unemployment and mental health: Understanding the interactions among gender, family roles, and social class. Am J Public Health. 2004, 94 (1): 82-88. 10.2105/AJPH.94.1.82.CrossRefPubMedPubMedCentral Artazcoz L, Benach J, Borrell C, Cortes I: Unemployment and mental health: Understanding the interactions among gender, family roles, and social class. Am J Public Health. 2004, 94 (1): 82-88. 10.2105/AJPH.94.1.82.CrossRefPubMedPubMedCentral
13.
go back to reference Paul KI, Moser K: Unemployment impairs mental health: Meta-analyses. J Vocat Behav. 2009, 74 (3): 264-282. 10.1016/j.jvb.2009.01.001.CrossRef Paul KI, Moser K: Unemployment impairs mental health: Meta-analyses. J Vocat Behav. 2009, 74 (3): 264-282. 10.1016/j.jvb.2009.01.001.CrossRef
14.
go back to reference Brähler E, Laubach W, Stöbel-Richter Y: Belastung und Befindlichkeit von Arbeitslosen in Deutschland. Mensch unter Belastung: Erkenntnisfortschritte und Anwendungsperspektiven der Stressforschung. Edited by: Schumacher J, Reschke K, Schröder H, Frankfurt a M. 2002, VAS Verlag für Akademische Schriften,, 201-214. Brähler E, Laubach W, Stöbel-Richter Y: Belastung und Befindlichkeit von Arbeitslosen in Deutschland. Mensch unter Belastung: Erkenntnisfortschritte und Anwendungsperspektiven der Stressforschung. Edited by: Schumacher J, Reschke K, Schröder H, Frankfurt a M. 2002, VAS Verlag für Akademische Schriften,, 201-214.
15.
go back to reference Dooley D, Prause J, Ham-Rowbottom KA: Underemployment and depression: Longitudinal relationships. J Health Soc Behav. 2000, 41 (4): 421-436. 10.2307/2676295.CrossRefPubMed Dooley D, Prause J, Ham-Rowbottom KA: Underemployment and depression: Longitudinal relationships. J Health Soc Behav. 2000, 41 (4): 421-436. 10.2307/2676295.CrossRefPubMed
16.
go back to reference Andrews G, Hall W, Teesson M, Henderson S: The mental health of Australians. 1999, Department of Health and Aged Care, Canberra, Australian Capital Territory Andrews G, Hall W, Teesson M, Henderson S: The mental health of Australians. 1999, Department of Health and Aged Care, Canberra, Australian Capital Territory
17.
go back to reference Nordenmark M, Strandh M: Towards a sociological understanding of mental well-being among the unemployed: The role of economic and psychosocial factors. Sociology. 1999, 33 (3): 577-597. Nordenmark M, Strandh M: Towards a sociological understanding of mental well-being among the unemployed: The role of economic and psychosocial factors. Sociology. 1999, 33 (3): 577-597.
18.
go back to reference Moser K, Paul K: Arbeitslosigkeit und seelische Gesundheit. Verhaltensther psychosoz Prax. 2001, 33: 431-442. Moser K, Paul K: Arbeitslosigkeit und seelische Gesundheit. Verhaltensther psychosoz Prax. 2001, 33: 431-442.
19.
go back to reference Åhs A, Westerling R: Self-rated health in relation to employment status during periods of high and of low levels of unemployment. Eur J Public Health. 2006, 16 (3): 294-304. 10.1093/eurpub/cki165.CrossRef Åhs A, Westerling R: Self-rated health in relation to employment status during periods of high and of low levels of unemployment. Eur J Public Health. 2006, 16 (3): 294-304. 10.1093/eurpub/cki165.CrossRef
20.
go back to reference Schuring M, Mackenbach J, Voorham T, Burdorf A: The effect of re-employment on perceived health. J Epidemiol Community Health. 2011, 65 (7): 639-644. 10.1136/jech.2009.103838.CrossRefPubMed Schuring M, Mackenbach J, Voorham T, Burdorf A: The effect of re-employment on perceived health. J Epidemiol Community Health. 2011, 65 (7): 639-644. 10.1136/jech.2009.103838.CrossRefPubMed
21.
go back to reference Overland S, Glozier N, Mæland JG, Aarø LE, Mykletun A: Employment status and perceived health in the Hordaland Health Study (HUSK). BMC Publ Health. 2006, 6: 219-10.1186/1471-2458-6-219.CrossRef Overland S, Glozier N, Mæland JG, Aarø LE, Mykletun A: Employment status and perceived health in the Hordaland Health Study (HUSK). BMC Publ Health. 2006, 6: 219-10.1186/1471-2458-6-219.CrossRef
22.
go back to reference Schutgens CAE, Schuring M, Voorham TAJ, Burdorf A: Changes in physical health among participants in a multidisciplinary health programme for long-term unemployed persons. BMC Publ Health. 2009, 9: 197-10.1186/1471-2458-9-197.CrossRef Schutgens CAE, Schuring M, Voorham TAJ, Burdorf A: Changes in physical health among participants in a multidisciplinary health programme for long-term unemployed persons. BMC Publ Health. 2009, 9: 197-10.1186/1471-2458-9-197.CrossRef
23.
go back to reference Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J: Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002, 64 (4): 580-586.CrossRefPubMed Petrie KJ, Cameron LD, Ellis CJ, Buick D, Weinman J: Changing illness perceptions after myocardial infarction: An early intervention randomized controlled trial. Psychosom Med. 2002, 64 (4): 580-586.CrossRefPubMed
24.
go back to reference Adam S, Emmerson C, Frayne C, Goodman A: Early quantitative evidence on the impact of the pathways to work pilots. 2006, Department for Work and Pensions (DWP), London Adam S, Emmerson C, Frayne C, Goodman A: Early quantitative evidence on the impact of the pathways to work pilots. 2006, Department for Work and Pensions (DWP), London
25.
go back to reference Mathers CD, Schofield DJ: The health consequences of unemployment: The evidence. Med J Aust. 1998, 168 (4): 178-182.PubMed Mathers CD, Schofield DJ: The health consequences of unemployment: The evidence. Med J Aust. 1998, 168 (4): 178-182.PubMed
26.
go back to reference Bjorklund A, Eriksson T: Unemployment and mental health: Evidence from research in the Nordic countries. Int J Soc Welf. 1998, 7 (3): 219-235. 10.1111/j.1468-2397.1998.tb00286.x. Bjorklund A, Eriksson T: Unemployment and mental health: Evidence from research in the Nordic countries. Int J Soc Welf. 1998, 7 (3): 219-235. 10.1111/j.1468-2397.1998.tb00286.x.
27.
go back to reference Martella D, Maass A: Unemployment and life satisfaction: The moderating role of time structure and collectivism. J Appl Soc Psychol. 2000, 30 (5): 1095-1108. 10.1111/j.1559-1816.2000.tb02512.x.CrossRef Martella D, Maass A: Unemployment and life satisfaction: The moderating role of time structure and collectivism. J Appl Soc Psychol. 2000, 30 (5): 1095-1108. 10.1111/j.1559-1816.2000.tb02512.x.CrossRef
28.
go back to reference World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2000, 284 (23): 3043-3045.CrossRef World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects. JAMA. 2000, 284 (23): 3043-3045.CrossRef
29.
go back to reference Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30 (6): 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed Ware JE, Sherbourne CD: The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992, 30 (6): 473-483. 10.1097/00005650-199206000-00002.CrossRefPubMed
30.
go back to reference Bullinger M, Kirchberger I: SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. 1998, Hogrefe, Göttingen Bullinger M, Kirchberger I: SF-36. Fragebogen zum Gesundheitszustand. Handanweisung. 1998, Hogrefe, Göttingen
31.
go back to reference Burdine JN, Felix MRJ, Abel AL, Wiltraut CJ, Musselman YJ: The SF-12 as a population health measure: An exploratory examination of potential for application. Health Serv Res. 2000, 35 (4): 885-904.PubMedPubMedCentral Burdine JN, Felix MRJ, Abel AL, Wiltraut CJ, Musselman YJ: The SF-12 as a population health measure: An exploratory examination of potential for application. Health Serv Res. 2000, 35 (4): 885-904.PubMedPubMedCentral
32.
go back to reference Perneger TV, Burnand B: A simple imputation algorithm reduced missing data in SF-12 health surveys. J Clin Epidemiol. 2005, 58 (2): 142-149. 10.1016/j.jclinepi.2004.06.005.CrossRefPubMed Perneger TV, Burnand B: A simple imputation algorithm reduced missing data in SF-12 health surveys. J Clin Epidemiol. 2005, 58 (2): 142-149. 10.1016/j.jclinepi.2004.06.005.CrossRefPubMed
33.
go back to reference Zigmond AS, Snaith RP: The Hospital Anxiety and Depression scale. Acta Psychiatr Scand. 1983, 67 (6): 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed Zigmond AS, Snaith RP: The Hospital Anxiety and Depression scale. Acta Psychiatr Scand. 1983, 67 (6): 361-370. 10.1111/j.1600-0447.1983.tb09716.x.CrossRefPubMed
34.
go back to reference Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale: An updated literature review. J Psychosomat Res. 2002, 52 (2): 69-77. 10.1016/S0022-3999(01)00296-3.CrossRef Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale: An updated literature review. J Psychosomat Res. 2002, 52 (2): 69-77. 10.1016/S0022-3999(01)00296-3.CrossRef
35.
go back to reference Olsson I, Mykletun A, Dahl AA: The Hospital Anxiety and Depression Rating Scale: A cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry. 2005, 5 (1): 46-10.1186/1471-244X-5-46.CrossRefPubMedPubMedCentral Olsson I, Mykletun A, Dahl AA: The Hospital Anxiety and Depression Rating Scale: A cross-sectional study of psychometrics and case finding abilities in general practice. BMC Psychiatry. 2005, 5 (1): 46-10.1186/1471-244X-5-46.CrossRefPubMedPubMedCentral
36.
go back to reference Berth H, Forster P, Brahler E: Unemployment, job insecurity and their consequences for health in a sample of young adults. Gesundheitswesen. 2003, 65 (10): 555-560.CrossRefPubMed Berth H, Forster P, Brahler E: Unemployment, job insecurity and their consequences for health in a sample of young adults. Gesundheitswesen. 2003, 65 (10): 555-560.CrossRefPubMed
37.
go back to reference Berkhof J, Snijders TAB: Variance component testing in multilevel models. J Educ Behav Stat. 2001, 26 (2): 133-152. 10.3102/10769986026002133.CrossRef Berkhof J, Snijders TAB: Variance component testing in multilevel models. J Educ Behav Stat. 2001, 26 (2): 133-152. 10.3102/10769986026002133.CrossRef
38.
go back to reference Herrmann C: International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results. J Psychosomat Res. 1997, 42 (1): 17-41. 10.1016/S0022-3999(96)00216-4.CrossRef Herrmann C: International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results. J Psychosomat Res. 1997, 42 (1): 17-41. 10.1016/S0022-3999(96)00216-4.CrossRef
39.
go back to reference Robert-Koch-Institut: Beiträge zur Gesundheitsberichterstattung des Bundes. February 2011, Robert Koch Institut, Berlin, www.gbe-bund.de, Robert-Koch-Institut: Beiträge zur Gesundheitsberichterstattung des Bundes. February 2011, Robert Koch Institut, Berlin, www.​gbe-bund.​de,
40.
go back to reference Sacker A, Head J, Gimeno D, Bartley M: Social inequality in physical and mental health comorbidity dynamics. Psychosom Med. 2009, 71 (7): 763-770. 10.1097/PSY.0b013e3181b1e45e.CrossRefPubMed Sacker A, Head J, Gimeno D, Bartley M: Social inequality in physical and mental health comorbidity dynamics. Psychosom Med. 2009, 71 (7): 763-770. 10.1097/PSY.0b013e3181b1e45e.CrossRefPubMed
41.
go back to reference Schuring M, Burdorf A, Voorham AJ, der Weduwe K, Mackenbach JP: Effectiveness of a health promotion programme for long-term unemployed subjects with health problems: a randomised controlled trial. J Epidemiol Community Health. 2009, 63 (11): 893-899. 10.1136/jech.2008.080432.CrossRefPubMed Schuring M, Burdorf A, Voorham AJ, der Weduwe K, Mackenbach JP: Effectiveness of a health promotion programme for long-term unemployed subjects with health problems: a randomised controlled trial. J Epidemiol Community Health. 2009, 63 (11): 893-899. 10.1136/jech.2008.080432.CrossRefPubMed
42.
go back to reference Watson PJ, Booker CK, Moores L, Main CJ: Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004, 8 (4): 359-369. 10.1016/j.ejpain.2003.11.003.CrossRefPubMed Watson PJ, Booker CK, Moores L, Main CJ: Returning the chronically unemployed with low back pain to employment. Eur J Pain. 2004, 8 (4): 359-369. 10.1016/j.ejpain.2003.11.003.CrossRefPubMed
Metadata
Title
Factors associated with differences in perceived health among German long-term unemployed
Authors
Heribert Limm
Mechthild Heinmüller
Katrin Liel
Karin Seeger
Harald Gündel
Ahmet Kimil
Peter Angerer
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-485

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