Background: According to existing research, unemployment is related to health problems. The causal relationship is not yet fully understood. This secondary data analysis aims to study the interdependencies between unemployment and health.
Methods: This study is based on data from the German Labour Market and Social Security (PASS) panel study comprising a sample of beneficiaries of the Federal Employment Agency and their household members as well as a representative household sample. A total of 12,570 persons (aged 15 to 64 years) from 8,392 households were interviewed in wave 7 (2013) of PASS.
Results: The employed and unemployed differ substantially in terms of socio-demographic and health-related characteristics. Unemployed persons more often report worse or bad self-rated health (unemployed men: 31.0 % vs. employed men: 14.0 %; unemployed women: 37.7 % vs. employed women: 21.7 %) and feel being rather or much impaired by mental problems (unemployed men: 21.9 % vs. employed men: 7.2 %; unemployed women: 20.4 % vs. employed women: 15.8 %). For the unemployed, the proportion with an officially certified severe disability as well as another severe health impairment is much higher. They also more often report at least one hospital stay in the previous 12 months (unemployed men: 16.3 % vs. employed men: 9.9 %; unemployed women: 19.6 % vs. employed women: 12.2 %) and more contacts with physicians. In spite of that, unemployed persons do less exercise. Multivariate, longitudinal, logistic regression models demonstrate strong health-related selection effects on labour market transitions. Lower self-rated health is associated with a higher unemployment risk for employed persons as well as a lower probability of reintegration for unemployed persons. The most influential determinants of bad self-rated health are self-rated health status in the year before, while job loss and re-employment tend to influence the occurrence of bad self-rated health.
Discussion: The analyses show substantial health disparities to the detriment of the unemployed. They also refer to a need for prevention regarding healthcare and employment.
Keywords: Disability; Health services; Self-rated health status; Sport activity; Unemployment.