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The effect of re-employment on perceived health
  1. M Schuring1,
  2. J Mackenbach1,
  3. T Voorham2,
  4. A Burdorf1
  1. 1Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
  2. 2Municipal Health Service GGD Rotterdam, Rotterdam, The Netherlands
  1. Correspondence to Alex Burdorf, Department of Public Health, Erasmus MC, PO Box 2040, 3000 CA Rotterdam, The Netherlands; a.burdorf{at}


Background The relationship between unemployment and poor health has been well established. Unemployment causes poor health, and poor health increases the probability of unemployment.

Methods A prospective study with 6 months' follow-up was conducted among unemployed participants receiving social security benefits who were capable of full-time employment and were referred to a re-employment training centre. Re-employment was defined as ending social security benefits for at least 3 months because of starting with paid employment. Health-related quality of life was measured by the 36-Item Short-Form Health Survey. A Cox proportional hazards analysis was used to determine the factors that predicted re-employment during follow-up. The influence of re-employment on changes in perceived health was investigated with linear regression analysis.

Results Unemployed participants with a poor health at baseline were less likely to return to paid employment during follow-up. Almost all dimensions of health at baseline had an influence on the likelihood of becoming employed. Among the re-employed participants, general health, physical functioning, social functioning, vitality, mental health, bodily pain and role limitations due to emotional or physical problems improved, with an effect size varying from 0.11 to 0.66.

Conclusions This study provides evidence that re-employment leads to improvement of self-perceived health within a short time window. This suggests that labour force participation should be considered as therapeutic intervention within health promotion programmes among unemployed persons.

  • Self-rated health
  • unemployment
  • unemployment and health

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  • Funding This study received support from the Public Health Fund (Fonds OGZ), Laan van Nieuw Oost Indie 334, 2593 CE Den Haag, The Netherlands.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the medical ethics committee of the University Medical Center Rotterdam, Erasmus MC, Rotterdam, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.