TY - JOUR T1 - Health and re-employment in a two year follow up of long term unemployed. JF - Journal of Epidemiology and Community Health JO - J Epidemiol Community Health SP - 14 LP - 18 DO - 10.1136/jech.47.1.14 VL - 47 IS - 1 AU - B Claussen AU - A Bjørndal AU - P F Hjort Y1 - 1993/02/01 UR - http://jech.bmj.com/content/47/1/14.abstract N2 - STUDY OBJECTIVE--The aim was to examine re-employment and changes in health during a two year follow up of a representative sample of long term unemployed. DESIGN--This was a cross sectional study and a two year follow up. Health was measured by psychometric testing, Hopkins symptom checklist, General health questionnaire, and medical examination. Health related selection to continuous unemployment and recovery by re-employment was estimated by logistic regression with covariances deduced from the labour market theories of human capital and segmented labour market. SETTING--Four municipalities in Greenland, southern Norway. SUBJECTS--Participants were a random sample of 17 to 63 year old people registered as unemployed for more than 12 weeks. MAIN RESULTS--In the cross sectional study, the prevalence of depression, anxiety, and somatic illness was from four to 10 times higher than in a control group of employed people. In the follow up study, there was considerable health related selection to re-employment. A psychiatric diagnosis was associated with a 70% reduction in chances of obtaining a job. Normal performance on psychometric testing showed a two to three times increased chance of re-employment. Recovery of health following re-employment was less than expected from previous studies. CONCLUSIONS--Health related selection to long term unemployment seems to explain a substantial part of the excess mental morbidity among unemployed people. An increased proportion of the long term unemployed will be vocationally handicapped as years pass, putting a heavy burden on social services. ER -