PT - JOURNAL ARTICLE AU - David van de Ven AU - Suzan J W Robroek AU - Alex Burdorf AU - Merel Schuring TI - Inequalities in the impact of having a chronic disease on entering permanent paid employment: a registry-based 10-year follow-up study AID - 10.1136/jech-2022-219891 DP - 2023 May 23 TA - Journal of Epidemiology and Community Health PG - jech-2022-219891 4099 - http://jech.bmj.com/content/early/2023/05/23/jech-2022-219891.short 4100 - http://jech.bmj.com/content/early/2023/05/23/jech-2022-219891.full AB - Background This study aimed to investigate among unemployed persons (1) the impact of having a chronic disease on entering paid employment and obtaining a permanent contract and (2) whether these associations differed by educational attainment.Methods Register data from Statistics Netherlands on employment status, contract type, medication and sociodemographic characteristics were linked. Dutch unemployed persons between 18 and 64 years (n=667 002) were followed up for 10 years (2011–2020). Restricted mean survival time analyses (RMSTs) were used to investigate differences in average months until entering paid employment and until obtaining a permanent contract between persons with and without cardiovascular diseases, inflammatory conditions, diabetes, respiratory illness, common mental disorders and psychotic disorders. Interaction terms were included for education.Results One-third of the unemployed persons at baseline entered paid employment during follow-up. Persons with chronic diseases spent more months in non-employment compared with persons without chronic diseases (difference ranging from 2.50 months (95% CI 1.97 to 3.03 months) to 10.37 months (95% CI 9.98 to 10.77 months)), especially for persons with higher education. Conditional on entering paid employment, the time until a permanent contract was longer for persons with cardiovascular diseases (4.42 months, 95% CI 1.85 to 6.99 months), inflammatory conditions (4.80 months, 95% CI 2.02 to 7.59 months) and diabetes (8.32 months, 95% CI 4.26 to 12.37 months) than for persons without these diseases. These latter differences were similar across educational attainment.Conclusions Having a chronic disease is a barrier to entering permanent paid employment. The findings underline the need to prevent chronic diseases and promote an inclusive workforce.No data are available.