Worklessness and regional differences in the social gradient in general health: Evidence from the 2001 English census
Section snippets
Background
Worklessness is an important determinant of health with unemployment and other forms of economic inactivity (such as lone parenthood or long term sickness absence) being associated with an increased likelihood of morbidity and mortality (Bartley, 1994, Morris and Cook, 1994, Martikainen and Valkonen, 1996, Korpi, 2001, Rodriguez, 2001, Bartley and Plewis, 2002, Bartley and Ferrie, 2006). There is, for example, a well established literature on an individual and area level relationship between
Data and variables
The data set used in this study is the Individual Sample of Anonymised Records (Individual SAR); a 3% sample of the 2001 UK Census. The Samples of Anonymised Records scheme provides researchers with access to completely anonymised Census data to allow detailed micro level analysis. The Individual SAR was chosen for this study as it contained sufficiently detailed coding on employment status and socio-economic position. Full details on the Samples of Anonymised Records and the Individual SAR
Results
Overall 85.7% of men and 73.2% of women were employed in 2001 with regions of the north and London having the lowest levels (Table 1). There were also variations in employment by educational level within each region as illustrated in Fig. 1, Fig. 2 (with the age adjusted rates used given in Supplemental Table 1). For both men and women employment rates decline with lower education, but differences are largest in those regions with the lowest levels of employment. For example, the overall age
Discussion
In summary, the results suggest that for both men and women, differences in levels of worklessness play a significant role in educational inequalities in self-rated general health and in differences in the educational gradient between the regions of England. This extends the work of Arber (1987), who suggested an important role for employment status in understanding health inequalities in general health. It also extends previous work on inequalities in general health using the 2001 UK census
Conclusion
Health geography has focused on separating contextual and compositional influences on social inequalities in health. However, there has been less focus on the important role of place in shaping the distribution of risk factors (Tunstall et al., 2004). This paper is the first to examine regional variation in employment rates in England as an example of the role of place in shaping the distribution of social risks to health and of the social gradient in health. We have found that worklessness is
Acknowledgements
The 2001 SARs are provided through the Cathy Marsh Centre for Census and Survey Research (University of Manchester), with the support of the ESRC and JISC. All tables containing Census data, and the results of analysis, are reproduced with the permission of the Controller of Her Majesty's Stationery Office and the Queen's Printer for Scotland.
Contribution
CB had the original idea that both authors subsequently developed. FP conducted the analysis and CB drafted the paper. Both authors
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