Objectives: To study health and re-employment in a five-year follow-up of a community sample of long-term unemployed people.
Methods: A random sample registered for more than 12 weeks at the labour offices in Grenland, Norway, were given medical check-ups in 1988 and 1990, and a postal questionnaire in 1993.
Results: Only 37% were employed five years after the first spell of long-term unemployment. Recovery after re-employment was demonstrated, indicating that unemployment causes poor mental health. Health-related selection to continuous unemployment was only found for medical diagnoses. The unemployed who might be selected to continuous unemployment because of poor health at the two-year follow-up seemed to deteriorate most.
Conclusion: The high morbidity of mental health problems among unemployed people is mostly explained by the causal hypothesis. This is a challenge to preventive medicine. Sick unemployed people should be given special attention.