Abstract
BackgroundThere is increasing pressure to develop services to enhance the health of the workforce on the periphery of the labour market. Health promotion among unemployed people may improve their health but also to increase their employability. We tested whether re-employment can be enhanced with a health care intervention targeted at the unemployed.MethodsA 3-year follow-up, controlled design was used. The data were collected among unemployed people (n = 539) participating in active labour market policy measures. The baseline survey included established habitually used health questionnaires. The intervention consisted of three health check-ups and on-demand health services. Logistic regression analyses were used to obtain the odds ratios of the intervention group versus control group for being re-employed at follow-up. Health-related differences in the re-employment effects of the intervention were assessed through the significance of the interaction in the regression analyses.ResultsThe intervention did not serve to improve re-employment: at follow-up 50% of both the intervention group and the control group were at work. In further analyses, the odds ratios showed that the intervention tended to improve re-employment among participants in good health, whereas an opposite tendency was seen among those with poor health. The differences, however, were statistically non-significant.ConclusionThe experimental health service did not show any beneficial effects on re-employment. Nevertheless, rather than considering any particular health care as unnecessary and ineffective, we would like to stress the complexity of providing health services to match the diversity of the unemployed.
Highlights
There is increasing pressure to develop services to enhance the health of the workforce on the periphery of the labour market
Career Health Care (CHC) was an intervention resembling Finnish occupational health care services (OHC) services, except that the clients were recruited from jobseekers participating in active labour market policy (ALMP) measures
Among the participants at follow-up there were fewer women in the intervention group than in the control group (64% vs. 71%), whereas the groups did not differ in educational level, age and length of unemployment at baseline
Summary
There is increasing pressure to develop services to enhance the health of the workforce on the periphery of the labour market. It is well understood that the antithesis ‘selection or causation’ is false [3] Both selective and causal processes are relevant in considering the preventive and the illness-related health services for the working aged population. Policymakers and health service researchers consider health care for the unemployed a major challenge, but there are concerns about appropriate arrangements and the consequent effectiveness and efficiency of the service. Extensive development projects have been piloted in order to find ways to implement health services for the unemployed [8], and under the amendment to the Health Care Act of 2011 municipalities are obliged to provide health promotion and check-ups for the working aged who do not have access to OHC. Publications tend to write about the state of affairs and recommend novel services [9,10,11,12], whereas studies concentrating on the provision and effects of the services are scarce [e.g. 13-15]
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