Abstract

The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this ‘Depression identification pattern’ with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services.

Highlights

  • Unemployment is the one of the most crucial social determinants of health inequalities

  • The present study showed that among the long-term unemployed people believed by the employment authorities to have impaired working capacity, referred to thorough medical examinations on a particular project, and assessed as unable to work, over two thirds were eligible for a disability pension

  • Namely disability pension, indicates more severe depression, it is evident that in a considerable percentage of long-term unemployed people suffering from considerable depression, the depression goes undetected by the regular health service system

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Summary

Introduction

Unemployment is the one of the most crucial social determinants of health inequalities. It is associated with increased morbidity and mortality alongside various accompanying financial and social problems [1,2,3,4,5,6]. The interaction between unemployment and ill-health is accounted for through both selection and causation mechanisms [5,7,8]. Connections between unemployment and certain health problems, such as musculoskeletal and mental health disorders, seem to be eminently obvious [9,10,11]. Res. Public Health 2018, 15, 909; doi:10.3390/ijerph15050909 www.mdpi.com/journal/ijerph

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