Abstract
BackgroundA number of different models have been used in order to explain the links between unemployment and ill-health. The objective of this study was to test different proposed models in an empirical setting.MethodsA cohort of school-leavers consisting of more than 1000 persons was followed for 14 years up to the age of 30. They have repeatedly been asked questions that could be used to operationalise different proposed models as well as health outcomes. Seven different models explaining the health effect of unemployment were identified: an economic deprivation model, a lack of control model as well as a locus of control model, a stress model, a social support model, a work involvement model and a model of latent functions. Health outcomes used were somatic symptoms, depressive symptoms, self-perceived health and nervous problems. Statistical tests included bivariate correlations and logistic regression.ResultsMost of the models correlated fairly well with unemployment measures. The capacity of the models to explain the connection between unemployment and ill-health varied, however. The model of latent functions was most successful, followed by the economic deprivation model. The social support and the control models were also fairly good. The work involvement scale and the stress model demonstrated the smallest explanatory power.ConclusionStudies comparing different explanatory models in the field are rare. Few models apply a multidisciplinary approach. In view of the findings, it should be possible to develop multidisciplinary and better models to explain the links between unemployment and health in more detail.
Highlights
A number of different models have been used in order to explain the links between unemployment and ill-health
For this study we identified and tested seven different model concepts, namely: the economic deprivation model, the lack of control model as well as the locus of control model, the stress model, the social support model, the work involvement model and the model of latent functions
Three theoretical traditions can be traced with regard to unemployment research within the public health arena: i) the biomedical tradition, with its focus on physiological mechanisms to explain the correlation between mainly physical circumstances and biological phenomena; ii) the sociological tradition, with a focus on material circumstances creating both restrictions and possibilities for human development, and an important formative environment for health and disease; and iii) the psychological tradition, focusing on the individual and his or her individual possibilities[3]
Summary
A number of different models have been used in order to explain the links between unemployment and ill-health. Seldom a prime objective for public health research, a number of models have been developed that explain the connection between unemployment and health [1]. Studies comparing these different models are lacking, [2]. Three theoretical traditions can be traced with regard to unemployment research within the public health arena: i) the biomedical tradition, with its focus on physiological mechanisms to explain the correlation between mainly physical circumstances and biological phenomena (especially pathological phenomena); ii) the sociological tradition, with a focus on material circumstances creating both restrictions and possibilities for human development, and an important formative environment for health and disease; and iii) the psychological tradition, focusing on the individual and his or her individual possibilities (perception, learning, motivation etc.)[3]. From a public health point of view, all these theories need some reference to biological mechanisms
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