Division of Health Research, Lancaster University, England.
Int J Health Serv. 2011;41(3):415-30. doi: 10.2190/HS.41.3.b.
The authors investigate three hypotheses on the influence of labor market deregulation, decommodification, and investment in active labor market policies on the employment of chronically ill and disabled people. The study explores the interaction between employment, chronic illness, and educational level for men and women in Canada, Denmark, Norway, Sweden, and the United Kingdom, countries with advanced social welfare systems and universal health care but with varying types of active and passive labor market policies. People with chronic illness were found to fare better in employment terms in the Nordic countries than in Canada or the United Kingdom. Their employment chances also varied by educational level and country. The employment impact of having both chronic illness and low education was not just additive but synergistic. This amplification was strongest for British men and women, Norwegian men, and Danish women. Hypotheses on the disincentive effects of tighter employment regulation or more generous welfare benefits were not supported. The hypothesis that greater investments in active labor market policies may improve the employment of chronically ill people was partially supported. Attention must be paid to the differential impact of macro-level policies on the labor market participation of chronically ill and disabled people with low education, a group facing multiple barriers to gaining employment.
作者研究了劳动力市场放松管制、去商品化和对积极劳动力市场政策投资对慢性病和残疾人就业的影响的三个假设。该研究探讨了加拿大、丹麦、挪威、瑞典和英国这五个国家的男性和女性的就业、慢性病和教育水平之间的相互作用，这些国家都有先进的社会福利制度和全民医疗保健，但积极和消极劳动力市场政策的类型不同。研究发现，慢性病患者在北欧国家的就业方面表现优于加拿大或英国。他们的就业机会也因教育水平和国家的不同而有所差异。既有慢性病又受教育程度低的人，其就业机会受到的影响不是简单的叠加，而是协同的。这种放大作用在英国男性和女性、挪威男性以及丹麦女性中最为明显。劳动力市场监管更严格或福利更慷慨会产生抑制就业的假设并没有得到支持。积极劳动力市场政策投资可能会改善慢性病患者就业的假设得到了部分支持。必须关注宏观政策对低教育慢性病和残疾人群体劳动力市场参与的差异影响，因为这个群体在获得就业方面面临着多种障碍。
