Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
J Epidemiol Community Health. 2023 Jul;77(7):474-480. doi: 10.1136/jech-2022-219891. Epub 2023 May 23.
This study aimed to investigate among unemployed persons (1) the impact of having a chronic disease on entering paid employment and obtaining a permanent contract and (2) whether these associations differed by educational attainment.
Register data from Statistics Netherlands on employment status, contract type, medication and sociodemographic characteristics were linked. Dutch unemployed persons between 18 and 64 years (n=667 002) were followed up for 10 years (2011-2020). Restricted mean survival time analyses (RMSTs) were used to investigate differences in average months until entering paid employment and until obtaining a permanent contract between persons with and without cardiovascular diseases, inflammatory conditions, diabetes, respiratory illness, common mental disorders and psychotic disorders. Interaction terms were included for education.
One-third of the unemployed persons at baseline entered paid employment during follow-up. Persons with chronic diseases spent more months in non-employment compared with persons without chronic diseases (difference ranging from 2.50 months (95% CI 1.97 to 3.03 months) to 10.37 months (95% CI 9.98 to 10.77 months)), especially for persons with higher education. Conditional on entering paid employment, the time until a permanent contract was longer for persons with cardiovascular diseases (4.42 months, 95% CI 1.85 to 6.99 months), inflammatory conditions (4.80 months, 95% CI 2.02 to 7.59 months) and diabetes (8.32 months, 95% CI 4.26 to 12.37 months) than for persons without these diseases. These latter differences were similar across educational attainment.
Having a chronic disease is a barrier to entering permanent paid employment. The findings underline the need to prevent chronic diseases and promote an inclusive workforce.
本研究旨在调查失业人群中：(1) 患有慢性病对获得有薪工作和永久合同的影响；(2) 这些关联是否因教育程度而异。
从荷兰统计局的登记数据中获取就业状况、合同类型、药物使用情况以及社会人口学特征等信息，并进行链接。对 18-64 岁的失业荷兰人（n=667002）进行了 10 年（2011-2020 年）的随访。采用受限平均生存时间分析（RMST）来比较患有心血管疾病、炎症性疾病、糖尿病、呼吸系统疾病、常见精神障碍和精神障碍人群与无上述疾病人群进入有薪工作和获得永久合同的平均月数差异。纳入了教育程度的交互项。
三分之一的失业者在随访期间找到了有薪工作。患有慢性病的人在非就业状态下花费的时间比没有慢性病的人多（差异范围为 2.50 个月（95%CI 1.97 至 3.03 个月）至 10.37 个月（95%CI 9.98 至 10.77 个月）），尤其是对于受过高等教育的人。在获得有薪工作的前提下，患有心血管疾病（4.42 个月，95%CI 1.85 至 6.99 个月）、炎症性疾病（4.80 个月，95%CI 2.02 至 7.59 个月）和糖尿病（8.32 个月，95%CI 4.26 至 12.37 个月）的人获得永久合同的时间比没有这些疾病的人要长。这些差异在不同教育程度之间是相似的。
患有慢性病是进入永久有薪就业的障碍。这些发现强调了预防慢性病和促进包容性劳动力的必要性。
