Sickness absence in a re-employment program as a predictor of labor market attachment among long-term unemployed individuals: A 6-year cohort study in Finland.

Objectives We examined whether sickness absence during participation in a state subsidized re-employment program among long-term unemployed people was associated with subsequent labor market attachment. Methods We linked 18 944 long-term unemployed participants (aged 18-60 years) of a six-month subsidized re-employment program in Finland to their records of sickness absence during the program and labor market status after the program. We used the latent class growth model to identify labor market attachment trajectories over a six-year follow-up period and multinomial logistic regression to investigate the association between sickness absence and labor market attachment trajectories. Results We identified four labor market attachment trajectories: "strengthening", (77%), "delayed" (6%), "leavers" (10%), and "non-attached" (7%). Sickness absence was associated with an increased risk of belonging to the leavers and non-attached trajectories. Having >30 days of sickness absence during the six-month re-employment program increased the risk for belonging to the future non-attached trajectory in all age groups, but in particular for those aged 30-44 [odds ratio (OR) 7.35, 95% confidence interval (CI) 4.85-11.14] and 18-29 years (OR 5.38, 95%CI 3.76-7.69). At these ages, having fewer than 30 days sickness absences was also associated with an elevated risk of belonging to the non-attached trajectory, while this risk was lower for those aged 45-60. Conclusions Sickness absence during participation in a subsidized re-employment program increased the risk for poor labor market attachment during the subsequent six years. The risk was particularly high among younger participants with >30 days of sickness absence.

Chronic diseases as predictors of labour market attachment after participation in subsidised re-employment programme: a 6-year follow-up study.

BACKGROUND: Little is known about the work patterns of re-employed people. We investigated the labour market attachment trajectories of re-employed people and assessed the influence of chronic diseases on these trajectories. METHODS: The study was based on register data of 18 944 people (aged 18-60 years) who participated in a subsidised re-employment programme in Finland. Latent class growth analysis with zero-inflated Poisson was used to model the labour market attachment trajectories over a 6-year follow-up time. Multinomial logistic regression was used to examine the associations between chronic diseases and labour market attachment trajectories, adjusting for age, gender, educational level, size of town and calendar year in subsidised re-employment programme. RESULTS: We identified four distinct labour market attachment trajectories, namely: strengthening (a relatively stable attachment throughout the follow-up time; 77%), delayed (initial weak attachment increasing later; 6%), leavers (attachment declined with time; 10%) and none-attached (weak attachment throughout the study period; 7%). We found that severe mental problems strongly increased the likelihood of belonging in the leavers (OR 3.61; 95% CI 2.23 to 5.37) and none-attached (OR 3.41; 95% CI 1.91 to 6.10) trajectories, while chronic hypertension was associated with none-attached (OR 1.37; 95% CI 1.06 to 1.77) trajectory. The associations between other chronic diseases (diabetes, heart disease, asthma and arthritics) and labour market attachment trajectories were less evident. CONCLUSIONS: Re-employed people appear to follow distinct labour market attachment trajectories over time. Having chronic diseases, especially mental disorders appear to increase the risk for relatively poor labour market attachment.

Musculoskeletal pain and re-employment among unemployed job seekers: a three-year follow-up study.

BACKGROUND: Poor health is a potential risk factor for not finding employment among unemployed individuals. We investigated the associations between localized and multiple-site musculoskeletal pain and re-employment in a three-year follow-up of unemployed job seekers. METHODS: Unemployed people (n = 539) from six localities in southern Finland who participated in various active labour market policy measures at baseline in 2002/2003 were recruited into a three-year health service intervention trial. A questionnaire was used to collect data on musculoskeletal health and background characteristics at baseline and on employment status at the end of the follow-up. We conducted a complete case (n = 284) and multiple imputation analyses using logistic regression to investigate the association between baseline musculoskeletal pain and re-employment after three years. RESULTS: Participants with severe pain in the lower back were less likely to become re-employed. This was independent of potential confounding variables. Pain in the hands/upper extremities, neck/shoulders, lower extremities, as well as multiple site were not determinants of re-employment. CONCLUSIONS: Our findings lend some support to the hypothesis that poor health can potentially cause health selection into employment. There is the need to disentangle health problems in order to clearly appreciate their putative impact on employment. This will allow for more targeted interventions for the unemployed.

Muscular fitness and re-employment among unemployed job seekers in Finland: a three-year follow-up study.

BACKGROUND: Research suggests that health is an important determinant of re-employment. However, the association between specific physical health components, such as muscular fitness, and re-employment has not been well studied. OBJECTIVE: In a three-year follow-up of unemployed people, we investigated whether muscular fitness is associated with re-employment. METHODS: In 2002-2005, unemployed people (n=130) who were participants in active labour market policy measures were recruited to participate in a Career Health Care (CHC) project. Data on background characteristics and muscular fitness were collected in 2002/2003 using a questionnaire and laboratory measurements. Clientship in the CHC lasted for three years, and at its end, participants' employment status was assessed by a questionnaire. Logistic regression was used to investigate the association between baseline muscular fitness (repetitive lift, sit-ups, and squats) and re-employment after three years. RESULTS: The probability of re-employment within three years significantly increased with improved performances on muscular fitness tests (lifting, sit-up, and squatting) after adjustment for age and gender. CONCLUSIONS: Unemployed people with good muscular fitness had increased probability for re-employment as compared to those with poor muscular fitness.