Unemployment, re-employment and the use of primary health care services.
OBJECTIVE
To examine the association between re-employment and the use of primary health care services.


METHODS
A cohort study of employed teenagers and a 'natural experiment' among adult long-term unemployed with an intervention group of re-employed, a control group of not re-employed, and a matched control group of permanently employed.


METHODS
An industrial town (pop. 25,000) in southwestern Finland.


METHODS
84 teenage and 143 adult long-term unemployed and 82 permanently employed individuals.


METHODS
Frequency of primary health care visits.


RESULTS
Primary health care visits increased during re-employment among both teenage and adult re-employed (n = 82), but not in a control group of 61 long-term unemployed who were not employed under the re-employment scheme. A comparison with persons in regular wage employment indicated that visits increased from a low to a normal level.


CONCLUSIONS
To explain the results, reference is made to the need for sickness absence certificates and to epidemiological factors. The findings also raise serious questions with regard to the ability of the health care system to reach, let alone help, unemployed citizens.
Virtanen
P
P
University of Tampere, Department of Public Health, Finland.
D000041:Absenteeism; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D004651:Employment / Q000331:legislation & jurisprudence / Q000523:psychology; D005194:Family Practice; D005260:Female; D005387:Finland / Q000453:epidemiology; D006302:Health Services Research; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009017:Morbidity; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012946:Social Welfare / Q000331:legislation & jurisprudence; D014478:Unemployment