title: How do macro-level contexts and policies affect the employment chances of chronically ill and disabled people? Part I: The impact of recession and deindustrialization.
abstract: Low employment rates of chronically ill and disabled people are of serious concern. Being out of work increases the risk of poverty and social exclusion, which may further damage the health of these groups, exacerbating health inequalities. Macro-level policies have a potentially tremendous impact on their employment chances, and these influences urgently need to be understood as the current economic crisis intensifies. In Part I of this two-part study, the authors examine employment trends for people who report a chronic illness or disability, by gender and educational level, in Canada, Denmark, Norway, Sweden, and the United Kingdom in the context of economic booms and busts and deindustrialization. People with the double burden of chronic illness and low education have become increasingly marginalized from the labor market. Deindustrialization may have played a part in this process. In addition, periods of high unemployment have sparked a downward trend in employment for already marginalized groups who did not feel the benefits when the economy improved. Norway and Sweden have been better able to protect the employment of these groups than the United Kingdom and Canada. These contextual differences suggest that other macro-level factors, such as active and passive labor market polices, may be important, as examined in part II.
authors.affiliation: Division of Health Research, Lancaster University, England.
authors.forename: Paula
authors.initials: P
authors.lastname: Holland
authors.forename: Bo
authors.initials: B
authors.lastname: Burström
authors.forename: Margaret
authors.initials: M
authors.lastname: Whitehead
authors.forename: Finn
authors.initials: F
authors.lastname: Diderichsen
authors.forename: Espen
authors.initials: E
authors.lastname: Dahl
authors.forename: Ben
authors.initials: B
authors.lastname: Barr
authors.forename: Lotta
authors.initials: L
authors.lastname: Nylén
authors.forename: Wen-Hao
authors.initials: WH
authors.lastname: Chen
authors.forename: Karsten
authors.initials: K
authors.lastname: Thielen
authors.forename: Kjetil A
authors.initials: KA
authors.lastname: van der Wel
authors.forename: Stephen
authors.initials: S
authors.lastname: Clayton
authors.forename: Sharanjit
authors.initials: S
authors.lastname: Uppal
mesh_terms: D000328:Adult; D002170:Canada; D002908:Chronic Disease / Q000191:economics; D006233:Persons with Disabilities; D057172:Economic Recession; D004522:Educational Status; D004651:Employment / Q000706:statistics & numerical data / Q000639:trends; D005060:Europe; D005260:Female; D006306:Health Surveys; D006801:Humans; D007221:Industry; D008297:Male; D008875:Middle Aged; D012922:Social Change; D014478:Unemployment / Q000706:statistics & numerical data* / Q000639:trends*