title: The influence of perceived health on labour participation among long term unemployed.
abstract: BACKGROUND
  Few studies have addressed the specific contribution of health in relation to socio-demographic and motivational aspects to re-entering paid employment. The purpose of this study among beneficiaries of unemployment benefits is to evaluate the detrimental effects of poor health and a lack of motivation on the likelihood of getting a job and to develop a decision support model that predicts remaining unemployment after 12 months.
  
  
  METHODS
  A longitudinal cohort study was conducted among people on unemployment benefit (UB) or social insurance benefit (SIB). The time-window of the study was 18 months. Written questionnaires were filled out 3 months post-benefit assessment, 6, 12 and 18 months. Multivariate logistic regression analysis was used to identify the barriers of re-entering paid employment. Subsequently, a predictive model was constructed to estimate the probability for every combination of determinants for a person to remain unemployed in the next 12 months.
  
  
  RESULTS
  Older age (≥55 years), a poor perceived health, and a lack of willingness to accept a job were the most prominent predictive factors for remaining unemployed after 12 months in both UB and SIB groups. Lower education in the UB group and being married or living together and poor self-reliance in the SIB group were additional risk factors for long-term unemployment.
  
  
  CONCLUSIONS
  Vocational rehabilitation of people on long-term social benefit should address perceived health, socio-demographic, and motivational aspects as key factors that determine prolonged unemployment. A predictive flow chart can be used to detect most vulnerable persons at risk for remaining long-term unemployment.
authors.affiliation: Department of Health Economics, Institute of Health Policy & Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands. lotters@bmg.eur.nl
authors.forename: Freek
authors.initials: F
authors.lastname: Lötters
authors.forename: Bouwine
authors.initials: B
authors.lastname: Carlier
authors.forename: Bernhard
authors.initials: B
authors.lastname: Bakker
authors.forename: Natacha
authors.initials: N
authors.lastname: Borgers
authors.forename: Merel
authors.initials: M
authors.lastname: Schuring
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003863:Depression / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011237:Predictive Value of Tests; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000523:psychology* / Q000706:statistics & numerical data