Worklessness is bad for your health.

The upside of a work injury or illness is a change of scene.  It can be fun for a while, but if it goes on the absence of routine and activity can damage health and significantly increase the risk of mortality.  In short it can kill you.

The impact of worklessness on health has been a particular concern of researchers in the UK for the last decade.  The best work has been done there, but in research terms ten years is not a long time and more work needs to be done.  For example the research clearly shows that worklessness (the Brits invented the word) has a negative effect on some aspects of health, but it cannot yet provide the exact reasons.  That is, we know that not working is bad for your health, but we don't exactly know why.

The most significant impacts are on the heart and the head. 

Following is an extract from the NHS Health Development Agency's 'Worklessness and health - what do we know about the causal relationship?' evidence review (an evidence review is a summary of the findings of many research projects) (in this case 14 different projects):

Mortality and unemployment – population studies

• England and Wales (among other countries) demonstrate a positive association between mortality and unemployment for all age groups, with suicide increasing within a year of job loss, and cardiovascular mortality accelerating after two or three years and continuing for the next 10-15 years.
   
• Standard mortality ratios are higher for men who have been out of work.
   
• There is an estimated 20% excess risk of death for both men actively seeking work and their wives, with the possibility that this may be higher still in areas of higher unemployment.
   
• While poverty can be thought of as one of the potential mediating factors for increased mortality, unemployed people also adapt to their new status so that further deterioration (in terms of health and social status) does not occur beyond 12-18 months.

Mortality and unemployment – deaths due to cardiovascular disease and other physical health conditions

• There appears to be some association between unemployment and mortality due to health conditions such as cardiovascular disease, but this relationship is less clear for other conditions such as stroke.

Morbidity and unemployment – physical health conditions and health service usage

• Studies illustrate that during the anticipation and termination phase of factory closure, illness and health service use increase, the rate of hospital admissions doubles and conditions such as cardiovascular disease and higher blood pressure increase.

Psychiatric morbidity and unemployment

Evidence suggests that there is a strong association  between unemployment and measures of psychological and psychiatric morbidity. Factors such as levels of social support, geography, gender, age and type of employment appear to be confounders to this relationship. Upon re-employment, there appears to be a reversal of these effects. While the direction of causality is difficult to determine, unemployment is considered to be a significant cause of psychological distress in itself.

Suicide

• While unemployment may be associated with increased suicide, there is no clear evidence for a relationship in the UK. There appears to be a stronger relationship between parasuicide (Ed - attempted suicide) and unemployment.

On the impact of worklessness Professor Mansel Aylward, director of the Unum Centre for Psychosocial and Disability Research at Cardiff University and former chief medical adviser at the UK Department for Work and Pensions said:

"Suicide rates of young men who are out of work for six months increase by 40 times."

Recent US research by the Harvard School of Public Health, and reported by the New York Times, shows people who lose their jobs have a dramatically increased chance of developing a chronic health condition.

The evidence is in, people who are not working (and their partners) are at a 20% greater risk of death. They can have heart problems, become depressed and attempt suicide.  It is significant that when people return to work the psychological and psychiatric problems reverse.  Their heads get better, but if the heart has suffered......

In the UK this research evidence has now begun to filter into policy and practice.  For example, doctors no longer write 'sick notes' for people who are off work, instead they write 'fit notes'.  The focus is on what people can do rather than on what they can't.