Arbeitslosigkeit und Gesundheit : ein Überblick über empirische Befunde und die Arbeitslosen- und Krankenkassenstatistik (Unemployment and health : an overview of empirical findings and the unemployment and health insurance statistics)

"Compared with the employed, unemployed people show a clearly poorer health condition. This is substantiated by representative surveys and by the statistics of the health insurance companies in Germany. International meta-analyses show that long-lasting unemployment does not only correlate with mental illnesses but can also cause or aggravate them. In the official unemployment statistics about a quarter of the unemployed have health-related problems that affect placement. In the routine report procedures of the medical service of the Federal Employment Service (Bundesanstalt für Arbeit) in 2001 'mental illnesses and behavioural disorders' were diagnosed the most frequently after 'illnesses of the muscular-skeletal system'. However, the proportion of unemployed people with health problems is systematically underestimated in the unemployment statistics. As a result of the outflows of unemployed people who are unfit for work and other special groups from the stock, selection effects and artefacts occur in the statistics. In 2001 approximately 76,000 recipients of unemployment benefit or unemployment assistance who were unable to work for health reasons were not counted in the annual average. As a result of the remarks made by the placement officers in the applicant offers, social-medical reports and certificates of incapacity for work, health-related data are available for a large number of unemployed people. The information remains fragmentary, however, and the sources of data are not linked. At the same time unemployed people are taken insufficiently into account in the health reports of the individual health insurance companies and in the national statistics covering all types of health insurance. In addition to this, unemployed people are neglected as a target group for prevention and health promotion. A vicious circle is beginning to emerge for unemployed individuals with health problems, as they have poorer chances of being reintegrated into the labour market and are in greater danger of becoming long-term unemployed. It is therefore essential to develop approaches to health promotion that take the labour market into account. By intensifying the prevention idea in the catalogue of tasks of the health insurance companies and by introducing 'profiling' and 'case management' in the Job-AQTIV law, new opportunities could arise for unemployed people with health problems." (Author's abstract, IAB-Doku) ((en))