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Factors associated with differences in perceived health among German long-term unemployed.

Limm H, Heinmüller M, Liel K, Seeger K, Gündel H, Kimil A, Angerer P - BMC Public Health (2012)

Bottom Line: Unemployment is associated with reduced physical and psychological well-being.Perceived health is an important factor influencing health outcomes as well as successful returns to work.Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Am Hochsträß 8, D-89081, Ulm, Germany. heribert.limm@uni-ulm.de

ABSTRACT

Background: Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons.

Methods: Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health.

Results: The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models.

Conclusions: Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market setting and some of the socio-demographic and health behavior variables. Further research is needed to determine risk factors leading to reduced perceived health in the unemployed. The strong association between mental health and perceived health suggests interventions targeting mental health are urgently needed to positively influence perceived health, a key determinant of individuals' chances to successfully return to work.

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Mean (95% CI) SF-12 scores by problematic health status.
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Figure 1: Mean (95% CI) SF-12 scores by problematic health status.

Mentions: As is illustrated in Figure 1, the mean physical and mental SF-12 scores were significantly lower in the group of participants with problematic mental health statuses (participants with a HADS-Anxiety ≥8 and/or HADS-Depression ≥8). These results were confirmed in the multiple linear regression models presented in Table 2. According to HADS, problematic mental health status was the factor most strongly correlated with both dimensions of perceived health. After adjusting for all other variables in the model, problematic mental health status led to an estimated reduction in the physical and mental SF-12 scores of 4.9 and 12.7 points, respectively. The other independent variables included in the age-sex adjusted final regression model for perceived physical health were BMI, which was negatively associated with perceived physical health; and, setting. After adjusting for all other variables in the model, there was an estimated reduction of 3.2 points in the SF-12 physical component score for unemployed persons recruited from the job centers as opposed to the secondary labor market.


Factors associated with differences in perceived health among German long-term unemployed.

Limm H, Heinmüller M, Liel K, Seeger K, Gündel H, Kimil A, Angerer P - BMC Public Health (2012)

Mean (95% CI) SF-12 scores by problematic health status.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3403995&req=5

Figure 1: Mean (95% CI) SF-12 scores by problematic health status.
Mentions: As is illustrated in Figure 1, the mean physical and mental SF-12 scores were significantly lower in the group of participants with problematic mental health statuses (participants with a HADS-Anxiety ≥8 and/or HADS-Depression ≥8). These results were confirmed in the multiple linear regression models presented in Table 2. According to HADS, problematic mental health status was the factor most strongly correlated with both dimensions of perceived health. After adjusting for all other variables in the model, problematic mental health status led to an estimated reduction in the physical and mental SF-12 scores of 4.9 and 12.7 points, respectively. The other independent variables included in the age-sex adjusted final regression model for perceived physical health were BMI, which was negatively associated with perceived physical health; and, setting. After adjusting for all other variables in the model, there was an estimated reduction of 3.2 points in the SF-12 physical component score for unemployed persons recruited from the job centers as opposed to the secondary labor market.

Bottom Line: Unemployment is associated with reduced physical and psychological well-being.Perceived health is an important factor influencing health outcomes as well as successful returns to work.Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Ulm, Am Hochsträß 8, D-89081, Ulm, Germany. heribert.limm@uni-ulm.de

ABSTRACT

Background: Unemployment is associated with reduced physical and psychological well-being. Perceived health is an important factor influencing health outcomes as well as successful returns to work. This study aims to determine the extent to which perceived health correlates with mental health, various health risk characteristics and socio-demographic characteristics in a setting-selected sample of long-term unemployed persons.

Methods: Using SF-12, 365 long-term unemployed persons were assessed for self-perceived health and various socio-demographic and health characteristics. Perceived health data of the sample was compared to the German SF-12 reference population. Bivariate analyses and multiple linear regression models were applied to identify those variables significantly associated with perceived health.

Results: The study population reported poorer perceived health compared with the general population. Analyses showed that perceived mental health was significantly worse in women, among persons with heightened depression and anxiety scores, and in participants reporting reduced levels of physical activity. Perceived physical health was significantly lower among older persons, participants with a higher BMI, and participants with heightened depression and anxiety scores. Both mental and physical health were worse among the unemployed assigned to an employment center as compared to those engaged in the secondary labor market. In total, 36% of the variance in the SF-12 mental score and 20% of the variance in the SF-12 physical score were explained by the factors included in the final multiple linear regression models.

Conclusions: Perceived health among a select group of long-term unemployed is reduced to a clinically relevant extent compared to the general population. The preliminary findings underline an association between mental health and perceived health. Negative self-perceptions of health were also associated with the labor market setting and some of the socio-demographic and health behavior variables. Further research is needed to determine risk factors leading to reduced perceived health in the unemployed. The strong association between mental health and perceived health suggests interventions targeting mental health are urgently needed to positively influence perceived health, a key determinant of individuals' chances to successfully return to work.

Show MeSH
Related in: MedlinePlus