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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1997 Jun;51(3):283–288. doi: 10.1136/jech.51.3.283

Effect of labour market conditions on reporting of limiting long-term illness and permanent sickness in England and Wales.

R Haynes 1, G Bentham 1, A Lovett 1, J Eimermann 1
PMCID: PMC1060474  PMID: 9229058

Abstract

STUDY OBJECTIVE: To identify any bias in the reporting of limiting long term illness and permanent sickness due to labour market conditions, and show the absence of the effect in mortality rates. DESIGN: A geographically based study using data from the 1991 census. Standardised ratios for mortality and long term illness in people aged 0-64 years and permanent sickness in people of working age were compared with Carstairs deprivation scores in multilevel models which separated the effects operating at three geographical scales: census wards, travel to work areas, and standard regions. Holding ward and regional effects constant, variations between travel to work areas were compared with long term unemployment rates. SETTING: Altogether 8690 wards and 262 travel to work areas in England and Wales. MAIN RESULTS: Variations in mortality, limiting long term illness, and permanent sickness were related to Carstairs deprivation scores and standard region. With these relationships controlled, limiting long term illness and permanent sickness were significantly related to long term unemployment levels in travel to work areas, but mortality was not affected. Self reported morbidity was more sensitive to variations in long term unemployment rates in conditions of high social deprivation than in affluent populations. CONCLUSIONS: Limiting long term illness and permanent sickness measures may reflect a tendency for higher positive response in difficult labour market conditions. For average social deprivation conditions, standardised limiting long term illness for people aged 0-64 years was 20% higher in travel to work areas where employment prospects were relatively poor compared with areas with relatively good employment prospects. This casts doubt on the use of limiting long term illness as an indicator of objective health care needs for resource allocation purposes at national level.

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Selected References

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  1. Bartley M. Unemployment and ill health: understanding the relationship. J Epidemiol Community Health. 1994 Aug;48(4):333–337. doi: 10.1136/jech.48.4.333. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bentham G., Eimermann J., Haynes R., Lovett A., Brainard J. Limiting long-term illness and its associations with mortality and indicators of social deprivation. J Epidemiol Community Health. 1995 Dec;49 (Suppl 2):S57–S64. doi: 10.1136/jech.49.suppl_2.s57. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Brennan M. E., Clare P. H. The relationship between mortality and two indicators of morbidity. J Epidemiol Community Health. 1980 Jun;34(2):134–138. doi: 10.1136/jech.34.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Brenner M. H., Mooney A. Unemployment and health in the context of economic change. Soc Sci Med. 1983;17(16):1125–1138. doi: 10.1016/0277-9536(83)90005-9. [DOI] [PubMed] [Google Scholar]
  5. Carstairs V., Morris R. Deprivation, mortality and resource allocation. Community Med. 1989 Nov;11(4):364–372. [PubMed] [Google Scholar]
  6. Jarman B. Underprivileged areas: validation and distribution of scores. Br Med J (Clin Res Ed) 1984 Dec 8;289(6458):1587–1592. doi: 10.1136/bmj.289.6458.1587. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Morris R., Carstairs V. Which deprivation? A comparison of selected deprivation indexes. J Public Health Med. 1991 Nov;13(4):318–326. [PubMed] [Google Scholar]
  8. Parson D. O. The male labour force participation decision: health, reported health and economic incentives. Economica. 1982;49(193):81–91. [PubMed] [Google Scholar]
  9. Smith P., Sheldon T. A., Carr-Hill R. A., Martin S., Peacock S., Hardman G. Allocating resources to health authorities: results and policy implications of small area analysis of use of inpatient services. BMJ. 1994 Oct 22;309(6961):1050–1054. doi: 10.1136/bmj.309.6961.1050. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Smith R. "I'm just not right": the physical health of the unemployed. Br Med J (Clin Res Ed) 1985 Dec 7;291(6509):1626–1629. doi: 10.1136/bmj.291.6509.1626. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Whiteside N. Unemployment and health: an historical perspective. J Soc Policy. 1988 Apr;17(2):177–194. doi: 10.1017/s0047279400016627. [DOI] [PubMed] [Google Scholar]

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