Abstract
Background
The unemployed have higher morbidity compared to the employed. Both frequent use and the underutilization of healthcare services appear common among the unemployed, potentially leading to unmet care needs. We studied the differences in self-reported no need and unmet need for healthcare services between unemployed and employed persons and how different health-related factors were associated to these differences.
Methods
We used the Healthy Finland Survey in 2022-2023, including employed and unemployed people aged 20-64 (N = 9841). Outcomes were 1) no need for health care services and 2) unmet need for healthcare services in the previous 12 months. We used logistic regression and controlled for sociodemographic factors. Studied health-related factors included limiting long-terms illness, psychological distress, perceived functional ability, perceived work ability, social inclusion, smoking and alcohol use.
Results
The unemployed and the employed did not differ in no need for doctor or nurse (OR 1.3, 95% CI 1.0-1.7). When controlling for health-related factors, especially long-term illness and work ability, the difference increased. In the full model the OR was 1.9 (95% CI 1.3-2.6). Unemployed were more likely than employed to have unmet need for doctor or nurse (OR 2.4, 95% CI 1.9-3.0). For most of the health-related factors, especially work ability, controlling decreased the difference, whereas controlling for smoking and alcohol had little effect. In the full model the OR was 1.3 (95% CI 1.0-1.8).
Conclusions
Unemployed people may not always recognise their need for healthcare services. Their more common unmet need was mostly explained by health-related factors. In particular, poor work capacity emerged as a key factor. Effective and timely use of healthcare services is important, as delays in treatment can lead to undiagnosed or untreated illnesses. It can also lead to underutilisation of sickness benefits and thus to unmet rehabilitation needs.
Key messages
• Services should strive to meet healthcare needs of unemployed people, in order to reduce future healthcare costs and promote employment and wellbeing of this vulnerable population.
• Efforts should focus on improving the working capacity of the unemployed, for example through multidisciplinary teamwork and rehabilitation.