abstract: 'Unhealthy persons are more likely to lose their jobs than those who are

  healthy but whether this is affected by recession is unclear. We asked

  how healthy and unhealthy persons fared in labour markets during

  Europe''s 2008-2010 recessions and whether national differences in

  employment protection helped mitigate any relative disadvantage

  experienced by those in poor health. Two retrospective cohorts of

  persons employed at baseline were constructed from the European

  Statistics of Income and Living Conditions in 26 EU countries. The first

  comprised individuals followed between 2006 and 2008, n = 46,085

  (pre-recession) and the second between 2008 and 2010, n = 85,786 (during

  recession). We used multi-level (individual- and country-fixed effects)

  logistic regression models to assess the relationship (overall and

  disaggregated by gender) between recessions, unemployment, and health

  status, as well as any modifying effect of OECD employment protection

  indices measuring the strength of policies against dismissal and

  redundancy. Those with chronic illnesses and health limitations were

  disproportionately affected by the recession, respectively with a 1.5-

  and 2.5-fold greater risk of unemployment than healthy people during

  2008-2010. During severe recessions (>7\% fall in GDP), employment

  protections did not mitigate the risk of job loss (OR = 1.06, 95\% CI:

  0.94-1.21). However, in countries experiencing milder recessions (<7\%

  fall in GDP), each additional unit of employment protection reduced job

  loss risk (OR = 0.72, 95\% CI: 0.58 -0.90). Before the recession, women

  with severe health limitations especially benefited, with additional

  reductions of 22\% for each unit of employment protection (AOR(female) =

  0.78, 95\% CI: 0.62 -0.97), such that at high levels the difference in

  the risk of job loss between healthy and unhealthy women disappeared.

  Employment protection policies may counteract labour market inequalities

  between healthy and unhealthy people, but additional programmes are

  likely needed to protect vulnerable groups during severe recessions. (C)

  2014 Elsevier Ltd. All rights reserved.'
affiliation: 'Reeves, A (Corresponding Author), Univ Oxford, Dept Sociol, Oxford OX1
  2JD, England.

  Reeves, Aaron; Stuckler, David, Univ Oxford, Dept Sociol, Oxford OX1 2JD, England.

  Karanikolos, Marina; McKee, Martin, London Sch Hyg \& Trop Med, ECOHOST, London,
  England.

  Karanikolos, Marina; McKee, Martin; Stuckler, David, London Sch Hyg \& Trop Med,
  European Observ Hlth Syst \& Policies, London, England.

  Mackenbach, Johan, Univ Med Ctr Rotterdam, Erasmus MC, Dept Publ Hlth, Rotterdam,
  Netherlands.'
author: Reeves, Aaron and Karanikolos, Marina and Mackenbach, Johan and McKee, Martin
  and Stuckler, David
author-email: aaron.reeves@sociology.ox.ac.uk
author_list:
- family: Reeves
  given: Aaron
- family: Karanikolos
  given: Marina
- family: Mackenbach
  given: Johan
- family: McKee
  given: Martin
- family: Stuckler
  given: David
da: '2023-09-28'
doi: 10.1016/j.socscimed.2014.09.034
files: []
issn: 0277-9536
journal: SOCIAL SCIENCE \& MEDICINE
keywords: Chronic illness; Recession; Disability; Employment protection
keywords-plus: 'PAID EMPLOYMENT; ECONOMIC-CHANGE; HEALTH-STATUS; ILL HEALTH; JOB LOSS;

  UNEMPLOYMENT; MEN; DISABILITY; MORTALITY; IMPACT'
language: English
month: NOV
number-of-cited-references: '36'
orcid-numbers: 'Mckee, Martin/0000-0002-0121-9683

  McKee, Marc D/0000-0001-8349-965X

  Reeves, Aaron/0000-0001-9114-965X

  Stuckler, David/0000-0002-1288-8401

  Karanikolos, Marina/0000-0002-3824-8226'
pages: 98-108
papis_id: 4c3d10d22c3c89d5ec0c06e9639c8c60
ref: Reeves2014doemployment
researcherid-numbers: 'Stuckler, David/H-2261-2012

  Mckee, Martin/E-6673-2018

  McKee, Marc D/E-2187-2011

  '
times-cited: '41'
title: Do employment protection policies reduce the relative disadvantage in the labour
  market experienced by unhealthy people? A natural experiment created by the Great
  Recession in Europe
type: article
unique-id: WOS:000345183900013
usage-count-last-180-days: '0'
usage-count-since-2013: '35'
volume: '121'
web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,

  Biomedical'
year: '2014'