Work can have a positive impact on health. It brings with it not only financial stability, but also personal contentment; it provides social connections as well as opportunities for growth and development. The relationship between health and work is complex – work affects health and health affects work (Public Health England (PHE), 2019).
Unemployed people are more than five times as likely to have poor health as employees. Only 33% of unemployed people reported their health as either ‘very good’ or ‘excellent’, compared with 48% of people in employment (Tinson, 2020). Unemployment can be defined as a situation where people of working age are without a job, but would like to be in employment. A local area's employment rate is correlated to life expectancy (how long people are likely to live) and healthy life expectancy (how many years they can expect to live, enjoying good health). In those places with higher economic inactivity (less affluence), people are more likely to have a lower healthy life expectancy.
It has been consistently shown that unemployment has a negative impact on a range of health outcomes. There are associations between unemployment and self-rated health, with worse outcomes for men as well as those who are unemployed due to health reasons. These consequences are improved when individuals have strong social networks. There are similar relationships between unemployment and mental health, for example, depression, anxiety and levels of self-esteem (Wilson and Finch, 2021).
Unemployment may cause harm to health in a variety of ways. Being unemployed can bring with it stress, which may ultimately have a physiological impact. This may be because of the stress of losing the structure of work, the difficulties associated with seeking new work or the stigma associated with unemployment. The harm to mental health caused by unemployment can result in unhealthy coping behaviours, for example, smoking or an increase in alcohol consumption. Unemployment may also result in a reduction in overall financial resources, leaving people with less to spend on essential items. It can harm future employment outcomes, leaving people with a lower earning potential and as such lower future resources.
Low-quality work (poor job satisfaction, job wellbeing, job autonomy, job security and pay) can affect employees' health. Low-quality work can be just as bad for a person's health as unemployment. This can be as a result of workplace hazards and poor work conditions, as well as the stress and anxiety that can be caused by a lack of control or autonomy, job insecurity or insufficient income due to low pay. More people with a measure of low job quality report having worse health than those without one. The quality of work should not negatively affect a person's health; minimum employment standards should ensure this, through measures such as enforcement and regulation. Employers have to be made more aware of how work affects health, to improve their understanding and to encourage better job design (PHE, 2019).
Nurses need to be aware that employment and economic inactivity levels are both related to healthy life expectancy for men and women. There is a positive correlation between an area's employment rates and a person's healthy life expectancy. That suggests there is some association at an area level between health and employment. It should be noted that this relationship can go both ways: unemployment can cause harm to health and poor health can make it harder for people to find or sustain employment. Policies that are proposed to improve health have the potential to increase employment rates, while policies designed to boost access to, and the availability of good-quality work, may also contribute to better health outcomes. Work matters.