Project

Employment states, employment transitions, and health across deprived and less deprived areas in England: causation or selection?- PhD

The associations of employment transitions, employment states, physical health across deprived and less deprived areas in England were studied. The perspectives of social causation and health selection were considered

Summary

Previous studies have found employment states or employment transitions were associated with physical health (Eshak et al. 2017; Stauder 2019). However, area differences have received less attention (Pickett and Pearl 2001). Additionally, the associations of employment states or employment transitions on physical health are difficult to clarify because of the possibility of selection bias: physical health may simultaneously affect employment states and employment transitions (Barban et al. 2017; Jusot et al. 2008). The following are the research questions for this project: 1. Do employment states or employment transitions associate with physical health? (i.e., social causation) 2. Do physical health associate with employment states or employment transitions (i.e., health selection)?

Analytic samples were drawn from wave 2 to wave 10 of Understanding Society (the University of Essex, Institute for Social and Economic Research, NatCen Social Research, Kantar Public 2020). Both employment deprivation and income deprivation were drawn from National Statistics to categorise local authority districts (Department for Communities and Local Government 2015). Fixed effect models and cross-lagged panel models were used to test hypotheses.   

Project aims/objectives  

  1. The associations of employment states and employment transitions on physical health across deprived and less deprived areas in England were investigated.
  2. The associations of physical health on employment states and employment transitions were examined across deprived and less deprived areas in England.

Project activity  

This project involved three main activities: literature review, statistical analysis, and presentations. I did a literature review from October 2020 to December 2020. Statistical analyses were performed in Stata between January 2021 to present.

Two presentations have been given. I participated in an online conference held by the School of Health and Social Care at the University of Essex by presenting a poster to show the findings of this project. I also presented the research findings in the ISER PhD seminar.

The potential or actual impact

I found that job loss (i.e., employment transitions) improved physical health among individuals in less disadvantaged areas but decreased physical health among individuals in disadvantaged areas. This main finding is different to the belief that that unemployment decreased health (Eshak et al. 2017). Differences in the nature of jobs and health-relevant resources in disadvantaged and less disadvantaged areas may explain the finding. People in deprived areas worked in manual or physically demanding jobs before being unemployed. Additionally, people who lived in less disadvantaged areas could use health resources (e.g., health services, shops to buy wholesome food with affordable prices, parks) in their residential areas (Stafford, Gimeno, and Marmot 2008).

To check the main finding, future research could test the associations of the manual job, health resources, and deprived areas to understand the distributions of job characteristics and health resources in deprived and less deprived areas. Practitioners should focus on the physical health of unemployed people who live in areas with high employment deprivation if deprived areas significantly have more manual jobs and have fewer health resources.

Papers/resources associated with this study 

Barban, N., X. de Luna, E. Lundholm, I. Svensson, and F. C. Billari. 2017. ‘Causal Effects of the Timing of Life-Course Events: Age at Retirement and Subsequent Health’. Sociological Methods & Research 49(1):216–49. doi: 10.1177/0049124117729697.

Department for Communities and Local Government. 2015. ‘English Indices of Deprivation 2015’.

Eshak, Ehab S., Kaori Honjo, Hiroyasu Iso, Ai Ikeda, Manami Inoue, Norie Sawada, and Shoichiro Tsugane. 2017. ‘Changes in the Employment Status and Risk of Stroke and Stroke Types’. Stroke 48(5):1176–82. doi: 10.1161/STROKEAHA.117.016967.

Jusot, F., M. Khlat, T. Rochereau, and C. Serme. 2008. ‘Job Loss from Poor Health, Smoking and Obesity: A National Prospective Survey in France’. Journal of Epidemiology & Community Health 62(4):332–37. doi: 10.1136/jech.2007.060772.

Kawachi, I., B. P. Kennedy, and R. Glass. 1999. ‘Social Capital and Self-Rated Health: A Contextual Analysis.’ American Journal of Public Health 89(8):1187–93. doi: 10.2105/AJPH.89.8.1187.

Pickett, K. E., and M. Pearl. 2001. ‘Multilevel Analyses of Neighbourhood Socioeconomic Context and Health Outcomes: A Critical Review’. Journal of Epidemiology & Community Health 55(2):111–22. doi: 10.1136/jech.55.2.111.

Stafford, M., D. Gimeno, and M. G. Marmot. 2008. ‘Neighbourhood Characteristics and Trajectories of Health Functioning: A Multilevel Prospective Analysis’. The European Journal of Public Health 18(6):604–10. doi: 10.1093/eurpub/ckn091.

Stafford, Mai, and Michael Marmot. 2003. ‘Neighbourhood Deprivation and Health: Does It Affect Us All Equally?’ International Journal of Epidemiology 32(3):357–66. doi: 10.1093/ije/dyg084.

Stauder, Johannes. 2019. ‘Unemployment, Unemployment Duration, and Health: Selection or Causation?’ The European Journal of Health Economics 20(1):59–73. doi: 10.1007/s10198-018-0982-2.

The University of Essex, Institute for Social and Economic, NatCen Social Research, and Kantar Public. 2020. ‘Understanding Society: Waves 2-10, 2009-2019’. UK Data Service. doi: http://doi.org/10.5255/UKDA-SN-6614-14.

Next steps

The associations of social capital, deprived areas, and physical health in England will be studied.

Recent activity

Literature review and statistical analysis

Who is involved?

Laura Ai Sim Tan

Researchers and institutions

Institute for Social and Economic Research (ISER) and School of Health and Social Care (HSC)

Contact: 

Laura Ai Sim Tan

LT18741@essex.ac.uk