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The impact on health of employment and welfare transitions for those receiving out-of-work disability benefits in the UK

机译:在英国那些因失业而失业的人对就业和福利过渡的健康产生了影响

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摘要

Employment status has a dynamic relationship with health and disability. There has been a striking increase in the working age population receiving out-of-work disability benefits in many countries, including the UK. In response, recent UK welfare reforms have tightened eligibility criteria and introduced new conditions for benefit receipt linked to participation in return-to-work activities. Positive and negative impacts have been suggested but there is a lack of high quality evidence of the health impact when those receiving disability benefits move towards labour market participation. Using four waves of the UK’s Understanding Society panel survey (2009–2013) three different types of employment and welfare transition were analysed in order to identify their impact on health. A difference-in-difference approach was used to compare change between treatment and control groups in mental and physical health using the SF-12. To strengthen causal inference, sensitivity checks for common trends used pre-baseline data and propensity score matching. Transitions from disability benefits to employment (n = 124) were associated on average with an improvement in the SF12 mental health score of 5.94 points (95% CI = 3.52–8.36), and an improvement in the physical health score of 2.83 points (95% CI = 0.85–4.81) compared with those remaining on disability benefits (n = 1545). Transitions to unemployed status (n = 153) were associated with a significant improvement in mental health (3.14, 95% CI = 1.17–5.11) but not physical health. No health differences were detected for those who moved on to the new out-of-work disability benefit. It remains rare for disability benefit recipients to return to the labour market, but our results indicate that for those that do, such transitions may improve health, particularly mental health. Understanding the mechanisms behind this relationship will be important for informing policies to ensure both work and welfare are ‘good for health’ for this group.
机译:就业状况与健康和残疾有动态关系。在包括英国在内的许多国家,领取工作失能残障津贴的劳动年龄人口急剧增加。作为回应,英国最近的福利改革收紧了资格标准,并为与参加重返工作活动相关的福利接收引入了新条件。已经提出了正面和负面影响,但是当获得残障福利的人转向劳动力市场参与时,缺乏对健康影响的高质量证据。根据英国理解协会小组调查(2009-2013年)的四次调查,分析了三种不同类型的就业和福利过渡,以确定其对健康的影响。差异差异方法用于比较使用SF-12在心理健康和身体健康方面的治疗组和对照组之间的变化。为了加强因果关系推断,使用基线前数据和倾向得分匹配对常见趋势进行敏感性检查。从残疾福利到就业的过渡(n = 124)平均与SF12精神健康得分改善了5.94分(95%CI = 3.52-8.36)和身体健康得分改善了2.83分(95 CI的百分比为0.85-4.81),而残障津贴的百分比为CI(n = 1545)。过渡到失业状态(n = 153)与心理健康的显着改善(3.14,95%CI = 1.17–5.11)有关,但与身体健康无关。对于那些新的失职残障补助金,没有发现健康差异。残障补助金获得者重返劳动力市场的情况仍然很少见,但我们的结果表明,对于那些这样做的人,这种过渡可能会改善健康,尤其是精神健康。理解这种关系背后的机制对于告知政策以确保该群体的工作和福利都“有益于健康”非常重要。

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