WORK ABILTY, PHYSICAL CAPACITY AND MUSCULOSKELETAL PAIN AS PREDICTORS OF RE-EMPLOYMENT AMONG UNEMPLOYED: FINDINGS FROM A 3 YEAR FOLLOW UP STUDY

Background: Although unemployment has been associated with many adverse health conditions, the direction of the association between unemployment and ill-health is still debated. Many studies suggest that unemployment causes ill-health (causation hypothesis). Others argue ill-health predisposed unemployed individuals from becoming re-employed (selection hypothesis). Studies in favor of selection hypothesis are still limited and have largely focused on mental and lifestyle-related health factors. Very scanty evidence exist in relation to health-based selection out of unemployment on the account of work ability, with no known studies reporting the effect of physical capacity and musculoskeletal pain. However, these health variables have been shown as important factors as far as work and employment is concerned. It would be interesting therefore, to investigate whether these factors (work ability, physical capacity and musculoskeletal pain) predicted re-employment among unemployed. Aim of the study: The main goal of the present study is to investigate whether work ability, physical capacity and musculoskeletal pain predicted re-employment among unemployed after three years of follow up. Materials and Methods: A total of 539 study sample was drawn from among unemployed individuals who were actively involved in one of the three different employment policy measures. Of this total, 265 were randomly selected as participants in an intervention program that was carried out between 2002 -2005. Half of those in the intervention program participated in a performance test offered as part of the intervention program. Data collected with questionnaires at the beginning and end of the three year follow-up from the 539 study sample, and data collected from those who participated in the performance test were used in the present study. The questionnaire comprised of data on background characteristics, work ability and musculoskeletal pain, while the performance test data was based on physical capacity measurements. Both univariate and multivariate logistic regression were used to assess the predicting effect of these health variables on re-employment at 3 years. All analyzes were carried out using SPSS version 13. Results: On univariate analysis, all health measures assessed in this study (work ability, physical capacity and musculoskeletal pain) predicted re-employment. On adjusting for age, gender, educational level and marital status, physical capacity and musculoskeletal pain (particularly leg pain) remained the only independent predictors of re-employment among unemployed after three years of follow up. In other words, unemployed subjects whose performance were better in the physical capacity test had increased likelihood of being re-employed as compared to those whose performance were poor. Similarly, those unemployed with low leg pain were nearly twice as likely to be re-employed as those who reported having high leg pain. Discussion and Conclusion: The present study showed an evidence of health-selection into unemployment on the account of physical capacity and musculoskeletal pain. More studies are, however, needed to ascertain whether these effects are common among other unemployed population groups. Asiasanat:Work ability, physical capacity, musculoskeletal pain,re-employment, unemploymen