Transcript EVALUATION

Work and Wellbeing
Professor Ewan Macdonald OBE
University of Glasgow
But what is Work?
Its not only being in a paid job with 6 months full
pay and 6 months half pay

Paid employment

Self Employment

Voluntary work

Carer

Homemaker

Child rearing

Full time/ part-time

Community activities, clubs, church

Etc
ALL OF THE ABOVE ARE BENEFICIAL TO SOCIETY AND THE
INDIVIDUAL PROVIDED THEY HAVE ENOUGH MONEY
Jimmy - Road Worker case study
Jimmy – a 45 year old
distribution worker

Contractor

Irritant dermatitis

Minimal health and
safety

Back injury in past

Osteoarthritis of
spine,shoulders ,
elbows and knees

No eye protection

No ear muffs

Early noise induced
hearing loss

6 visits to accident
and emergency

Vibration white finger

One hand fracture

Several Eye injuries
in past

Getting a bit past it
Jimmy

Average housing

Left school with no
qualifications

Poor diet, not much
fruit, veg or fish

Jobs on building sites

Frequently does
overtime

Sometimes in informal
economy

Few of his employers
have occ health and
safety resource

4 pints of beer a
night (occas drink at
lunchtime)

20cigs a day

No leisure exercise
Jimmy

Separated lives with
partner and two
stepchildren

Has been on
courses to use
power tools

Two children by first
wife

No other education

Reads paper
occasionally

Has home
computer-on
internet

Financial problems

Child care issues
Jimmy

He has an accident – pipe rolled on leg
fracture of right tibia and fibula

Taken to hospital – transferred to
orthopaedics – surgery, plated , discharged
on crutches after two days (superb treatment)

No record of job in the hospital notes

No physiotherapy

Gets Fit note “unfit”

No guidance about rehabilitation
Jimmy

Rests at home, watches TV (gets depressed)

Progresses to walking with a stick

Wasting of quadriceps (50%) and reduction in power
both legs, pain at fracture site

After six weeks starts physiotherapy – once per week
for six weeks

Pain and weakness still a problem, Family doctor
advises job will be too much for him

Follow up hospital appointment – no discussion about
work
Jimmy - Options

Probably dismissed within 4 weeks

Friendly with the boss – given job
driving the dump truck

Goes on to long term Health Benefit
(ESA) after six months
Sickness Related Benefits Growth 1979 2005
Facts about Incapacity Benefit in
Scotland (Brown, Hanlon, Macdonald et al, J. Pub.Health 2008)

2.5% of Working age population go on to IB
each year (3.5% in Glasgow)

55-59 yr old males – 18% on IB (35% in
Glasgow, 60% in districts)

Mental Health problems cause 50% of IB

10 years ago main cause was
musculoskeletal
Rate of
IB receipt
by MSP
Constituency
2008
Scottish Observatory
for Work & Health
http://www.gla.ac.uk/
departments/hwlgroup/
Age standardised mortality (Men)
per 100,000
Relationship between mortality (age/sex standardised rates
per 100,000 population) and deprivation (as measured by the
Scottish Index of Multiple Deprivation)
Work and Inequality

Your status is determined by having
a job and the level of that job

Your job (or jobless) level determines
your life expectancy

Your job (or jobless) level determines
how long you will survive the same
medical condition
Work is good for you

“Overall the beneficial effects of work
outweigh the risks of work, and are
greater than the harmful effects of longterm unemployment or prolonged
sickness absence. Work is generally
good for health and well-being”

Waddell and Burton 2006
What else do we know about
being out of work?

Unemployment is bad for you:
– Loss of Income¹
– Destructive on self-respect¹
– Risks of ill-health²
– The “psychosocial scar” persists³
– Trans-generational effects
1.
2.
3.
4.
Winkelmann and Winkelmann 1996
Clark, Georgellis, Samfey 2001
Clark and Oswald 1996
Aylward 2006
Long-term worklessness is one of the
greatest known risks to public health

Health Risk = smoking 10 packs of cigarettes per day (Ross
1995)

Suicide in young men > 6 months out of work is increased
40 x (Wessely, 2004)

Suicide rate in general increased 6x in longer-term
worklessness (Bartley et al, 2005)

Health risk greater and life expectancy worse than many
“killer diseases” (Waddell & Aylward, 2005)

Greater risk than most dangerous jobs (construction/North
Sea)
The Scottish Healthy Working Lives
paradigm 2003 (Macdonald E, Docherty G. 2007)
 “A healthy working life is one that
continuously provides working age people
with the opportunity ability support and
encouragement to work in ways and in an
environment which allows them to sustain
and improve their health and well being. It
means that individuals are empowered and
enabled to do as much as possible, for as
long as possible, or as long as they want, in
both their working and non working lives”
Self Reported Health from British Household
Panel Survey
0
.2
.4
.6
.8
Self-Reported Health by Economic Group in Scotland
Employed
Workless
Excellent/Good
Scottish Observatory for Work and Health, University of Glasgow
(Data Source: BHPS)
Incapacity Benefit
Less than Good
BHPS Study
0
.1
.2
.3
.4
.5
Self-Reported Health by Economic Group
Employed
Workless
Excellent
Good
Poor
Very Poor
Incapacity Benefit
Fair
Scottish Health Survey Study
Employment status and education, SHS 2003
% of claims in each economic group
50
40
30
20
10
0
Employed
Unemployed
Economic Group
Degree or higher
No qualifications
Economically Inactive
In Scotland
Worklessness is the single
most important cause of health
inequality, social exclusion,
deprivation , and mortality