Does a working day keep the doctor away? A critical review of the impact of unemployment and job insecurity on health and social care utilisation

Keyi Li (), Paula Lorgelly, Sarah Jasim, Tiyi Morris and Manuel Gomes
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Keyi Li: University College London
Sarah Jasim: University College London
Tiyi Morris: University College London
Manuel Gomes: University College London

The European Journal of Health Economics, 2023, vol. 24, issue 2, No 4, 179-186

Abstract: Abstract While the negative impact of unemployment on health is relatively well established, the extent to which that impact reflects on changes in health and social care utilisation is not well understood. This paper critically reviews the direction, magnitude and drivers of the impact of unemployment and job insecurity on health and social care utilisation across different care settings. We identified 28 relevant studies, which included 79 estimates of association between unemployment/job insecurity and healthcare utilisation. Positive associations dominated mental health services (N = 8 out of 11), but not necessarily primary care (N = 25 out of 43) or hospital care (N = 5 out of 22). We conducted a meta-analysis to summarise the magnitude of the impact and found that unemployed individuals were about 30% more likely to use health services compared to those employed, although this was largely driven by mental health service use. Key driving factors included financial pressure, health insurance, social network, disposable time and depression/anxiety. This review suggests that unemployment is likely to be associated with increased mental health service use, but there is considerable uncertainty around primary and hospital care utilisation. Future work to examine the impact across other settings, including community and social care, and further explore non-health determinants of utilisation is needed. The protocol was registered in PROSPERO (CRD42020177668).

Keywords: Unemployment; Job insecurity; Health service use; Health care utilisation (search for similar items in EconPapers)
JEL-codes: I14 I18 (search for similar items in EconPapers)
Date: 2023
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DOI: 10.1007/s10198-022-01468-4

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