Hard Times: MEDICAL MATTERS:Being out of work can be damaging to physical and psychological health but a good frame of mind can help
" Work is nature's best physician" – Galen
" Work is the curse of the drinking classes" – Oscar Wilde
IS WORK good for your health? With thousands losing their jobs here every week, what physical, psychological and social benefits might the jobless lose?
We are classified socially by the work we do. It drives many of our experiences and creates at least some of our social circle.
Employment can be mundane, repetitive and not always enjoyable, but from a broad public health perspective, work is generally good for us.
So what happens when we become unemployed? Long-term worklessness is definitely bad for health. It has been quantified as the equivalent of smoking 200 cigarettes a day. We tend to drink more when we are unemployed.
And despite the extra time on our hands, being out of a job for a long period is associated with weight gain and reduced physical exercise.
Unemployment is definitely not good for our psychological health.
It is associated with a greater incidence of self-harm, depression and anxiety. The risk of attempted suicide increases with the length of time a person is out of a job. Even the threat of redundancy causes psychological distress, while mental health improves when the person finds work again.
Some studies have found that unemployment renders young men more prone to risky health behaviours such as excessive drinking and the suicide rate is increased by a factor of 40 in young men who have been unemployed for six months.
Research from previous recessions has also found high levels of lung cancer, heart disease and accidents among the unemployed.
There is anecdotal evidence that in the immediate aftermath of mass redundancy, young fit employees use their redundancy money to move to other areas seeking work. Older and less fit men tend to remain behind and adopt a more fatalistic attitude; happy to “put their feet up”.
Long-term unemployment is associated with higher death rates from all causes and with a greater prevalence of long-standing illness. Because of this, recessionary times put greater demands on health services, with higher medical consultation rates, higher consumption of medication and more hospital admissions.
This results in a double whammy of increased demand coinciding with fewer resources as tax receipts plummet and health budgets are pared back. This comes on top of an ageing population, greater public expectation from healthcare and a growth in lifestyle diseases.
A British study into employment and health between 1973 and 1993 found a link between illness and the possibility of re-employment: only healthy men experienced a recovery in employment rates as the economic situation improved.
In particular, men with a chronic illness who worked in manual jobs were not drawn back into the labour force during the economic recovery of the late 1980s.
A trans-European study found a consistent negative relationship between unemployment and health across the continent.
In contrast to other research, it found that health inequalities between the unemployed and employed were greater among women.
This was especially true in countries where welfare systems means test unemployment benefits. More women will lose their jobs in this recession because the workforce is more feminised than it was in the 1980s. So welfare arrangements may need to become more sensitive to moderating the effects of unemployment on the health of women.
Given that we do not have the individual power to switch off the recession, is there anything we can do to protect our health?
For those who are still in a job, but petrified that it might disappear at any moment, it is important to try to switch off a cycle of negative thinking. It is all too easy to adopt a victim mentality and to overestimate how negative a situation is. In some ways the fear is worse than the event itself. Even the most catastrophic life changes cause less distress than we anticipate.
Oscar Wilde’s wry take on work may not be quite the positive thought you were looking for but it is a reminder that however much work defines us, there is a life to be led outside the confines of the “9 to 5”.
* Dr Houston is pleased to hear from readers at mhouston@irishtimes.com but regrets he is unable to reply to individual medical queries
