Health care and social benefits among long-term unemployed

Abstract Background There is limited knowledge on the diverse pathways behind long-term unemployment. It is considered that impaired health may lead to exclusion from working life, and that unemployment together with financial difficulties may impair health. In this study, we identify different pathways behind long-term unemployment, and analyse differences in health care and social benefits use based on the diverse pathways. This study contributes to the early identification and supportive efforts for those in risk of labour market marginalisation. Methods Those who had been mainly unemployed in years 2020 and 2021 were identified among all working age (18 to 64 years) Finnish citizens. Register data from Statistics Finland, the Social Insurance Institution of Finland and THL were combined for the analysis. Sequence analysis was conducted for individuals with main activity information for each observation years from 2013 until 2021 (n = 72,485, age 26 to 64 in year 2021). Results Those unemployed for two years were on average 49 years of age (38% women). Five clusters were identified based on the main activity over the nine observation years: unemployed (54%), students (3%), employed (23%), inactive (10%) and those returned to unemployment (10%). Health care attendance was most frequent among those in cluster inactive. Mental health diagnoses were most common among those in clusters inactive and students. Share of those with musculoskeletal diagnoses doubled from 2013 until 2021 among the previously employed. Yearly percentage of those with sickness absence (>10 days) varied from 5 to 13% based on a cluster and a year. Share of recipients of basic social assistance was relatively stable throughout the years in all clusters being highest among inactive (50 to 60%) and lowest among students (6 to 18%). Conclusions Information on labour market background might be useful for preventive efforts and while developing services and social security for those in long-term unemployment. Key messages • There exists diverse backgrounds behind long-term unemployment. • Labour market background should be considered while developing services for those in long-term unemployment.