Identifying population groups at risk of a very weak experience of social inclusion in Finland

Abstract Background The experience of social inclusion (ESI) is an important part of psychosocial wellbeing and has significant public health implications. ESI includes aspects of agency, belonging, social support, meaningfulness, and trust, which may facilitate healthier behaviors. Previous studies also showed that ESI helps individuals to cope with difficult life situations, such as protecting adolescents from anxiety during the COVID-19 pandemic. Our study aimed to identify population groups with a high prevalence of very weak ESI. Methods We used data from the 2019 FinSote survey representative of the Finnish population aged 20 + (n = 5943). ESI was measured using the Experiences of Social Inclusion Scale (ESIS), with scores below 50 indicating very weak ESI. Logistic regression was used to calculate gender and age-adjusted odds ratios (OR). Other variables included marital status, labor market position (LMP), education, self-rated health (SRH), work ability, and functional capacity. Results Particularly work-related variables were strongly associated to ESI. Among the employed, 7.7% had very weak ESI, compared to 24.5% among the unemployed. The OR for unemployed job seekers was 4.2 (95% CI 2.9-6.2), and for those on disability pension 4.3 (95% CI 2.5-7.3) compared to the employed. Respondents with reduced work ability had an OR of 3.4 (95% CI 2.7-4.4) and those with lower SRH 2.7 (95% CI 2.2-3.5). In the full model with all variables, the effects of gender, age, marital status, LMP, work ability, and SRH remained significant (Wald p < 0.05), indicating independent effects. Conclusions Work life participation, health, and work ability are crucial for ESI. Vulnerable groups, such as the unemployed, people on disability pension, and those with reduced work ability or low SRH, have a particularly high prevalence of very weak ESI. Timely and targeted interventions to strengthen ESI in these groups are advised to prevent further healthcare costs and improve overall public health. Key messages • Exclusion from work life, impaired health and reduced work ability are detrimental for ESI, which is crucial for wellbeing and a resource for future health outcomes. • From a public health perspective, targeted interventions for vulnerable groups such as the unemployed or disabled can strengthen ESI. This can be seen as an investment to reduce healthcare costs.