The effect of health on refugees’ labor market integration: Evidence from a natural experiment in Germany

This paper analyzes the role of health for refugees' integration into host countries' labor markets. We exploit the quasi-random dispersal policies of refugees across regions in Germany to analyze the causal effect of health on employment. Based on regional and temporal heterogeneity in a policy adoption that provided earlier access to healthcare services through electronic health cards (eHCs), combined with the regional availability of healthcare services and pre-migration health status, we construct instrumental variables (IVs) providing plausibly exogenous variation in refugees' post-arrival health status. Our results reveal that favorable physical health (PCS) improves refugees' employment probability. Favorable mental health (MCS) increases only females' employment rates, although this effect must be scrutinized due to weak instruments. Regarding potential mechanisms, we provide evidence that better health increases language course participation and German language proficiency for female refugees.

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Publication Details

Journal
PLoS ONE
Published
2026-04-20
DOI
https://doi.org/10.1371/journal.pone.0346936
Primary Topic
Migration, Health and Trauma
Type
article
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article

The effect of health on refugees’ labor market integration: Evidence from a natural experiment in Germany

Philipp Jaschke, Yuliya Kosyakova, Laura Goßner
PLoS ONE
Migration, Health and Trauma
article

The effect of health on refugees’ labor market integration: Evidence from a natural experiment in Germany

Philipp Jaschke, Yuliya Kosyakova, Laura Goßner
article en

Abstract

This paper analyzes the role of health for refugees' integration into host countries' labor markets. We exploit the quasi-random dispersal policies of refugees across regions in Germany to analyze the causal effect of health on employment. Based on regional and temporal heterogeneity in a policy adoption that provided earlier access to healthcare services through electronic health cards (eHCs), combined with the regional availability of healthcare services and pre-migration health status, we construct instrumental variables (IVs) providing plausibly exogenous variation in refugees' post-arrival health status. Our results reveal that favorable physical health (PCS) improves refugees' employment probability. Favorable mental health (MCS) increases only females' employment rates, although this effect must be scrutinized due to weak instruments. Regarding potential mechanisms, we provide evidence that better health increases language course participation and German language proficiency for female refugees.

PLoS ONEVol. 21(4)
Institut für Arbeitsmarkt und Berufsforschung (DE), Federal Employment Agency (DE), University of Bamberg (DE)
Reduced inequalities
Openalex Percentile: Top 9%
Migration, Health and Trauma
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The effect of health on refugees’ labor market integration: Evidence from a natural experiment in Germany — Philipp Jaschke, Yuliya Kosyakova, et al. · PLoS ONE (2026) | TGRS Research Map | TGRS