Living in an unhealthy neighbourhood impacts individual employment status

Abstract Objectives Individual characteristics including poor health are well-known to affect labour market participation. However, less is known on the role of health at the residential neighbourhood level. This study examines cross-sectional and longitudinal associations between neighbourhood heal...

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Main Authors: Patricia Ots, Sander K. R. van Zon, Jochen O. Mierau, Sandra Brouwer
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23345-4
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author Patricia Ots
Sander K. R. van Zon
Jochen O. Mierau
Sandra Brouwer
author_facet Patricia Ots
Sander K. R. van Zon
Jochen O. Mierau
Sandra Brouwer
author_sort Patricia Ots
collection DOAJ
description Abstract Objectives Individual characteristics including poor health are well-known to affect labour market participation. However, less is known on the role of health at the residential neighbourhood level. This study examines cross-sectional and longitudinal associations between neighbourhood health and employment status and the moderating role of individual health in the association between neighbourhood health and employment status. Methods Individual level data from the Lifelines Cohort Study (n = 137,921) was matched with full-population neighbourhood health data and registry data from Statistics Netherlands on employment status with up to 14 years of follow-up. Neighbourhood health indicators included the proportion of individuals in poor self-reported health (nHealth) and with a chronic disease (nDisease) within neighbourhoods, divided in tertiles (T1, T2, T3). Individual health included dichotomized measures of self-reported poor health (iHealth) and the presence of a chronic disease (iDisease). Employment status comprised the categories employed, unemployed, work disabled, economically inactive and early retired. Logistic and cause-specific Cox regression analyses, including interaction terms between iHealth and nHealth, were used to examine the associations with employment status. Results Poorest nHealth and nDisease tertiles were associated with higher risks of unemployment and work disability. Cross-sectional odds ratios (OR)s for nHealth T3 were: 2.22 (95% CI: 2.06─2.39) for unemployment and 1.98 (95% CI: 1.81─2.16) for work disability. Longitudinal hazard ratios (HR)s for nHealth T3 were: 1.27 (95% CI: 1.22─1.32) for unemployment and 1.59 (95% CI: 1.45─1.74) for work disability. Associations for nDisease were weaker but statistically significant. iHealth and iDisease moderated the associations but stratified analyses yielded inconclusive results. Conclusions Neighbourhood health promotion may have societal and economic benefits by extending individual’s working lives.
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spelling doaj-art-e3abc005e29d4636a77e8a9a323eba102025-08-20T04:01:47ZengBMCBMC Public Health1471-24582025-07-012511910.1186/s12889-025-23345-4Living in an unhealthy neighbourhood impacts individual employment statusPatricia Ots0Sander K. R. van Zon1Jochen O. Mierau2Sandra Brouwer3Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center GroningenDepartment of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center GroningenFaculty of Economics and Business, University of GroningenDepartment of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center GroningenAbstract Objectives Individual characteristics including poor health are well-known to affect labour market participation. However, less is known on the role of health at the residential neighbourhood level. This study examines cross-sectional and longitudinal associations between neighbourhood health and employment status and the moderating role of individual health in the association between neighbourhood health and employment status. Methods Individual level data from the Lifelines Cohort Study (n = 137,921) was matched with full-population neighbourhood health data and registry data from Statistics Netherlands on employment status with up to 14 years of follow-up. Neighbourhood health indicators included the proportion of individuals in poor self-reported health (nHealth) and with a chronic disease (nDisease) within neighbourhoods, divided in tertiles (T1, T2, T3). Individual health included dichotomized measures of self-reported poor health (iHealth) and the presence of a chronic disease (iDisease). Employment status comprised the categories employed, unemployed, work disabled, economically inactive and early retired. Logistic and cause-specific Cox regression analyses, including interaction terms between iHealth and nHealth, were used to examine the associations with employment status. Results Poorest nHealth and nDisease tertiles were associated with higher risks of unemployment and work disability. Cross-sectional odds ratios (OR)s for nHealth T3 were: 2.22 (95% CI: 2.06─2.39) for unemployment and 1.98 (95% CI: 1.81─2.16) for work disability. Longitudinal hazard ratios (HR)s for nHealth T3 were: 1.27 (95% CI: 1.22─1.32) for unemployment and 1.59 (95% CI: 1.45─1.74) for work disability. Associations for nDisease were weaker but statistically significant. iHealth and iDisease moderated the associations but stratified analyses yielded inconclusive results. Conclusions Neighbourhood health promotion may have societal and economic benefits by extending individual’s working lives.https://doi.org/10.1186/s12889-025-23345-4Neighbourhood healthUnemploymentWork disability
spellingShingle Patricia Ots
Sander K. R. van Zon
Jochen O. Mierau
Sandra Brouwer
Living in an unhealthy neighbourhood impacts individual employment status
BMC Public Health
Neighbourhood health
Unemployment
Work disability
title Living in an unhealthy neighbourhood impacts individual employment status
title_full Living in an unhealthy neighbourhood impacts individual employment status
title_fullStr Living in an unhealthy neighbourhood impacts individual employment status
title_full_unstemmed Living in an unhealthy neighbourhood impacts individual employment status
title_short Living in an unhealthy neighbourhood impacts individual employment status
title_sort living in an unhealthy neighbourhood impacts individual employment status
topic Neighbourhood health
Unemployment
Work disability
url https://doi.org/10.1186/s12889-025-23345-4
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AT jochenomierau livinginanunhealthyneighbourhoodimpactsindividualemploymentstatus
AT sandrabrouwer livinginanunhealthyneighbourhoodimpactsindividualemploymentstatus