Intended for healthcare professionals


Relation between socioeconomic status, employment, and health during economic change, 1973-93

BMJ 1996; 313 doi: (Published 24 August 1996) Cite this as: BMJ 1996;313:445
  1. Mel Bartley, senior visiting research fellowa,
  2. Charlie Owen, research officerb
  1. a Social Statistics Research Unit, City University, London EC1V 0HB
  2. b Thomas Coram Research Unit, Institute of Education, University of London, London WC1H 0AA
  1. Correspondence to: Dr Bartley.
  • Accepted 11 April 1996


Objective: To investigate the association between the national unemployment rate and class differences in the relation between health and employment during the period 1973-93.

Design: Data from general household surveys, 1973-93. Comparison of rates of employment, unemployment, and economic inactivity among those with and without limiting longstanding illness in different socioeconomic groups and how these varied over 20 years.

Subjects: All men aged 20-59 years in each survey between 1973 and 1993.

Main outcome measures: Change over time in class specific rates of employment, unemployment, and economic inactivity in those with and without limiting longstanding illness.

Results: Men in socioeconomic groups 1 and 2 with no longstanding illness experienced little decrease in their chances of being in paid employment as the general unemployment rate rose. Those most affected were men in manual groups with limiting longstanding illness. The likelihood of paid employment was affected far less by such illness in non-manual than in manual groups. In group 1 about 85% of men with such illness were in paid employment in 1979 and 75% by 1993; in group 4 the equivalent proportions were 70% and 40%. In men in manual groups with limiting longstanding illness there was no sign of employment rates rising again as the economy recovered.

Conclusion: Socioeconomic status makes a large difference to the impact of illness on the ability to remain in paid employment, and this impact increases as unemployment rises. Men with chronic illness in manual occupations were not drawn back into the labour force during the economic recovery of the late 1980s.


  • Funding The work reported in this paper was carried out at the Thomas Coram Research Unit as part of a study funded by the Economic and Social Research Council, grant number R000 23 1774.

  • Conflict of interest None.

  • Accepted 11 April 1996
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