What we know
What information do we have about the Eastern Board area?
What is the result of this on our health locally?
Policies
What is happening in the Eastern Board area?
References

Unemployment puts health at risk, and the risk is higher in regions where unemployment is widespread. Evidence from a number of countries shows that, even allowing for other factors, unemployed people and their families suffer a substantially increased risk of premature death. The health effects of unemployment are linked to both its psychological consequences and the financial problems it brings – especially debt. The health effects start when people feel their jobs are threatened, even before they actually become unemployed. This shows that anxiety about security is also detrimental to health. Job insecurity has been shown to increase effects on mental health, self-reported ill-health, heart disease and risk factors for heart disease. Because very unsatisfactory or insecure jobs can be as harmful as unemployment, merely having a job will not always protect physical and mental health. (WHO, 2003)

Employment is intrinsically linked to who we are and how we feel about ourselves. Being in secure employment is usually beneficial to health as it provides a sense of purpose and achievement, social contact and status. Research has also suggested that our physical wellbeing is linked to whether we are meaningfully occupied. (Ross & Mirowsky)

The link between poverty and ill health was established in the Black Report (1980). The report showed that the unemployed suffer worse mental and physical health than those in work. Unemployment can lead to poverty, ill health and premature death.

The Acheson Report (1998) highlighted three areas of importance:

	All policies likely to have an impact on health should be evaluated in terms of their impact on health inequalities
	A high priority should be given to the health of families with children
	Further steps should be taken to reduce income inequalities and improve the living standards of poor households

The physical health of the unemployed deteriorates. Unemployed people and their families suffer a much higher risk of premature death. The British Regional Health Study indicates a greater use of tranquilisers and more prevalence of smoking and drinking among the unemployed, leading to increased rates of poor health. Ill health is known to increase with the length of unemployment.

Unemployment also causes a great deal of psychological distress as shown by increased rates of suicide. The unemployed suffer higher levels of relative depression, as do their partners. The New Deal, retraining schemes and various Government initiatives designed to increasing employability are aimed at tackling some of these problems. However, reducing unemployment is complex and requires long term intersectoral working along with significant funding.

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In the Eastern Board area there were almost 20,000 unemployed in 2001, 4.10% of the Eastern Board population. Census figures indicate that men represent a higher proportion of unemployed people in the Eastern Board area with 5.57% of men in the Eastern Board area unemployed compared to a figure of 2.57% for women.

The Eastern Board area is diverse in relation to income deprivation and unemployment. It contains some of the most and least income deprived areas in Northern Ireland. The levels of unemployment in the Belfast travel to work area have fallen dramatically in recent years reflecting the improvement in the local economy. In Northern Ireland the unemployment rate has fallen from just under 20% in 1984 to 4.14% in 2001. Unemployment or even the threat of unemployment has been shown to adversely affect health. Improvements in local employment rates should result in better health status for those in work, but many people still remain in long-term unemployment.

The link between health and unemployment has been illustrated with the 2001 Census figures which show that in the Eastern Board area, of those people who describe themselves as having a long standing illness, 30% are unemployed and 46% economically inactive.

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Investing for Health provides a framework for action to improve health and well-being and reduce inequalities in Northern Ireland. It indicates that those who are not in secure employment or unemployed are more likely to become depressed or anxious and experience social exclusion.

Areas in the Eastern Board area vary dramatically in relation to unemployment. In 2001, for example, the proportion of unemployed in Belfast was 5.41%, higher than the overall Northern Ireland figure of 4.14%. In particular, the areas of North and West Belfast have significant unemployment rates with the 2001 census indicating that 6.05% and 7.81% respectively of people aged 16-74 are unemployed. In contrast the proportion of unemployed in the Castlereagh area was 2.53%. Those in insecure employment or unemployed are more likely to die prematurely than those in secure, rewarding jobs.

NISRA’s 2001 Health and Social Wellbeing Survey shows that in Northern Ireland, unemployed people are almost twice as likely to show signs of a possible mental health problem (30%) as those in employment (16%). In the Eastern Board these figures are similar with 28% of unemployed and 16% of employed people experiencing mental health problems. Unemployed people in the Eastern Board area are almost 5 times as likely as those in employment to report their health as not good (28% compared with 6%).

Low income has a major impact on health not only arising from material deprivation but also from the social and psychological problems of living in poverty. Relative poverty as well as absolute poverty has been shown to lead to poor health and increased risk of early death. The implications of this for Health and Personal Social Services include ensuring that barriers to accessing services by people with low income are removed, strategies to ensure uptake of benefits are in place for those entitled to them and the needs of people on low income are taken into account when planning preventative and treatment services.

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