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16.10.2015 1
EMPLOYMENT, HEALTH, AND WELL-BEING.
SOME EVIDENCE FROM THE PALTAMO EMPLOYMENT MODEL EVALUATION
EU-HEMP workshop seminar, LSE, London / Lars Leemann
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 2
Municipality of Paltamo
Before the start of the Paltamo Employment Model:
• Population: 3998 (31. 12. 2008, declining)
• Unemployment rate: 18.9% (Jan. 2009)
• Project duration: 2009 – 2013
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 3
Aims of the Paltamo Full-Employment Project
• to offer all jobseekers paid employment and concentrate social security to those who are not capable of working,
• to intensify cooperation with jobseekers to find employment,
• to improve social participation and to increase health and well-being,
• to provide occupational health care services to the jobseekers,
• to study, how many jobseekers continuously depend on an intermediate labour market,
• to compare the impacts of the full-employment model to current labour market policies.
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 4
Project Evaluation A)
Effects on health and well-being
(THL)
B)
Impacts on rehabilitation
(THL)
C)
Employment of persons over 50
(THL)
D)
Experienced well-being
(University of Lapland)
E)
Youth employment
(Kela)
F)
Process evaluation
(Kajanoja)
G)
Self-evaluation of the labour force
centre
H)
Shifts in income and incentives
(THL)
I)
Economical impacts
(VATT)
J)
Developing the evaluation model
Research coordination
(THL)
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 5
Project Evaluation A)
Effects on health and well-being
(THL)
B)
Impacts on rehabilitation
(THL)
C)
Employment of persons over 50
(THL)
D)
Experienced well-being
(University of Lapland)
E)
Youth employment
(Kela)
F)
Process evaluation
(Kajanoja)
G)
Self-evaluation of the labour force
centre
H)
Shifts in income and incentives
(THL)
I)
Economical impacts
(VATT)
J)
Developing the evaluation model
Research coordination
(THL)
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 6
Research Focus
• Physical health
• Dental health
• Mental well-being
• Functional capacity
• Alcohol use disorders, substance abuse, smoking
• Nutritional behaviour
• Social exclusion
• Use of services
• Life quality
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 7
Research Design
• Unemployed of Paltamo to be compared with two control groups:
• Experimental group: Unemployed of Paltamo (per 31. 12. 2008, n = 292)
• Control groups: Employed of Paltamo (fitted sample, n = 313) Unemployed of Sonkajärvi (per 31. 12. 2008, n = 295)
• Total N 900
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 8
Research Design
• Data collection: 2009/2010: Baseline (beginning of the project) 2010/2011: Halftime 2012: close to end of the project
• Combination of interviews, questionnaires, medical check-ups, cognitive tests, and register data
• Panel data for 3 points of time
• “Intention-to-Treat” panel regression models
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 9
Key Findings
• The unemployed of Paltamo formed an heterogeneous group, i.e. there is a considerable polarisation for some indicators.
• Health and well-being were substantially poorer among Paltamo’s unemployed than Paltamo’s employed for most indicators.
• Sonkajärvi’s unemployed often took a middle position between the Paltamo groups.
• Many of these differences persisted over the evaluation period.
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 10
Key Findings
Over the evaluation period, Paltamo’s unemployed…
• … decreasingly reported back pains.
• … reduced regular use of painkillers.
• … changed to healthier eating habits.
• … reduced risky alcohol usage.
• … started to use health care services more often.
• … exhibited increasing trust towards local policy making and local media.
• … felt themselves less and less lonely and increased their participation in social activities.
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 11
Example: Mental Health
Share of persons scoring high on the General Health Questionnaire (GHQ-12; cut-off: 4 points or more; %):
Statistical significance:
Differences between groups:
All groups, all times: p < 0.0001***
Pto. unempl. vs. empl. 2009: p < 0.0001***
Pto. unempl. vs. Skj. 2009: p = 0.0589˚
Differences over time:
All groups: p = 0.0870˚
Pto unempl. 2009-2012: p = 0.5133
Differential development:
All groups: p = 0.5849
Pto. unempl. vs. empl. 2009-2012: p = 0.3626
Pto. unempl. vs. Skj. 2009-2012: p = 0.7672
Työttömät Työttömät Vertailuryhmä
0
10
20
30
40
2009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 12
Example: Health Behaviour
Share of persons reporting risky alcohol use (AUDIT-C; cut-off: women 5 or more, men 6 or more points; %):
Statistical significance:
Differences between groups:
All groups, all times: p = 0.0620˚
Pto. unempl. vs. empl. 2009: p = 0.0145*
Pto. unempl. vs. Skj. 2009: p = 0.8265
Differences over time:
All groups: p = 0.5155
Pto unempl. 2009-2012: p = 0.0332*
Differential development:
All groups: p = 0.1894
Pto. unempl. vs. empl. 2009-2012: p = 0.0325*
Pto. unempl. vs. Skj. 2009-2012: p = 0.1009
Työttömät Työttömät Vertailuryhmä
0
10
20
30
40
50
602009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 13
Example: Social Exclusion
Share of persons actively taking part in interest groups or clubs (%):
Statistical significance:
Differences between groups:
All groups, all times: p = 0.6365
Pto. unempl. vs. empl. 2009: p = 0.0570˚
Pto. unempl. vs. Skj. 2009: p = 0.2259
Differences over time:
All groups: p = 0.2903
Pto unempl. 2009-2012: p = 0.0015**
Differential development:
All groups: p = 0.0158*
Pto. unempl. vs. empl. 2009-2012: p = 0.0023**
Pto. unempl. vs. Skj. 2009-2012: p = 0.1509
Työttömät Työttömät Vertailuryhmä
0
10
20
30
40
50 2009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 14
Example: Social Exclusion
Share of persons feeling themselves often or all the time lonely (%):
Statistical significance:
Differences between groups:
All groups, all times: p = 0.0554˚
Pto. unempl. vs. empl. 2009: p = 0.0008***
Pto. unempl. vs. Skj. 2009: p = 0.0430*
Differences over time:
All groups: p = 0.4789
Pto unempl. 2009-2012: p = 0.0414*
Differential development:
All groups: p = 0.3270
Pto. unempl. vs. empl. 2009-2012: p = 0.1824
Pto. unempl. vs. Skj. 2009-2012: p = 0.1993
Työttömät Työttömät Vertailuryhmä
0
5
10
15
20
25
302009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 15
Example: Use of Services
Share of persons using occupational health care services within the last 12 months (%):
Työttömät Työttömät Vertailuryhmä
0
10
20
30
40
50
60
2009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
Statistical significance:
Differences between groups:
All groups, all times: p = 0.0017**
Pto. unempl. vs. empl. 2009: p = 0.0027**
Pto. unempl. vs. Skj. 2009: p = 0.8704
Differences over time:
All groups: p = 0.4058
Pto unempl. 2009-2012: p = 0.0004***
Differential development:
All groups: p = 0.0234*
Pto. unempl. vs. empl. 2009-2012: p = 0.0035**
Pto. unempl. vs. Skj. 2009-2012: p = 0.0061**
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 16
Example: Use of Services
Share of persons reporting a consultation with a public health care physician within the last 12 months (%):
Työttömät Työttömät Vertailuryhmä
0
20
40
60
80
1002009 2010 2012
Paltamo Sonkajärvi Paltamo
Unemployed
Paltamo
Unemployed
Sonkajärvi
Employed
Paltamo
Statistical significance:
Differences between groups:
All groups, all times: p < 0.0001***
Pto. unempl. vs. empl. 2009: p = 0.0005***
Pto. unempl. vs. Skj. 2009: p = 0.2714
Differences over time:
All groups: p < 0.0001***
Pto unempl. 2009-2012: p = 0.0161*
Differential development:
All groups: p = 0.0008***
Pto. unempl. vs. empl. 2009-2012: p = 0.2240
Pto. unempl. vs. Skj. 2009-2012: p = 0.0004***
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 17
Outlook
• Post-intervention follow-up 2015-2017: Currently a fourth data collection is getting underway, realisation in winter 2015/16, restriction to major indicators and Paltamo groups due to budget limitations.
• Deepening analyses: Stronger focus on re-employment (i.e. dynamic groups), more socioeconomic control variables, and possible mediators. Funding is currently not secured.
16.10.2015 EU-HEMP workshop seminar, LSE, London / Lars Leemann 18
End of Presentation
• Both baseline and final report available online (in Finnish but with English abstracts): www.julkari.fi ( search “Paltamo”)
• Thank you very much!
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