Scottish Longitudinal Study
Development & Support Unit

Current Projects

Project Title:

Permanent sickness, returning to employment and health

Project Number:



Frank Popham (RUHBC, University of Edinburgh)

Start Date:

Approved on 21-02-2007


The UK Government is presently reforming the benefits system for people of working age who because of ill health are economically inactive [1]. The aim of the reform is to encourage people back into the labour market. Even though the UK has seen a decline in rates of unemployment in recent years there has been a steady rise in the number of people out of work and claiming sickness benefit [2]. It is argued that there has been a diversion of the unemployed from unemployment benefit to sickness benefit particularly in areas affected most by de-industrialisation [2]. As Fotthergill argues “Scotland’s enormous number of incapacity claimants should really be interpreted as the legacy of twenty years of de-industrialisation and job destruction” [3].
While the census does not collect information on benefits, most of those out of work and receiving sickness benefit will classify themselves as being permanently sick [4]. People classified as being permanently sick nearly all report having a longstanding limiting illness [5]. Longitudinal research using the BHPS has shown that people often do recover from longstanding limiting illness [6][7] and that being in employment makes recovery most likely whilst being economically inactive makes recovery least likely [6]. The main aim of the project is to assess the health impact (both self report and mortality) of returning to employment for people who were permanently sick (the size of the SLS allowing focus on this group rather than the broader category of economically inactive).

A limited number of studies have explored the impact of welfare programmes aimed at returning the chronically sick to work but have tended not to explore socio-economic characteristics of those returning to work [8]. So additionally this study aims to describe the socio-economic circumstances of those returning to work from permanent sickness.

The main research question of the project is: Who returns to employment from permanent sickness and what is the impact on their health?

More specific questions are:

  1. What was the likelihood of working age people who were permanently sick in 1991 being in employment in 2001?
  2. Are there demographic and socio-economic differences between those who returned to work and those who had not?
  3. Were those who had returned to employment less likely to report a limiting illness in 2001 than those who had not returned?
  4. Was mortality risk (post 2001 census) lower for people who had returned to employment?
  5. Can health differences found in 3 and 4 be explained by differences highlighted in 2?


  1. Department for Work and Pensions:

  2. Beatty C, Fothergill S: The diversion from 'unemployment' to 'sickness' across British regions and districts. Regional Studies: The Journal of the Regional Studies Association 2005, 39:837-854.

  3. Fothergill S: Scotland's incapacity benefit claimants. Glasgow: Scottish Enterprise; 2006.

  4. Adams J, Holland L, White M: Changes in socioeconomic inequalities in census measures of health in England and Wales, 1991-2001. J Epidemiol Community Health 2006, 60:218-220.

  5. Norman P, Bambra C: The utility of medically certified sickness absence data as an updatable indicator of population health. Manchester: Cathie Marsh Centre for Census and Survey Research Working paper, University of Manchester; 2005.

  6. Bartley M, Sacker A, Clarke P: Employment status, employment conditions, and limiting illness: prospective evidence from the British household panel survey 1991-2001. J Epidemiol Community Health 2004, 58:501-506.

  7. Burchardt T: The dynamics of being disabled. London: Centre for Analysis of Social Exclusion Working Paper, London School of Economics; 2000.

  8. Bambra C, Whitehead M, Hamilton V: Does `welfare-to-work' work? A systematic review of the effectiveness of the UK's welfare-to-work programmes for people with a disability or chronic illness. Social Science & Medicine 2005, 60:1905-1918.

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