Sustainable employment of vulnerable groups in the Netherlands

Sandra Brouwer, PhD Community and Occupational Medicine University Medical Center Groningen, Groningen, The Netherlands

1

Who are vulnerable?

“Persons with health problems” Workers on long-term sickness absence Starters at the labour market with disabilities Long-term unemployed Older workers with chronic diseases difficulties in finding and retaining work decreased (financial) protection

2

Dutch history: changes in the Dutch Social Security System

Economic situation deteriorated (‘80):

Increase in claims for disability benefits and ‘improper use’ of the Occupational Disability Insurance Act:

conditions for disability benefits were more favourable than for unemployment benefits.

Increase in work disability pensions from 1998-2003 Almost 1 million employees received disability pensions in

2000 (13% of working age population)

“Keeping the Dutch social security system affordable”

1. Prevent long-term sickness and promote return-to-work Gatekeeper Improvement Act (2002) Extension of Income Payment Act (2004)

Employer and employee responsible for RTW-process in 24 months of sickness absence

Occupational Health Services assist employer and employee

2. Decrease of influx in disability benefits Labour Capacity Act (WIA, 2006) Disability Assistance Act for Handicapped Young Persons (Wajong, 2010)

Emphasis by Social Security Institute on what they can do rather than what they cannot do

Support for finding a job and support at the work place if needed

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Conclusion: The Netherlands is successful in preventing work disability due to LBP: • a collaborative action is needed

by the stakeholders at the workplace

• encouraging RTW-activities without risk of losing benefits

J Occup Rehabil (2009)

Effect on sustainable RTW in LBP

UWV Kenniscentrum, 2011

Effect on influx disability benefits

(much) smaller group accepted for incapacity benefit. criteria for acceptance have changed……but employment rates are still low.

780000

800000

820000

840000

860000

880000

900000

920000

2006 2007 2008 2009

Employment rates are still low

Cancer survivors are 1.4 times more likely to be unemployed than healthy people (De Boer et al., 2011)

20-30% of workers with mental disorders experience

recurrent sickness absence (Arends et al., 2013)

25% of young people with disabilities find work, only

9% retain at work for >12 months (Holwerda et al., 2013)

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8

J Occup Rehab, 2011

Sickness absence rates of workers with and without chronic diseases - age

9

Sickness absence percentages of workers with chronic diseases

Sickness absence percentages of workers without chronic diseases

SCP/CBS/TNO/UWV Kenniscentrum, 2012

The challenges of ageing workforce

Inclusion of older workers and workers with a health condition or manageable chronic disease in the labor force Retirement age from 65 to 67 yrs Elimination of tax facilities for early retirement and pre-

pension arrangements

Vulnerable: decline in physical and mental health status increased prevalence of chronic health condition low educated workers

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Conclusion: Older workers with a chronic health condition (CHC) experience more problems and obstacles and report more support needs compared to ‘healthy’ older workers. This implies a work situation that facilitates and supports older workers with CHC to stay active and healthy at the labour market till reaching retirement age.

J Occup Rehab, 2013

Effectiveness of the ‘Staying healthy at work’ intervention

• No effects on primairy outcome measures: work ability, vitality and productivity

• Beneficial effect on perceived work attitude, self-efficacy and skill discretion

Wendy Koolhaas, Sandra Brouwer, Johan Groothoff, Jac van der Klink (submitted)

A problem-solving based intervention to improve sustainable employability

of ageing workers

• High satisfaction with regard to the content and relevance of the intervention

• Workers were more prepared for the dialogue with the supervisor • Increasing awareness of the workers own responsibility for actions towards

sustainable employability

In conclusion

Policy changes successfully decreased the influx in benefits /

early exit from the labour market;

The employment rates of persons receiving (partial) disability

benefits are still low

More ‘vulnerable groups’at the labour market

Evidence on effective interventions is needed (what works for

whom, when and why): return-to-work and staying-at work

Thank you for your attention