Why employment is important to population health, and how hospitals can help.

Ross and Mirowsky found that health is improved when individuals are employed (1995). Ross and Mirowsky conducted a study that was done over one year using a survey which showed that the health of those who were employed did not change in the year, while those who were not employed showed a significant decline (1995). Therefore, over time, those who are not employed will see significant impacts to their health (Ross & Mirowsky, 1995). An obvious benefit that impacts health through employment is being paid. This affects health as those without employment may not be able to afford various necessities such as treatments, medicine, nutritious food and rent (Ross & Mirowsky, 1995).

In a study conducted by St. Michael’s Hospital, the researchers looked into how healthcare organizations can help individuals to find a job with the aim of improving the individual’s health (Gajic, 2018). Through their literature review, they found that when health care organizations helped individuals find employment, 51% of individuals were successfully able to secure jobs (Gajic, 2018). The five factors that they found through their research to be helpful with assisting individuals to find employment were (Gajic, 2018):

    1. An intervention team composed of individuals who worked in employment services and healthcare who would work closely with the patient to understand their employment needs.
    2. Various services offered for patients to help them when applying for jobs such as: networking events, expert advice, helping patients search for jobs, and mentors.
    3. One-on-one meetings with the patient to tailor to their individual needs and skills.
    4. Interventions that addressed other social determinants of health, such as access to transportation, and not just employment.
    5. An intervention team that are involved with employers and had open communication with employers to ensure that both the patients needs, such as accommodations, and employers needs were met.

Hospitals helping those in precarious employment situations is a way to help improve patient social determinants of health and patient outcomes. Adler and Stead found that being able to identify social determinants of health early through an EHR would be able to improve patient outcomes, and population health (2015). Outcomes improved as hospitals and clinicians tailored services for patients for their specific needs such as an employment care-management program, and provided better preventative care (Adler & Stead, 2015). Lastly, the benefits and improvements to patients’ health from assessing and addressing patients social determinants is projected to also reduce costs due to there a lower health service utilization (Adler & Stead, 2015).

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Adler, N. E. & Stead, W. W. (2015). Patients in Context – EHR Capture of Social and Behavioral Determinants of Health. The New England Journal of Medicine, 372(8), 698-701. Retrieved from https://www-nejm-org.libaccess.lib.mcmaster.ca/doi/pdf/10.1056/NEJMp1413945

Gajic, A. (2018, September 10). Prescribing employment: Study identifies key features of interventions to help patients get jobs. Retrieved from http://www.dfcm.utoronto.ca/news/prescribing-employment-study-identifies-key-features-interventions-help-patients-get-jobs

Ross, C. E., & Mirowsky, J. (1995). Does employment affect health? Journal of Health and Social Behavior, 36(3), 230-43. doi:http://dx.doi.org.libaccess.lib.mcmaster.ca/10.2307/2137340