Health and Labour Force Participation: ‘Stress’, Selection and the Reproduction Costs of Labour Power

ABSTRACTThis paper will discuss the applicability of concepts of ‘stress’ and ‘selection’ to which health researchers appealed in their attempts to explain the relationship between health and unemployment, and examine the implications of some of the major studies carried out in Europe and the USA for these competing approaches. The contradictions arising from this evidence will then be addressed with the aid of a technical advance in population statistics which allows us to test hypotheses about whether the associations between socio-demographic characteristics and mortality may be due to selective mobility of seriously ill persons into socially disadvantaged positions. It is concluded that a better understanding of the results of available studies may be reached if we avoid the dichotomy between ‘stress’ and ‘selection’, and explore whether concepts of labour market processes and the reproduction costs of labour power can throw new light on the relationship between health and patterns of labour force participation. The paper aims both to encourage health researchers to consider policy and market variables more closely, and to tempt researchers more specialised in these latter fields to apply recent advances in the understanding of the interaction between labour market and income maintenance policies to the question of how economic conditions and change may affect health.