Keeping the unemployed healthy: the effect of means-tested and entitlement benefits in Britain, Germany, and the United States

Am J Public Health. 2001 Sep;91(9):1403-11. doi: 10.2105/ajph.91.9.1403.


Objectives: Although considerable evidence about the health effects of unemployment exists, little is known about the possible protective effects of various social interventions. This study examined the role that means-tested and entitlement programs could have in ameliorating the health impact of unemployment in Britain, Germany, and the United States.

Methods: Logistic regression models were used to analyze panel data from Britain (1991-1993), Germany (1991-1993), and the United States (1985-1987) available in the Household Panel Comparability Project database. The analysis included 8,726 respondents from Britain, 11,086 from Germany, and 11,668 from the United States. The health-dependent variable used was a single measure of perceived health status.

Results: Evidence was found of differences in perceived health status between groups of unemployed people characterized by the types of benefits they receive. When socioeconomic characteristics and previous health and employment status are controlled for, means-tested benefits do not seem sufficient to reduce the impact of unemployment on health.

Conclusions: Monitoring the possible health effects of changes in public assistance benefits should be given priority in the research and political agenda.

Publication types

  • Comparative Study
  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude to Health
  • Germany
  • Health Promotion / organization & administration*
  • Health Services Research
  • Health Status*
  • Humans
  • Insurance Benefits*
  • Linear Models
  • Logistic Models
  • Longitudinal Studies
  • Medical Assistance / organization & administration*
  • Program Evaluation
  • Social Security / organization & administration*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Unemployment* / statistics & numerical data
  • United Kingdom
  • United States