“ Health promotion for elder unemployed regarding preservation of employability and quality of life” – most needed, least promoted! Dr. Peter Kuhnert (University of Dortmund, Germany)

Current conditions for unemployed in Germany „ Workplace Health Promotion in an enlarging Europe“ is very important (Ylikoski, 2006) – but what about the unemployed and precarious employed? Only half of the German companies employs elderly people (50 years+) (Keuler, 2005) Trend to go on pension very early and a “focus on youth” (Naegele & Reichert, 2005) Discrepancy between the official “elderly-friendly” positions and the consequent exclusion strategy within the companies (Bäcker, 2003) Up to date only few projects contributed to an improvement of job opportunities for the elderly (Eichenhorst & Sprouß, 2005)

„ Workplace Health Promotion in an enlarging Europe“ is very important (Ylikoski, 2006) – but what about the unemployed and precarious employed?

Only half of the German companies employs elderly people (50 years+) (Keuler, 2005)

Trend to go on pension very early and a “focus on youth” (Naegele & Reichert, 2005)

Discrepancy between the official “elderly-friendly” positions and the consequent exclusion strategy within the companies (Bäcker, 2003)

Up to date only few projects contributed to an improvement of job opportunities for the elderly (Eichenhorst & Sprouß, 2005)

Current conditions for unemployed in Germany 50-60 year old long-term unemployed reached a re-employment rate of 24% - compared to a group using the “usual official channel” only 5% (Bröker & Schöning, 2005) Qualification programmes in Germany lack psycho-social counselling in general although complex cases of problems of unemployed increase (Kuhnert & Kastner, 2006) Stabilising Groups can help to strenghten resources since the acceptance for this kind of group offers is rather high (58,7%) within the target group (Kuhnert, 2007) Community psychology orientation can re-establish vitality and confidence, a community related health promotion improved e.g. psycho-social well-being significantly (Sickendiek, Engel & Nestmann,2002; Collins&Benedict, 2006; Yaggy et al., 2006) Incidence probability for a disease was lower when livelihood was not constantly threatened and friends and neighbours were not excluding or dooming (Starrin & Jönsson, 2006)

50-60 year old long-term unemployed reached a re-employment rate of 24% - compared to a group using the “usual official channel” only 5% (Bröker & Schöning, 2005)

Qualification programmes in Germany lack psycho-social counselling in general although complex cases of problems of unemployed increase (Kuhnert & Kastner, 2006)

Stabilising Groups can help to strenghten resources since the acceptance for this kind of group offers is rather high (58,7%) within the target group (Kuhnert, 2007)

Community psychology orientation can re-establish vitality and confidence, a community related health promotion improved e.g. psycho-social well-being significantly

(Sickendiek, Engel & Nestmann,2002; Collins&Benedict, 2006; Yaggy et al., 2006)

Incidence probability for a disease was lower when livelihood was not constantly threatened and friends and neighbours were not excluding or dooming (Starrin & Jönsson, 2006)

Current conditions for unemployed in Germany Prevention can delay age morbidity (up to 10 years) in 50 to 65 year old unemployed, who are neglected target group up to now (Altgeld et al., 2006; Klein & Semman; Tiemann; Brehm & Sygusch, 2003) Elderly unemployed who are high underrepresented in health-sports-programmes benefit from special health-sport offers which were especially created for little-moving persons More tangible steps towards a coping with everyday life like e.g. „interchange circles“ (Tauschringe) are important for a positive self-esteem of unemployed people (Krebs, 2005; Potreck-Rose & Jacob, 2003) Proved protective factors against psychic and addiction diseases like: experienced social support, good social and communication skills, optimism and humour, active coping strategies and meanigfullness ( Southwick et al. 2006)

Prevention can delay age morbidity (up to 10 years) in 50 to 65 year old unemployed, who are neglected target group up to now (Altgeld et al., 2006; Klein & Semman; Tiemann; Brehm & Sygusch, 2003)

Elderly unemployed who are high underrepresented in health-sports-programmes benefit from special health-sport offers which were especially created for little-moving persons

More tangible steps towards a coping with everyday life like e.g. „interchange circles“ (Tauschringe) are important for a positive self-esteem of unemployed people (Krebs, 2005; Potreck-Rose & Jacob, 2003)

Proved protective factors against psychic and addiction diseases like: experienced social support, good social and communication skills, optimism and humour, active coping strategies and meanigfullness ( Southwick et al. 2006)

Demands for unemployed in Germany Study with 20.000 unemployed shows: 40% of the unemployed need a debt counselling almost 30% an intensive health and family counselling 20% have insufficient abilities of writing, reading and calculating According to our social code long-term unemployed are to receive qualifications within the employment opportunities – up to now this is hardly implemented (Schwendy, 2004)

Study with 20.000 unemployed shows:

40% of the unemployed need a debt counselling

almost 30% an intensive health and family counselling

20% have insufficient abilities of writing, reading and calculating

According to our social code long-term unemployed are to receive qualifications within the employment opportunities – up to now this is hardly implemented (Schwendy, 2004)

Leisure- and health relevant aspects for more employability for elderly people (50 plus) Study of the University of Dortmund: long-term unemployed (N=229) with lively leisure time activities (intensive hobbies) have significant better mental health and coping strategies (Kuhnert, 1999) Positive as well as negative leisure time activities (TV, alcohol, pets, sexual intercourse, etc.) buffer effect of negative experiences (Kleiber, Hutchinson & Williams, 2002) Humour allows to refrain from stressors (Kuhnert, 2007), including ability to see something from at least two perspectives and have a new perception of negative experiences (McGhee, 1996)

Study of the University of Dortmund: long-term unemployed (N=229) with lively leisure time activities (intensive hobbies) have significant better mental health and coping strategies (Kuhnert, 1999)

Positive as well as negative leisure time activities (TV, alcohol, pets, sexual intercourse, etc.) buffer effect of negative experiences (Kleiber, Hutchinson & Williams, 2002)

Humour allows to refrain from stressors (Kuhnert, 2007), including ability to see something from at least two perspectives and have a new perception of negative experiences (McGhee, 1996)

„ Lack of perspective is my illness“ Former long-term unemployed (more than 7 years) on average 55 years old working in temporary job-creating-schemes (ABM) improved psychological complaints (depression, sleep disorders, nervousness) but increase in the end of employment (Lauenroth & Swart, 2005) Future prospects are an important determent of health – “Lack of perspective is my illness” (Long-term unemployed, 50+)

Former long-term unemployed (more than 7 years) on average 55 years old working in temporary job-creating-schemes (ABM) improved psychological complaints (depression, sleep disorders, nervousness) but increase in the end of employment (Lauenroth & Swart, 2005)

Future prospects are an important determent of health – “Lack of perspective is my illness” (Long-term unemployed, 50+)

Results of selected European Studies East-German study: 0 (!) % of long-term unemployed older than 50 years believed in getting a job in the first labour market West-German study: 65% of long-term unemployed evaluated their vocational future extremely negative, 2/3 had great fears to fail in their vocation (Kuhnert, 1999) Swiss evaluation study: missing cooperation of different services of the agencies for employment and public health authorities complicate the development of health relevant support for unemployed and precarious employed (Kuhnert, 2007) Finnish study: unemployed with a low income have the highest health risk (Virtanen et al., 2003) Australian study: especially job insecurity intensifies the risk of fear- and depression affections (D’Souza et al., 2003)

East-German study:

0 (!) % of long-term unemployed older than 50 years believed in getting a job in the first labour market

West-German study:

65% of long-term unemployed evaluated their vocational future extremely negative,

2/3 had great fears to fail in their vocation (Kuhnert, 1999)

Swiss evaluation study:

missing cooperation of different services of the agencies for employment and public health authorities complicate the development of health relevant support for unemployed and precarious employed (Kuhnert, 2007)

Finnish study:

unemployed with a low income have the highest health risk (Virtanen et al., 2003)

Australian study:

especially job insecurity intensifies the risk of fear- and depression affections (D’Souza et al., 2003)

Problems in health counselling of unemployed At least 30% of unemployed have physical or psychological problems Long-term unemployed have more severe restraints - e.g. Burn-Out-Syndrome is much more frequent in these groups (41%) than within employees in public service (6,5%) (Wüstner, 2005) - studies of the University of Dortmund even find percentages of 40-50% ( Kuhnert & Kastner, 2006)

At least 30% of unemployed have physical or psychological problems

Long-term unemployed have more severe restraints

- e.g. Burn-Out-Syndrome is much more frequent in these groups (41%) than within employees in public service (6,5%) (Wüstner, 2005)

- studies of the University of Dortmund even find percentages of 40-50% ( Kuhnert & Kastner, 2006)

New issues in health counselling health related counselling with 50-60 year-old unemployed can decrease morbidity rate (delay for one decade approx.) Altgeld et al., 2006, S. 21) Dortmund: sports-programmes succesfully evaluated for unemployed have been especially designed for people with little affinity to movement (“Koko”-Sport) (Tiemann, Brehm & Sygusch, 2003) A future domain of counselling will be the „Working Poor“, who constitute a major part of 1,8 million Germans living in concealed poverty (Hans-Böckler-Stiftung, 2006)

health related counselling with 50-60 year-old unemployed can decrease morbidity rate (delay for one decade approx.) Altgeld et al., 2006, S. 21)

Dortmund: sports-programmes succesfully evaluated for unemployed have been especially designed for people with little affinity to movement (“Koko”-Sport) (Tiemann, Brehm & Sygusch, 2003)

A future domain of counselling will be the „Working Poor“, who constitute a major part of 1,8 million Germans living in concealed poverty (Hans-Böckler-Stiftung, 2006)

New issues in health counselling Multicomponent programmes: individual and life-related counselling different intervention forms participation of target-groups  promises best outcomes for persons with multiple problems Target-group-participation: e.g. senior employees help senior unemployed in Sweden (Schmugge, Künzi & Guggisberg, 2007) voluntary addiction councelors help integrate unemployed substance-abusers in their groups in Dortmund (expert interview, March 2007)

Multicomponent programmes:

individual and life-related counselling

different intervention forms

participation of target-groups

 promises best outcomes for persons with multiple problems

Target-group-participation:

e.g. senior employees help senior unemployed in Sweden

(Schmugge, Künzi & Guggisberg, 2007)

voluntary addiction councelors help integrate unemployed substance-abusers in their groups in Dortmund (expert interview, March 2007)

Thank you for your attention! Contact: Dr. Peter Kuhnert, University of Dortmund, T. 0049-231-755-4114/6570 [email_address]

Thank you for your attention!

Contact:

Dr. Peter Kuhnert, University of Dortmund,

T. 0049-231-755-4114/6570

[email_address]

Possible questions for the further discussion! Workshop: How do you think could the problem of acquisition be solved? (unemployed people with the greatest need, but who are inactive, isolated and/or uninterested) Which management-strategies could improve the cooperation of the different actors of the work- and health sector? Which method of intervention do you think is the most successful? (e.g. motivational interviewing, stress management) Which positive and/ or negative experiences do you have in respect to specific topics? Which institutional barriers exist in your country? Which characteristics have to be considered when working with this target group (50+)?

Workshop:

How do you think could the problem of acquisition be solved? (unemployed people with the greatest need, but who are inactive, isolated and/or uninterested)

Which management-strategies could improve the cooperation of the different actors of the work- and health sector?

Which method of intervention do you think is the most successful? (e.g. motivational interviewing, stress management)

Which positive and/ or negative experiences do you have in respect to specific topics?

Which institutional barriers exist in your country?

Which characteristics have to be considered when working with this target group (50+)?