Labour market participation of people with work limitations due to health problems Data from the EU Labour Force Survey Belgium and the Regions April 2016 Erik Samoy
2
Labour market participation of people with work limitations due to health problems Belgium and the Regions 20111
What is the Labour Force Survey The European Union Labour Force Survey is conducted in the 28 Member States of the European Union (EU-28) and in a few other countries. It is a large household sample survey providing quarterly results on labour participation of people aged 15 and over, as well as on persons outside the labour force. The target population is composed of people living in private households, excluding those living in collective households or in institutions. The national statistical institutes are responsible for selecting the sample, preparing the questionnaires, conducting the face-to-face interviews with households, and forwarding the results to the statistical office of the European Union Eurostat. Health and Disability in the Labour Force Survey Standard EU LFS questionnaires do not contain questions on health or disability. However, each year a special block of questions or so-called “ad hoc module” is used to obtain more detailed information on a specific subject. In 2011 (second quarter) the module topic was health and disability. Countries may of course ask questions about this topic on other occasions than the EU module, but few do so. This may be because they don’t want to lengthen the standard interviews or because they want to avoid being pressured towards adding questions about other topics. However we strongly advocate the inclusion of at least one disability variable in all LFS questionnaires because an individual's labour market position is determined as much, if not more, by health or disability than by sex, age or education. This appears also from the module data. Many of the questions in the disability module are used to define a target group of people with a long-standing health condition or disease in order to allow for comparison of this group with the other respondents on the core variables of the LFS. To that end respondents are asked to indicate their most important and second most important long-standing health problem or disease in a fixed list of 18 items. They are also asked whether they have problems performing 10 listed activities of daily living (ADLs) and whether they experience limitations in the amount of work (i.e. the number of hours) or the type of work they could do or in getting to and from work. Based on the lists of health problems and of ADL problems and on the 3 work-related limitations, a group of people with work limitations (PWL) caused by a long-standing health condition or an ADL problem” is identified.2
1 Special thanks are due to Lina Waterplas, sociologist, for her comments on this text. 2 “Definition 4 of Disability: People limited in work (LIMHOURS, LIMTRANS or LIMTYPEW) because of health condition (HEALTHMA) or basic activity difficulty (DIFFICMA)”. Eurostat, Statistical analysis and publication of the results of the 2011 Labour Force Survey ad hoc module on employment of disabled people. Report of work carried out by Eurostat. (draft) 2015, p. 95. http://doc.ukdataservice.ac.uk/doc/7688/mrdoc/pdf/ahm2011_evaluation_report.pdf
3
Because these item lists are time consuming to administer, it is unpractical to incorporate them in all the LFS questionnaires. A possible alternative is to ask a single general question, as is done in Belgium in every LFS. But does this lead to the same results and, if not, is the difference acceptable? Could a single short question do the trick? Evidence from Belgium In Belgium, every LFS questionnaire contains the following general question: “Are you hampered in your daily activities (whether or not work-related) by a disability, a long-standing health condition or disease (related to work or not)? Yes, severely, Yes, to some extent, No.” 3 When the disability module was included in the LFS in 2011 (2nd quarter) the standard question about being hampered in daily activities preceded the module. As appears from Table 1, this question does not capture the same population as the module questions containing a list of health or ADL problems. In reply to the general question, 15.2% of people aged 15-64 report to be hampered in their daily activities by a disability or health problem. When presented with item lists, one person out of four (24.8%) claims to have a longstanding health problem and/or an ADL problem, i.e. 10 percentage points more. Analysis also reveals that the population with ADL problems on the basis of the list question and those who are hampered (general question) differ considerably although their numbers are close (13.9 % vs 15.2%). Table 1. Size of target groups according to different criteria (Belgium, 15-64) Ad hoc module At least one long-standing health problem (list of 18 problems) At least one ADL problem (list of 10 activities) At least one health problem and/or ADL problem Work limitations General question on disability, health condition or disease* Severely hampered Hampered to some extent Total hampered
% 23.6 13.9 24.8 13.2 7.9 7.2 15.2
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc module LFS 2nd quarter 2011.
As can be seen in Table 2, 13.2% of the respondents report limitations in work. The overlap with the general question about feeling hampered (yes answers on both criteria) is 11.0%; non-overlap is 6.4%. (Cohen’s kappa: 0.744). It can be concluded that, although the general question and the (constructed) variable “limitations in work” do not measure exactly the same reality, the divergence is small enough to allow for the substitution of one by the other for practical reasons. 3 Original question in Dutch: “Ervaart U in uw dagelijkse bezigheden (op het werk of daarbuiten) hinder door een handicap, een langdurige aandoening of een langdurige ziekte (al dan niet werkgerelateerd)? Ja, in erge mate, Ja, in zekere mate, Neen” and in French : “Vous sentez-vous entravé(e) dans vos activités quotidiennes (au travail ou en dehors) en raison d’un handicap, d’une affection ou d’une maladie de longue durée (lié ou non au travail) ? Qui, considérablement, Oui, un peu, Non.” 4 Cohen’s kappa is a statistic measuring agreement between observers of the same issue, normalized / corrected for chance agreement. A Cohen’s kappa above 0.4 is considered acceptable and above 0.6 good.
4
Table 2. Feeling hampered and work limitations (total percentages) Hampered (general question) yes no Work limitations yes 11.0 2.2 no 4.2 82.6 Total % 15.2 84.8
Total 13.2 86.8 100.0
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc module LFS 2nd quarter 2011.
Based on our analysis, we recommend to include a general question in every LFS questionnaire. We do not claim that the Belgian question on being hampered in daily activities is the best one imaginable. Asking people whether they are hampered in their work might be an even better proxy for limitations in work, but this cannot be tested using the 2011 database. Another option is to combine the general question with questions about limitations in work. We did this using the 2011 database to construct a new variable, Work limitations 2, identifying those hampered in daily activities who experience at least one problem in the amount or the type of work they can do or in getting to and from work. As a result the 15.2% of people feeling hampered were reduced to 11.0% feeling hampered and having at least one work limitation. Table 3. Belgian respondents (15-64) by work limitations and work limitations 2 (total %) Work limitations 2 yes no Total Work limitations yes 11.0 2.2 13.2 no 0.0 86.8 86.6 Total % 11.0 89.0 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc module LFS 2nd quarter 2011.
Because both variables make use of the same work limitation criteria the agreement between the measurements is very high (Cohen’s kappa: 0.90). The work limitations 2 measurement is a good option because it is easy to administer. No need to go through long lists of health and ADL problems. In their study of eleven measurements of disability, including subjective, administrative and functional ones, Molden and Tøssebro (2010) found that subjective definitions yield widely diverging disability prevalence, ranging from less than 5% to more than 30% in EU countries.5 Using a constructed variable such as work limitations only slightly reduces this variation, from 6.7% to 22.2% (see Table 29). However, as appears from Belgian data, within a single country even a subjective measure such as the general question remains stable and reliable over the years. Nonetheless, to measure work disability, we recommend to add some questions on specific work limitations.
5
Molden, T. H., J. Tøssebro (2010) Measuring disability in survey research : Comparing current measurements within one data set. ALTER, European Journal of Disability Research n° 4, 174-189.
5
Results from the 2011 LFS module for Belgium and the Regions Characteristics of people with work limitations In what follows, we present the results of the 2011 module with a focus on “people with work limitations�. As a reminder, this is a constructed category based on a cluster of questions from the 2011 module: the questions on health and on ADL problems and the three work-related questions: limitation in the type of work and the amount of work and in transportation from and to work. People fall in this category when they have a health problem and/or a problem in at least one ADL activity and at least one problem in their work or, when inactive, a problem to find a job. The figures in all the following tables are weighted and are therefore not as precise as they appear. Absolute numbers are rounded to the nearest thousand. Table 4. People with work limitations in Belgium and the Regions (15-64) Brussels Capital Flemish Region Walloon Region % 13.5 12.6 14.4 N 97 000 509 000 313 000
Belgium 13.2 919 000
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc module LFS 2nd quarter 2011.
As can be seen in Table 4, people with work limitations represent 13.2% of the Belgian population aged 15-64 (just above 900 000 persons). In Flanders, the percentage is 12.6%, in Brussels-Capital 13.5% and in the Walloon Region 14.4%. More than half (54%) are women. In Flanders 56% are women and in the Walloon Region and in Brussels-Capital 50%. Table 5. People with or without work limitations by age and region (15-64) Brussels Capital Flemish Region Walloon Region Belgium Age E x p e r i e n c i n g w o r k l i m i ta t i o n s Yes No Yes No Yes No Yes No 15-19 2.4 8.7 2.2 9.7 1.2 10.7 1.9 9.9 20-24 3.7 10.9 2.7 10.0 3.0 10.7 2.9 10.3 25-29 4.9 13.4 3.6 10.1 4.6 9.9 4.0 10.4 30-34 5.9 14.6 6.9 10.1 5.4 10.1 6.3 10.5 35-39 10.5 12.1 6.3 10.1 7.7 10.6 7.2 10.5 40-44 14.8 10.5 9.4 11.3 10.5 10.7 10.3 11.0 45-49 12.2 9.8 13.8 11.6 13.2 10.7 13.4 11.1 50-54 17.7 7.6 16.2 10.7 15.8 9.9 16.2 10.1 55-59 13.4 7.1 19.8 8.7 19.3 8.6 19.0 8.5 60-64 14.4 5.3 19.0 7.8 19.3 8.0 18.6 7.6 Total % 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total N 97000 619000 509000 3544000 313000 187000 919000 6032000 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc module LFS 2nd quarter 2011.
As appears from Table 5, the people with work limitations are much older than the rest of the population : more than half are over 50, compared to a quarter among the rest of the population and less than 5% are under 25, compared to 20%. Their age distribution is similar in Flanders and the Walloon region (mean = 40.2 vs 39.9). In Brussels-Capital the population is somewhat younger (mean = 38). 6
Table 6 shows that people with work limitations have a much lower level of education than the rest of the population. The largest share with a low level of education is to be found in Brussels-Capital. Table 6. People with or without work limitations by level of education and region (15-64) Brussels Capital Flemish Region Walloon Region Belgium Education E x p e r i e n c i n g w o r k l i m i ta t i o n s level Yes No Yes No Yes No Yes No Low 60.5 33.4 48.5 25.6 54.6 31.7 51.9 28.3 Medium 23.2 26.4 34.4 41.5 32.5 37.3 32.6 38.7 High 16.3 40.2 17.0 32.9 12.9 31.0 15.5 33.1 Total % 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total N 97000 619000 509000 3544000 313000 1869000 919000 6032000 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium – A hoc module LFS 2nd quarter 2011.
As appears from Table 7, more than half of the people with work limitations have an official recognition of a disability. Table 7. People with work limitations with an official recognition of a disability (15-64) by region Brussels Capital Flemish Region Walloon Region Belgium Official recognition of a disability Yes 50.7 60.6 56.2 58.0 No 49.3 39.4 43.8 42.0 Total % 100.0 100.0 100.0 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 8 shows that in Belgium, the Flemish Region and Brussels Capital amongst people born outside of the EU-15 or the 12 new Members States (EU27) there are more people with work limitations than among the people born in Belgium. However this is not the case in the Walloon region. Table 8. People with or without work limitations (PWL) by country of birth and region (15-64) Belgium Country of birth Belgium EU-15 New EU MS6 Other Total PWL Yes 13.0 14.3 06.0 15.5 13.2 No 87.0 85.7 94.0 84.5 86.8 total % 100.0 100.0 100.0 100.0 100.0 N 5860000 374000 96000 620000 6950000 Flemish Region Country of birth Belgium EU-15 New EU MS Other PWL Yes 12.4 16.0 08.4 13.9 12.6 No 87.6 84.0 91.6 86.1 87.4 total % 100.0 100.0 100.0 100.0 100.0 N 3628000 136000 44000 245000 4052000 6
The new Member States (MS) are: Bulgaria, Cyprus, Czech Republic, Estonia, Hungary, Latvia,
Lithuania, Malta, Poland, Romania, Slovakia, Slovenia.
7
PWL total
PWL total
Yes No % N
Belgium 14.5 85.5 100.0 1868000
Yes No % N
Belgium 12.0 88.0 100.0 364000
Walloon Region Country of birth EU15 New EU MS 15.0 05.2 85.0 94.8 100.0 100.0 144000 12000 Brussels-Capital Country of birth EU15 New EU MS 10.7 03.7 89.3 96.3 100.0 100.0 95000 40000
Other 12.9 87.1 100.0 159000
14.4 85.6 100.0 2182000
Other 19.1 80.9 100.0 217000
13.5 86.5 100.0 715000
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
It appears from table 9 that the household situation of people with work limitations is very different from that of the rest of the population: they are much more often living alone or with a partner without children, and much less often with their parents. The latter is probably related to the different age structure. Table 9. People with or without work limitations by household situation (15-64) Living (with) Brussels Capital Flemish Region Walloon Region Belgium E x p e r i e n c i n g w o r k l i m i ta t i o n s Yes No Yes No Yes No Yes No Alone 24.0 20.9 18.5 9.2 23.8 11.1 20.9 11.0 Partner no 11.2 11.5 28.8 17.7 21.2 13.9 24.3 15.9 children Partner 1 child Partner 2 children Partner 3 children Head one- parent family With parents Other Total %
10.5 15.9 10.6 11.9
9.1 9.8 8.8 9.3
13.8 9.4 5.1 7.7
13.4 14.9 6.5 6.6
9.6 7.5 5.0 14.4
9.5 13.8 8.4 9.0
12.0 9.4 5.6 10.4
11.7 14.0 7.3 7.6
8.1 7.8 100.0
19.5 11.1 100.0
7.0 9.8 100.0
20.8 11.0 100.0
6.5 12.0 100.0
21.9 12.4 100.0
6.9 10.3 100.0
21.0 11.5 100.0
Total N 97000 619000 509000 3544000 313000 1869000 919000 6032000 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 10 shows that most people with work limitations have at least one ADL problem. There is not much difference between the regions.
8
Table 10. People with work limitations according to ADL problems (15-64) ADL-problem Brussels Flemish Walloon Belgium Capital Region Region Yes 80.2 78.9 77.5 78.5 No 19.8 21.1 22.5 21.5 Total % 100.0 100.0 100.0 100.0 N 97000 509000 313000 919000 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
In Tables 11 to 14 we take a closer look at the long-standing health problems of people with work-limitations. LFS respondents could name more than one problem, but the tables only show the problem they considered to be most important as far as the impact on their everyday life was concerned. As a reminder, “long-standing” means that the health condition or disease has lasted or is likely to last for at least six months. For the sake of clarity, the data for Belgium and for each region are presented in separate tables. Table 11. Most important long-standing health problem of people with work limitations (15-64) - Belgium - 2011 * N % Problems with back or neck (which includes arthritis or rheumatism) 276000 30.0 Problems with legs or feet (which includes arthritis or rheumatism) 105000 11.4 Problems with arms or hands (which includes arthritis or rheumatism) 85000 9.3 Heart, blood pressure or circulation problems 63000 6.8 Cancer 46000 5.0 Depression 41000 4.4 Mental handicap / intellectual disability : light , moderate or severe 38000 4.1 Chest or breathing problems, including asthma and bronchitis 31000 3.4 Other mental, nervous or emotional problems 31000 3.3 Diabetes 28000 3.0 Stomach, liver, kidney or digestive problems 24000 2.6 Severe headache such as migraine 16000 1.7 Other progressive illnesses (which include multiple sclerosis, HIV, 15000 1.7 Alzheimer's disease, Parkinson’s disease) Chronic anxiety 10000 1.1 Epilepsy (including fits) (9000) (1.0) Skin conditions, including allergic reactions and severe disfigurement (7000) (0.7) Learning difficulties (reading, spelling or math disability) (5000) (0.6) Other long-standing health problems 90000 9.8 Total 919 000 100.0 * Figures below 10 000 are bracketed because they are too small to be statistically reliable. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
9
Table 12. Most important long-standing health problems of people with work limitations (15-64) - Brussels Capital 2011 * N % Problems with back or neck (which includes arthritis or rheumatism) 17000 17.9 Problems with legs or feet (which includes arthritis or rheumatism) 11000 11.8 Problems with arms or hands (which includes arthritis or rheumatism) (9000) (9.7) Diabetes (9000) (9.2) Heart, blood pressure or circulation problems (8000) (8.3) Depression (7000) (7.6) Mental handicap / intellectual disability : light , moderate or severe (5000) (5.0) Cancer (5000) (4.7) Stomach, liver, kidney or digestive problems (4000) (4.5) Other mental, nervous or emotional problems (3000) (2.8) Severe headache such as migraine (3000) (2.6) Chest or breathing problems, including asthma and bronchitis (2000) (2.3) Other progressive illnesses (which include multiple sclerosis, HIV, Alzheimer's (2000) (1.9) disease, Parkinson’s disease) Chronic anxiety (2000) (1.6) Skin conditions, including allergic reactions and severe disfigurement (1000) (1.4) Epilepsy (including fits) (1000) (1.0) Learning difficulties (reading, spelling or math disability) 0 0 Other long–standing health problems (7000) (7.6) Total 97 000 100.0 * Figures below 10 000 are bracketed because they are too small to be statistically reliable. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 13. Most important long-standing health problem of people with work limitations (15-64) - Flemish Region – 2011 * N % Problems with back or neck (which includes arthritis or rheumatism) 173000 34.0 Problems with legs or feet (which includes arthritis or rheumatism) 54000 10.6 Problems with arms or hands (which includes arthritis or rheumatism) 47000 9.3 Heart, blood pressure or circulation problems 28000 5.6 Other mental, nervous or emotional problems 23000 4.5 Cancer 23000 4.5 Mental handicap / intellectual disability : light , moderate or severe 21000 4.1 Depression 20000 4.0 Chest or breathing problems, including asthma and bronchitis 20000 3.8 Other progressive illnesses (which include multiple sclerosis, HIV, Alzheimer's 10000 (1.9) disease, Parkinson’s disease) Stomach, liver, kidney or digestive problems (9000) (1.8) Diabetes (9000) (1.8) Severe headache such as migraine (9000) (1.7) Epilepsy (including fits) (6000) (1.1) Learning difficulties (reading, spelling or math disability) (4000) (0.8) Chronic anxiety (3000) (0.6) Skin conditions, including allergic reactions and severe disfigurement (3000) (0.5) Other long-standing health problems 48000 9.5 Total 509 000 100.0 * Figures below 10 000 are bracketed because they are too small to be statistically reliable. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
10
Table 14. Most important long-standing health problem of people with work limitations (15-64) - Walloon Region -2011 * N % Problems with back or neck (which includes arthritis or rheumatism) 86000 27.4 Problems with legs or feet (which includes arthritis or rheumatism) 40000 12.6 Problems with arms or hands (which includes arthritis or rheumatism) 29000 9.1 Heart, blood pressure or circulation problems 26000 8.4 Cancer 18000 5.9 Depression 13000 4.2 Mental handicap / intellectual disability : light , moderate or severe 12000 3.8 Stomach, liver, kidney or digestive problems 10000 3.2 Diabetes 10000 (3.1) Chest or breathing problems, including asthma and bronchitis (9000) (3.0) Chronic anxiety (6000) (1.9) Other mental, nervous or emotional problems (5000) (1.6) Severe headache such as migraine (5000) (1.5) Other progressive illnesses (which include multiple sclerosis, HIV, Alzheimer's (4000) (1.2) disease, Parkinson’s disease) Epilepsy (including fits) (3000) (0.8) Skin conditions, including allergic reactions and severe disfigurement (2000) (0.8) Learning difficulties (reading, spelling or math disability) (1000) (0.4) Other long-standing health problems 34000 11.0 Total 313 000 100.0 * Figures below 10 000 are bracketed because they are too small to be statistically reliable. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Tables 11 to 14 show that half of the problems mentioned are problems with back, neck, legs, feet, arms or hands (50.7% in Belgium and, in descending order, 53.9% in the Flemish Region, 49.2% in the Walloon Region and 39.5% in Brussels). Taken together, diseases such as cancer, heart blood pressure or circulation problems, chest or breathing problems, including asthma and bronchitis, stomach, liver, kidney or digestive problems, diabetes come in second place (Belgium 20.8%, Brussels 29%, Walloon Region 23.6%, Flemish Region 17.4%). Psychological and psychiatric problems, such as chronic anxiety, depression and other mental, nervous or emotional problems taken together come in third place (Belgium 8.9%, Brussels 12.0%, Flemish Region 9.0% and Walloon Region 7.7%). Mental handicap (mental retardation or intellectual disability) accounts for 4.1% in Belgium and about the same percentage in all the regions.
11
Labour Market participation of People with a Limitation in Work As appears from Table 15, the employment rate of people with work limitations is only half the rate of people with no such limitations. They are more often unemployed and especially more often inactive. There are considerable differences between the regions. Table 15. People with or without work limitation by labour market situation and region (15-64) Brussels Capital Flemish Region Walloon Region Total LM situation E x p e r i e n c i n g w o r k l i m i ta t i o n s Yes No Yes No Yes No Yes No Employed 27.5 60.4 38.6 70.9 26.9 62.7 33.4 67.3 Unemployed 10.0 9.3 3.5 2.6 6.9 5.5 5.3 4.2 Inactive 62.5 30.3 57.9 26.5 66.2 31.8 61.2 28.5 Total % 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Total N 97000 619000 509000 3544000 313000 1869000 919000 6032000 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Tables 16 to 18 show that the employment rate of people with work limitations in Belgium and in the Flemish and the Walloon Region varies according to health problem. The number of cases for Brussels is too low to examine the distribution. For Belgium, the gap between the highest and the lowest employment rate ranges from nearly 50% (for severe headache such as migraine) to barely 6% (mental handicap). The gap between these health categories is 58% - 8% for the Flemish Region and 54% - 5% for the Walloon Region. People with psychological or psychiatric problems also have very low employment rates. Table 16. PWL : Employment rate according to health problem (15-64) - Belgium -2011 * % Severe headache such as migraine 49.7 Problems with back or neck (which includes arthritis or rheumatism) 45.6 Problems with arms or hands (which includes arthritis or rheumatism) 32.9 Other long–standing health problems 33.8 Stomach, liver, kidney or digestive problems 31.8 Cancer 28.7 Heart, blood pressure or circulation problems 26.8 Skin conditions, including allergic reactions and severe disfigurement (33.0) Problems with legs or feet (which includes arthritis or rheumatism) 32.0 Chronic anxiety 26.6 Chest or breathing problems, including asthma and bronchitis 23.7 Other progressive illnesses (includes multiple sclerosis, HIV, Alzheimer's disease, Parkinson’s) 22.8 Diabetes 27.2 Other mental, nervous or emotional problems 23.6 Learning difficulties (reading, spelling or math disability) (12.8) Depression 14.3 Mental handicap / intellectual disability : light , moderate or severe 5.9 Epilepsy (including fits) (0.0) Total 33.4 * Percentage bracketed when the number of cases is too low. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
12
Table 17. PWL : Employment rate according to health problem (15-64)* - Flemish Region -2011 % Severe headache such as migraine (57.8) Problems with back or neck (which includes arthritis or rheumatism) 50.2 Diabetes (40.6) Heart, blood pressure or circulation problems 37.5 Problems with legs or feet (which includes arthritis or rheumatism) 37.4 Other long–standing health problems 39.0 Problems with arms or hands (which includes arthritis or rheumatism) 37.1 Stomach, liver, kidney or digestive problems (32.6) Chronic anxiety (29.9) Cancer 34.2 Other progressive illnesses (includes multiple sclerosis, HIV, Alzheimer's disease, Parkinson’s) (23.9) Skin conditions, including allergic reactions and severe disfigurement (25.6) Other mental, nervous or emotional problems 21.7 Chest or breathing problems, including asthma and bronchitis 22.2 Depression 16.6 Learning difficulties (reading, spelling or math disability) (17.3) Mental handicap / intellectual disability : light , moderate or severe 7.9 Epilepsy (including fits) (0.0) Total 38.6 * Percentage bracketed when the number of cases is too low. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 18. PWL : Employment rate according to health problem (15-64) - Walloon Region 2011 % (54.1) (39.5) 35.6 28.9 (31.6) 27.8 27.7 27.4 (23.7) (22.6) 17.8 (25.0) 16.6 (20.1) 16.3 4.9 (0.0) (0.0) 26.9
Severe headache such as migraine Skin conditions, including allergic reactions and severe disfigurement Problems with back or neck (which includes arthritis or rheumatism) Problems with legs or feet (which includes arthritis or rheumatism) Other progressive illnesses (includes multiple sclerosis, HIV, Alzheimer's disease, Parkinson’s) Stomach, liver, kidney or digestive problems Problems with arms or hands (which includes arthritis or rheumatism) Other long–standing health problems Diabetes Chronic anxiety Heart, blood pressure or circulation problems Chest or breathing problems, including asthma and bronchitis Depression Other mental, nervous or emotional problems Cancer Mental handicap /intellectual disability : light , moderate or severe Learning difficulties (reading, spelling or math disability) Epilepsy (including fits) Total * Percentage bracketed when the number of cases is too low. Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
13
In Table 19 the most important health problems named by people with work limitations have been regrouped into four categories to allow for comparison of employment rates between regions. Table 19. Employment rate (%) of people with work limitations by most important health problem and region Belgium
Flemish Region
Walloon Region
Brussels Region
Problems with back, neck, legs, feet, arms or hands 40.2 45.4 32.4 34.4 Cancer, Heart blood pressure or circulation 27.4 33.1 20.5 27.5 problems, Chest or breathing problems, including asthma and bronchitis, Stomach, liver, kidney or digestive problems, Diabetes Psychological and Psychiatric problems, such as 19.4 19.9 18.9 18.3 Chronic anxiety, Depression, Other mental, nervous or emotional problems Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
The aim of Tables 20 to 23 is to examine how people’s long-standing health conditions or diseases or ADL problems interfere with the work they can do. The LFS questionnaire contains questions concerning: -
the amount of work (number of hours that someone can work in a week); the type of work (for instance, having problems in carrying heavy loads, working outdoors, sitting for a long time) that he/she can do; the ability to get to and from work.
For those in employment, the questions refer to their current situation, for those who are not employed (unemployed or inactive) they refer to a possible job. In Belgium and in the three regions, all people with work limitations have a problem with at least one of the above aspects. Table 20. People with work limitations by limitation and LM situation (15-64) Belgium Are you limited in the number of hours you could work or can work ? Not Employed Employed Total Limitation N % N % N % Yes 529000 86.5 136000 55.6 665000 72.4 No 83000 13.5 171000 44.4 253000 27.6 Total 611000 100.0 307000 100.0 919000 100.0 Are you limited in the type of work you could perform or perform ? Yes 557000 91.1 254000 82.8 812000 88.3 No 54000 8.9 53000 17.2 107000 11.7 Total 611000 100.0 307000 100.0 919000 100.0 Are you limited in getting to and from work ? Yes 299000 48.8 52000 16.8 350000 38.1 No 312000 51.2 255000 83.2 568000 61.9 Total 611000 100.0 307000 100.0 918000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
14
Table 21. People with work limitations by limitation and LM situation (15-64) Brussels Are you limited in the number of hours you could work or can work ? Not Employed Employed Total Limitation N % N % N % Yes 56000 80.7 15000 57.7 72000 74.4 No 13000 19.3 11000 42.3 25000 25.6 Total 69000 100.0 26000 100.0 97000 100.0 Are you limited in the type of work you could perform or perform ? Yes 62000 89.3 22000 84.6 85000 87.9 No 7000 10.7 4000 15.4 12000 12.1 Total 69000 100.0 26000 100.0 97000 100.0 Are you limited in getting to and from work ? Yes 35000 50.1 7000 26.9 42000 43.4 No 34000 49.9 19000 73.1 55000 56.6 Total 69000 100.0 26000 100.0 97000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 22. People with work limitations by limitation and LM situation (15-64) Flemish Region Are you limited in the number of hours you could work or can work ? Not Employed Employed Total Limitation N % N % N % Yes 272000 86.9 108000 55.2 380000 74.7 No 41000 13.1 88000 44.8 129000 25.3 Total 313000 100.0 196000 100.0 509000 100.0 Are you limited in the type of work you could perform or perform ? Yes 280000 89.7 163000 82.9 443000 87.1 No 33000 10.3 33000 17.1 66000 12.9 Total 313000 100.0 196000 100.0 509000 100.0 Are you limited in getting to and from work ? Yes 136000 43.7 26000 13.2 162000 31.9 No 176000 56.3 170000 86.8 347000 68.1 Total 313000 100.0 196000 100.0 509000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 23. People with work limitations by limitation and LM situation (15-64) Walloon Region Are you limited in the number of hours you could work or can work ? Not Employed Employed Total Limitation N % N % N % Yes 201000 87.6 47000 55.8 248000 79.1 No 28000 12.4 37000 44.2 65000 20.9 Total 229000 100.0 84000 100.0 313000 100.0 Are you limited in the type of work you could perform or perform ? Yes 214000 93.6 69000 82.2 284000 90.6 No 15000 6.4 15000 17.8 29000 9.4 Total 229000 100.0 84000 100.0 313000 100.0 15
Are you limited in getting to and from work ? Yes 127000 55.5 19000 No 102000 44.5 65000 Total 229000 100.0 84000
22.5 77.5 100.0
146000 167000 313000
46.7 53.3 100.0
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Nearly nine out of ten people with work limitations (Belgium, 88.3%) are limited in the type of work and nearly three out of four (72.4%) are limited in the number of hours they can or could perform. Much less people are limited in getting to and from work (38.1%). Amongst those not employed there is a larger group reporting such limitations than amongst the employed. The figures for the regions are similar to those for the whole of Belgium except for limitations in getting to and from work, where there are substantial differences between the regions. The purpose of Tables 24 to 27 is to identify the people with work limitations who, because of a health or ADL problem, need personal assistance, special equipment or workplace adaptations, and working arrangements to find employment, and those in employment who use these provisions. In Belgium, 3.6% of employed people with work limitations use personal assistance, but a much higher share of those not in employment (29.2%) report they would need it to be able to work. Special equipment or workplace adaptations are needed by 27.8%, whereas only 10.8% of the employed use these provisions. Special working arrangements are a necessity for 52.0% and are used by 18.9%. The differences between the Regions are rather small. Table 24. People with work limitations using or needing personal assistance, special equipment or workplace adaptations, and working arrangements (15-64) Belgium Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) personal assistance to enable him/her to work. Not Employed Employed Total N % N % N % Yes 178000 29.2 11000 3.6 190000 20.7 No 433000 70.8 296000 96.4 728000 79.3 Total 611000 100.0 307000 100.0 918000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) special equipment or needs (not employed persons)/has (employed persons) workplace adaptations to enable him/her to work Yes 170000 27.8 33000 10.8 203000 22.1 No 441000 72.2 274000 89.2 715 77.9 Total 611000 100.0 307000 100.0 918000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/has (employed persons) special working arrangements to enable him/her to work (such as, sedentary jobs, teleworking, flexible hours or less strenuous work) Yes 318000 52.0 58000 18.9 376000 40.9 No 293000 48.0 249000 81.1 542000 59.1 Total 611000 100.0 307000 100.0 918000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
16
Table 25. People with work limitations using or needing personal assistance, special equipment or workplace adaptations, and working arrangements (15-64) Brussels Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) personal assistance to enable him/her to work. Not Employed Employed Total N % N % N % Yes 19454 27.8 709 2.7 20163 20.9 No 50505 72.2 25858 97.3 76363 79.1 Total 70000 100.0 26000 100.0 96000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) special equipment or needs (not employed persons)/has (employed persons) workplace adaptations to enable him/her to work Yes 20000 28.5 3000 11.7 23000 23.9 No 50000 71.5 23000 88.3 73000 76.1 Total 70000 100.0 26000 100.0 96000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/has (employed persons) special working arrangements to enable him/her to work (such as, sedentary jobs, teleworking, flexible hours or less strenuous work) Yes 33000 47.1 5000 18.4 38000 39.2 No 37000 52.9 21000 81.6 58000 60.8 Total 70000 100.0 26000 100.0 96000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Table 26. People with work limitations using or needing personal assistance, special equipment or workplace adaptations, and working arrangements (15-64) Flemish Region Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) personal assistance to enable him/her to work. Not Employed Employed Total N % N % N % Yes 96000 30.7 7000 3.6 103000 20.2 No 216000 69.3 189000 96.4 406000 79.8 Total 313000 100.0 196000 100.0 509000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) special equipment or needs (not employed persons)/has (employed persons) workplace adaptations to enable him/her to work Yes 91000 29.2 21000 10.9 113000 22.1 No 222000 70.8 175000 89.1 396000 77.9 Total 313000 100.0 196000 100.0 509000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/has (employed persons) special working arrangements to enable him/her to work (such as, sedentary jobs, teleworking, flexible hours or less strenuous work) Yes 185000 59.0 41000 20.8 225000 44.3 No 128000 41.0 155000 79.2 283000 55.7 Total 313000 100.0 196000 100.0 509000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
17
Table 27. People with work limitations using or needing personal assistance, special equipment or workplace adaptations, and working arrangements (15-64) Walloon Region Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) personal assistance to enable him/her to work. Not Employed Employed Total N % N % N % Yes 63000 27.7 3000 4.1 67000 21.3 No 166000 72.3 81000 95.9 246000 78.7 Total 229000 100.0 84000 100.0 313000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/uses (employed persons) special equipment or needs (not employed persons)/has (employed persons) workplace adaptations to enable him/her to work Yes 59000 25.6 8000 10.2 67000 21.5 No 170000 74.4 76000 89.8 246000 78.5 Total 229000 100.0 84000 100.0 313000 100.0 Because of the health problem or difficulty the person needs (not employed persons)/has (employed persons) special working arrangements to enable him/her to work (such as, sedentary jobs, teleworking, flexible hours or less strenuous work) Yes 101000 44.0 12000 14.4 113000 36.0 No 128000 56.0 72000 85.6 200000 64.0 Total 229000 100.0 84000 100.0 313000 100.0 Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
Apart from health issues, the LFS explored other reasons restricting people with work limitations in the work they do or could do. Table 28 shows which reasons where chosen as most important out of a list of possible reasons. Lack of qualifications or experience, persnal reasons and lack of appropriate job opportunities were named most often. Table 28. Most important reason, besides health condition/disease or ADL problem restricting the work people with work limitations can or could do (employed or not, 15-64) Brussels Flemish Region Walloon Region Belgium N
%
N
%
N
%
N
%
Lack of qualifications or experience Lack of appropriate job opportunities Lack or poor transportation to and from workplace
13000
13.0
32000
6.2
27000
8.7
71000
7.8
4000
4.3
31000
6.2
18000
5.6
53000
5.8
1000
0.8
5000
1.1
6000
2.1
13000
1.4
Employers’ lack of flexibility Affects receipt of benefits Family and caring responsibilities Personal reasons Other reason No “other” restricting reason Total
2000
2.5
11000
2.1
9000
3.0
23000
2.5
2000
2.4
12000
2.3
4000
1.3
18000
2.0
4000
4.1
21000
4.1
8000
2.5
33000
3.6
5000 11000 54000
5.0 11.6 56.3
33000 25000 339000
6.4 4.9 66.7
28000 31000 182000
9.0 9.7 58.0
66000 66000 575000
7.2 7.2 62.6
96000
100
509000
100.0
313000
100.0
918000
100.0
Source : FOD Economie, Algemene Directie Statistiek - Statistics Belgium, Ad hoc Module LFS 2nd quarter 2011.
18
Table 29. Prevalence and employment rate of people with work limitations (Europe)
Bulgaria Hungary Ireland Romania Poland Slovakia Greece Malta Croatia Lithuania Estonia Belgium Spain Czech Republic Germany United Kingdom Italy European Union (28) Netherlands Latvia Denmark Cyprus Slovenia Portugal Luxemburg Austria Finland France Sweden
Prevalence (15-64)
Employment rate (15-64)
8.0 11.4 7.1 11.6 11.4 11.6 6.7 10.4 11.4 11.9 14.3 13.2 9.4 9.7 11.0 12.8 7.0 11.1 13.2 11.6 16.9 10.4 22.2 18.5 14.0 15.5 18.2 10.6 14.2
Work limitations Yes* (1) No (2) 17.7 62.1 18.1 61.0 21.7 62.1 23.9 64.8 26.2 63.9 29.2 70.3 29.8 58.8 30.0 60.6 31.6 55.0 32.5 63.9 33.3 70.4 33.4 67.3 33.8 61.8 34.5 69.3 35.4 72.6 36.0 75.6 37.0 59.3 38.1 67.3 39.4 80.3 40.6 63.1 41.5 80.0 41.7 70.5 44.0 70.3 44.0 69.6 47.9 66.9 48.2 76.1 50.6 74.7 59.6 64.5 61.5 76.4
Employment rate gap (ppt) (2) – (1)
44.4 42.9 40.4 40.9 37.7 41.1 29 30.6 23.4 31.4 37.1 33.9 28 34.8 37.2 39.6 22.3 29.2 40.9 22.5 38.5 28.8 26.3 25.6 19 27.9 24.1 4.9 14.9
Source: Eurostat, Labour Force Survey 2011, Ad Hoc Module on Disability. *Countries ranked according to ascending employment rates of persons with work limitations
The prevalence of people with work limitations (15-64) varies between 6.7% (Greece) and 22.2% (Slovenia). Comparisons of the employment rate only make sense between countries with prevalence rates that are not too wide apart. Therefore Belgium (with a prevalence rate of 13.2%) may for example be compared to the Netherlands, the United Kingdom and Sweden (resp. 13.2%, 12.8% and 14.2%). It appears that, compared to Belgium, the employment rate of people with work limitations is higher in the UK and in the Netherlands and much higher in Sweden. However, when we look at the difference in employment rate between the people with work limitations and the others, the gap in Belgium (33.9 ppt) is smaller than in the UK (39.6 ppt) and the Netherlands (40.9 ppt), but much larger than in Sweden (14.9 ppt).
19