Daniel Sage argues that welfare-to-work programmes, which have become integral to the British welfare state, have been characterised by exclusively economic objectives. Instead he suggests that such programmes should recognise the implications of unemployment for health and, through doing so, reorientate themselves to changing conditions of employment in an age of austerity.
During the past twenty years, welfare-to-work programmes have become a central feature of the British welfare state. Driven by the objective of speeding up returns to the labour market, the UK now has a Byzantine structure of ‘activation’ schemes. Since 2010, the Coalition government has strengthened this landscape by introducing a range of new interventions: the Work Programme, Mandatory Work Activity, Sector-Based Work Academics, amongst many more. The obvious aim of these programmes is to increase re-employment and bring about positive labour market outcomes. But focusing solely on the economic objectives of welfare-to-work ignores a blatant reality of unemployment. This is that for many people who are out of work, unemployment is not just an economic problem; it is also a health one.
Social scientists have discovered this through decades of empirical research. On the one hand we know that unemployment is related to poor physical health outcomes; rising unemployment is linked to higher suicide rates, whilst being out of work can have a ‘scarring effect’ on health up to twenty years down the line. On the other hand, unemployment is equally harmful to mental wellbeing. The unemployed have much lower levels of life satisfaction and happiness than those in paid work and, unsurprisingly, a much higher risk for onset of major clinical depression. Such evidence strengthens the argument that governments need to think about unemployment as much more than just an economic problem.
The most obvious solution to unemployment – as both an economic and health problem – is to get people back to work. Yet with a changing and more flexible labour market, full employment (as we once understood it) is a thing of the past. This means that as well as promoting paid work, policy-makers must find other ways of ameliorating the deleterious health effects of unemployment. So what can government do? One plausible solution may lie in the potential of welfare-to-work schemes.
An important reason why we might expect welfare-to-work interventions to improve health outcomes for unemployed people is rooted in research from social psychology. For a long time, academics considered why work was strongly associated with positive health outcomes. The most famous explanation came from Marie Jahoda, the Austrian social psychologist, who argued that there were certain side effects of working that improved our health and wellbeing: time structure, social activity, collective endeavour, regular activity and status and identity.
In considering welfare-to-work schemes, it is clear that some of these programmes – whilst clearly not matching the financial rewards of paid work – offer a very different environment to what might be termed ‘open unemployment’. They often involve learning new skills, having a daily routine and forming relationships with colleagues. If ‘open unemployment’ is indeed harmful to health and wellbeing, and the ‘side effects’ of paid work are positive, then welfare-to-work might be able to act as a bridge between these two statuses; moving people closer to work whilst nullifying the harmful health costs of being unemployed.
There are of course some caveats to the idea that welfare-to-work can bring about benefits to the health and wellbeing of unemployed people. There are circumstances and schemes, for example, that might have the opposite effect if they are deemed to be stigmatising and neglectful of a person’s autonomy and work ambitions. Further, there are many distinct types of welfare-to-work: from more basic advice and matching services to full-on training and work experience placements, all with varying levels of compulsion. We need to know much more about how different types of welfare-to-work interact with health before coming to any firm policy recommendations.
Of course, welfare-to-work interventions will probably always be seen as overwhelmingly economic, labour market-oriented programmes. Yet thinking about how they interact with health and wellbeing could end up having some important and positive consequences. Not least for those most disadvantaged by their exclusion from the labour market.
This is a short version of an article published in the International Journal of Sociology and Social Policy.
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Daniel Sage is a PhD student at the University of Stirling. His PhD thesis explores how welfare-to-work reforms have affected the experiences and interactions of benefit claimants with the welfare system.