Unemployment and economic inactivity affect public health: a study in the EU-15 identified unemployment as one of the 10 most important contributors to the total burden of disease in the 1990s. Structural Fund investments aimed at improving employment levels and the quality of employment consequently can bring health gains.

Understanding the policy context

The ex-ante conditionalities for the employment objective call on Member States to have effective employment services, a strategy for business creation and actions for active and healthy ageing.

The Europe 2020 Strategy provides further policy objectives in its priority for inclusive growth and a high-employment economy. The following three flagship initiatives of the Strategy contain key provisions for employment:

The strategy also emphasises the need for Europe's ageing population to remain economically active.

The EU has a body of labour law to protect working conditions and ensure worker consultation.

In addition, the EU has a comprehensive framework of legislation for worker health and safety; policy strategies in this area call for a reduction in workplace accidents and special attention to vulnerable groups of workers.

Strategic analysis and programming

When developing Operational Programmes, it will be valuable to keep in mind the numerous ways in which investment for better employment can support public health. These include:

  • Provision of specialist outreach engagement and support for vulnerable groups, such as people with low skills, people with disabilities and mental ill-health, single parents, and older/younger workers to find lasting employment will have a positive impact on the overall health status of these groups
  • Enhancing access to affordable and appropriate support for people with caring responsibilities (e.g. childcare)
  • Development of innovative approaches to help overcome transport barriers, including support for home working as well as flexible transport solutions
  • Support to employers to help existing employees (including part-time and temporary workers) to develop their skills and move into longer-term positions
  • Activities and support services that address the quality of work life, providing support to employers and employees for improvements occupational health and safety; work/family life balance; and access to health care through employment.

The table provides examples where the links between employment and health have been recognised by Member States and regions in their 2007-2013 programmes.



Where to find it

In the Algarve region (P), occupational health, hygiene and safety are important competitiveness factors according to the Division Head of the Regional Development and Coordination Commission. Moreover, Algarve’s OP acknowledges the importance of health to increase productivity levels of the economy and promote social inclusion.

Algarve Regional Operational Programme 2007-2013, Section 3, which summarises the Regional Development Strategy.

Document in Portuguese

In Wales, the links between literacy, economic inactivity and health are recognised in the rationale for the priority “Supplying young people withthe skills needed for learning and future employment”

Operational Programme for the European Social Fund 2007-2013, p. 24-25

The incidence of work-related accidents is one of the strategic indicators for Andalucía’s ESF OP.  It uses the so-called índice de incidencia (no. of accidents at work x 1000 / no. of insured workers) as proxy for the work accident rate. More precisely, this indicator is associated to the priority axis “Entrepreneurship promotion and improvement of the adaptability of workers, enterprises and entrepreneurs”

Andalucía ESF OP 2007-2013, table 49 in p. 95

Document in Spanish

Improvements in access to employment can have important impacts on the contribution to equal opportunities. In Andalucía, access to health resources and health services is identified as a powerful contributor to equal opportunities in the labour market.

Andalucía ESF OP 2007-21013, Section 4, Priority Axis 1 “Entrepreneurship promotion and improvement of the adaptability of workers, enterprises and entrepreneurs”, p. 121

Document in Spanish

In Denmark, priority 2 “Expansion of the workforce (more jobs)” focuses directly on “reduced absence due to illness”, rather than on occupational safety and health in general.

Programme for the European Social Fund in Denmark 2007–2013 Regional Competitiveness and Employment “More and Better Jobs”, Section 3, p. 72

Structural Funds authorities in Germany acknowledge the need to consider the barriers imposed by poor health to access to employment and revenue in the socioeconomic analysis.  This is within the socioeconomic analysis, in section 1.9 "Participation and social inclusion“.

Germany ESF OP, Convergence objective, Socioeconomic analysis, section 1.9 “Participation and social inclusion“, p. 73.

Document in German


It will also be valuable to understand the full extent of the links between health and employment. For example, long-term unemployment and economic activity can be linked to poor health – which in turn can prevent people. This was recognised the strategic analysis for the Welsh OP for ESF, which identified health conditions as work-limiting factors based on surveys of the population. As a result, the OP focused on health and work links, including improving health at work.

Developing Projects

Many projects developed and financed through the Structural Fund programmes that target employment will indirectly generate positive impacts on health. These include, for example, training for low-skilled workers and people in marginalised communities, as well as training on occupational health and safety.

The following good practice examples demonstrate the positive impacts of employment on health gains, as well as those that directly target health as a cause of long-term economic inactivity.

Cyrenians Cymru – Cyrenians Supported Employment and Training Project, P2 T1 – TPC £6.0m, ESF £3.3m

This project was designed to assist the most disengaged and vulnerable adults in the Swansea Bay community to develop employability skills and access to employment.  A key element of this will be dove-tailing the service with mainstream employment and recruitment agencies.  It provides targeted training to individuals facing multiple disadvantage to overcome their barriers.  Training is delivered via specialist premises (an arts and learning centre, a waste and recycling centre, a healthy living centre and a retail training unit).  A key element is the provision of lifestyle and healthy living training.

BTCV Family Employment Initiative – ESF Convergence TPC £2.8m, ESF £1.6m

The project helps individuals and families in the South Wales Valleys to challenge the personal and social barriers they face due to long-term worklessness.  Through engagement in volunteering opportunities and community work, including in the green spaces around them, the project helps people develop their confidence and skills, as well as their aspirations for themselves and their neighbourhoods, using new environmental awareness skills and participating in health benefitting activities. 

City of Swansea - COASTAL – TPC £51.7m,  ESF £27.0m

Covering Bridgend, Neath Port Talbot, Swansea, Carmarthenshire, Pembrokeshire and Ceredigion, the project provides vocational guidance, employment, skills training and lifelong learning opportunities for individuals who are currently economically inactive as a result of illness, disability (mental illness, learning disability, physical disability, sensory impairment), substance misuse problems and/or social disadvantage from transitioning from long-term care into adulthood.

Remploy – Wellbeing through Work TPC £23.6m, ESF £12.8m

Through this project, employees will have access to support from employment advisors. There will also be advice on reducing stress, as well as help for people who have experienced mental illness to get back to work. Professionals will also be available to tackle issues such as debt management and relationship problems which may impact on an individual’s ability to remain in work. In 2010 the project found more than 20,000 jobs in mainstream employment for disabled and disadvantaged people and employed 2,300 disabled people in 54 factories.