IDEAS home Printed from https://ideas.repec.org/a/sae/woemps/v39y2025i1p139-162.html

Medicalisation of Unemployment: An Analysis of Sick Leave for the Unemployed in Germany Using a Three-Level Model

Author

Listed:
  • Philipp Linden

    (Fulda University of Applied Sciences, Germany
    University of Siegen, Germany)

  • Nadine Reibling

    (Fulda University of Applied Sciences, Germany
    University of Siegen, Germany)

Abstract

The study investigates whether sick leave for the unemployed is used to address problems of labour market integration – a process that can theoretically be conceptualised as the medicalisation of unemployment. Estimating a multilevel logistic regression model on a sample of N = 20,196 individuals from the German panel study Labour Market and Social Security (PASS) reveals that, on average, 18% of the unemployed are on sick leave due to poor health. However, given a comparable state of health, the probability increases for men, older individuals and those with lower educational levels. These findings are crucial as they reveal a dual role of sick leave in a context with limited access to disability pensions: as a protective measure for sick, unemployed individuals and as medicalisation of unemployment by excluding those who face non-medical barriers to labour market integration.

Suggested Citation

  • Philipp Linden & Nadine Reibling, 2025. "Medicalisation of Unemployment: An Analysis of Sick Leave for the Unemployed in Germany Using a Three-Level Model," Work, Employment & Society, British Sociological Association, vol. 39(1), pages 139-162, February.
  • Handle: RePEc:sae:woemps:v:39:y:2025:i:1:p:139-162
    DOI: 10.1177/09500170241244688
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/09500170241244688
    Download Restriction: no

    File URL: https://libkey.io/10.1177/09500170241244688?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. David H. Autor & Mark G. Duggan, 2003. "The Rise in the Disability Rolls and the Decline in Unemployment," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 118(1), pages 157-206.
    2. Pierre Koning & Daniel van Vuuren, 2010. "Disability insurance and unemployment insurance as substitute pathways," Applied Economics, Taylor & Francis Journals, vol. 42(5), pages 575-588.
    3. Christina Beatty & Stephen Fothergill, 2002. "Hidden Unemployment Among Men: A Case Study," Regional Studies, Taylor & Francis Journals, vol. 36(8), pages 811-823.
    4. Semykina, Anastasia & Wooldridge, Jeffrey M., 2010. "Estimating panel data models in the presence of endogeneity and selection," Journal of Econometrics, Elsevier, vol. 157(2), pages 375-380, August.
    5. Bell, Andrew & Jones, Kelvyn, 2015. "Explaining Fixed Effects: Random Effects Modeling of Time-Series Cross-Sectional and Panel Data," Political Science Research and Methods, Cambridge University Press, vol. 3(1), pages 133-153, January.
    6. David Neumark & Ian Burn & Patrick Button, 2019. "Is It Harder for Older Workers to Find Jobs? New and Improved Evidence from a Field Experiment," Journal of Political Economy, University of Chicago Press, vol. 127(2), pages 922-970.
    7. Jenni Blomgren & Mikko Laaksonen & Riku Perhoniemi, 2021. "Changes in Unemployment Affect Sickness Absence and Disability Retirement Rates: A Municipality-Level Panel Study," IJERPH, MDPI, vol. 18(12), pages 1-14, June.
    8. Danielle Venn, 2012. "Eligibility Criteria for Unemployment Benefits: Quantitative Indicators for OECD and EU Countries," OECD Social, Employment and Migration Working Papers 131, OECD Publishing.
    9. Mark Trappmann & Jonas Beste & Arne Bethmann & Gerrit Müller, 2013. "The PASS panel survey after six waves [Die PASS-Panelbefragung nach sechs Wellen]," Journal for Labour Market Research, Springer;Institute for Employment Research/ Institut für Arbeitsmarkt- und Berufsforschung (IAB), vol. 46(4), pages 275-281, December.
    10. Carlsson, Magnus & Eriksson, Stefan, 2019. "Age discrimination in hiring decisions: Evidence from a field experiment in the labor market," Labour Economics, Elsevier, vol. 59(C), pages 173-183.
    11. Hanna Hultin & Christina Lindholm & Jette Möller, 2012. "Is There an Association between Long-Term Sick Leave and Disability Pension and Unemployment beyond the Effect of Health Status? – A Cohort Study," PLOS ONE, Public Library of Science, vol. 7(4), pages 1-7, April.
    12. Trappmann, Mark & Beste, Jonas & Bethmann, Arne & Müller, Gerrit, 2013. "The PASS panel survey after six waves," Journal for Labour Market Research, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany], vol. 46(4), pages 275-281.
    13. Rodrigo Fernandez & Alexander Hijzen & Daniele Pacifico & Stefan Thewissen, 2020. "Identifying and addressing employment barriers in Belgium, Korea and Norway: Implementing the OECD Jobs Strategy," OECD Social, Employment and Migration Working Papers 249, OECD Publishing.
    14. Ed Westerhout, 2001. "Disability Risk, Disability Benefits, and Equilibrium Unemployment," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 8(3), pages 219-244, May.
    15. Bernhard Boockmann & Stephan L. Thomsen & Thomas Walter, 2014. "Intensifying the use of benefit sanctions: an effective tool to increase employment?," IZA Journal of Labor Policy, Springer;Forschungsinstitut zur Zukunft der Arbeit GmbH (IZA), vol. 3(1), pages 1-19, December.
    16. Viola Angelini & Danilo Cavapozzi & Omar Paccagnella, 2012. "Cross-Country Differentials in Work Disability Reporting Among Older Europeans," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 105(2), pages 211-226, January.
    17. Hansen, Helena & Bourgois, Philippe & Drucker, Ernest, 2014. "Pathologizing poverty: New forms of diagnosis, disability, and structural stigma under welfare reform," Social Science & Medicine, Elsevier, vol. 103(C), pages 76-83.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Gijs Roelofs & Daniel Vuuren, 2017. "The Decentralization of Social Assistance and the Rise of Disability Insurance Enrolment," De Economist, Springer, vol. 165(1), pages 1-21, March.
    2. Gijs Roelofs & Daniel Vuuren, 2017. "The Decentralization of Social Assistance and the Rise of Disability Insurance Enrolment," De Economist, Springer, vol. 165(1), pages 1-21, March.
    3. Bähr, Holger & Kirchmann, Andrea & Schafstädt, Christin & Sippli, Khira & Späth, Jochen & Boockmann, Bernhard, 2019. "Bedarfsgemeinschaften und ihre Mitglieder in der Beratungs- und Vermittlungsarbeit der Jobcenter," IAB-Forschungsbericht 201906, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    4. Kesternich, Iris & Schumacher, Heiner & Siflinger, Bettina & Valder, Franziska, 2022. "Reservation wages and labor supply," Journal of Economic Behavior & Organization, Elsevier, vol. 194(C), pages 583-607.
    5. Bíró, Anikó & Elek, Péter, 2020. "Job loss, disability insurance and health expenditure," Labour Economics, Elsevier, vol. 65(C).
    6. repec:iab:iabfda:201307(en is not listed on IDEAS
    7. repec:iab:iabfme:201604(de is not listed on IDEAS
    8. Vendrik, M.C.M. & Cörvers, F., 2009. "Male and female labour force participation: the role of dynamic adjustments to changes in labour demand, government policies and autonomous trends," Research Memorandum 036, Maastricht University, Maastricht Research School of Economics of Technology and Organization (METEOR).
    9. Alho, Juha & Müller, Gerrit & Pflieger, Verena & Rendtel, Ulrich, 2017. "The fade away of an initial bias in longitudinal surveys," Discussion Papers 2017/25, Free University Berlin, School of Business & Economics.
    10. Hugo Benítez-Silva & Richard Disney & Sergi Jiménez-Martín, 2010. "Disability, capacity for work and the business cycle: an international perspective [Has the boom in incapacity benefit claimant numbers passed its peak?]," Economic Policy, CEPR, CESifo, Sciences Po;CES;MSH, vol. 25(63), pages 483-536.
    11. Schaubert, Marianna & Hänisch, Carsten, 2020. "Do Non-Resident Parents with Lower Labor Market Attachment React to Institutional Changes in Child Support Obligations? Evidence from IAB-PASS," EconStor Preprints 214624, ZBW - Leibniz Information Centre for Economics.
    12. Gross, Christiane & Gurr, Thomas & Jungbauer-Gans, Monika & Lang, Sebastian, 2020. "Prejudices against the unemployed - empirical evidence from Germany," Journal for Labour Market Research, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany], vol. 54, pages 1-003.
    13. Jesske, Birgit & Knerr, Petra & Kraft, Lisa, 2017. "Methodenbericht Panel Arbeitsmarkt und Soziale Sicherung PASS : 10. Erhebungswelle - 2016 (Haupterhebung)," FDZ Methodenreport 201709_de, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    14. De Brouwer, Octave & Leduc, Elisabeth & Tojerow, Ilan, 2019. "The Unexpected Consequences of Job Search Monitoring: Disability Instead of Employment?," IZA Discussion Papers 12304, IZA Network @ LISER.
    15. Hochmuth, Brigitte & Kohlbrecher, Britta & Merkl, Christian & Gartner, Hermann, 2021. "Hartz IV and the decline of German unemployment: A macroeconomic evaluation," Journal of Economic Dynamics and Control, Elsevier, vol. 127(C).
    16. Koning, Pierre & Prudon, Roger, 2025. "Sick or Unemployed? Examining Transitions into Sickness Insurance at Unemployment Benefit Exhaustion," IZA Discussion Papers 18264, IZA Network @ LISER.
    17. Melo, Vitor & Rocha, Hugo Vaca Pereira & Sigaud, Liam & Warren, Patrick L. & Gaddis, S. Michael, 2024. "Understanding Discrimination in College Admissions: A Field Experiment," SocArXiv 5ctms, Center for Open Science.
    18. Jesske, Birgit & Knerr, Petra & Schulz, Sabine, 2016. "Methodenbericht Panel Arbeitsmarkt und Soziale Sicherung PASS : 9. Erhebungswelle - 2015 (Haupterhebung)," FDZ Methodenreport 201604_de, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    19. Jonas Beste & Markus M. Grabka & Jan Goebel, 2018. "Armut in Deutschland [Poverty in Germany]," AStA Wirtschafts- und Sozialstatistisches Archiv, Springer;Deutsche Statistische Gesellschaft - German Statistical Society, vol. 12(1), pages 27-62, April.
    20. repec:iab:iabfme:201504(de is not listed on IDEAS
    21. Jesske, Birgit & Schulz, Sabine, 2018. "Methodenbericht Panel Arbeitsmarkt und Soziale Sicherung PASS : 11. Erhebungswelle - 2017 (Haupterhebung)," FDZ Methodenreport 201813_de, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    22. Fuchs, Benjamin & Lödel, Sarah & Otto, Michael, 2015. "Quick start file for the panel "Labour market and social security" (PASS) : analysing the PASS data using SPSS/PASW," FDZ Methodenreport 201508_en, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].
    23. Bach, Ruben L. & Eckman, Stephanie, 2017. "Does participating in a panel survey change respondents' labor market behavior?," IAB-Discussion Paper 201715, Institut für Arbeitsmarkt- und Berufsforschung (IAB), Nürnberg [Institute for Employment Research, Nuremberg, Germany].

    More about this item

    Keywords

    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;
    ;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:woemps:v:39:y:2025:i:1:p:139-162. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: http://www.britsoc.co.uk/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.