PHRC Phase 2 (2011-2019) projects – Projects related to living and working conditions

Mapping the literature on interventions to tackle the disability‐employment gaps

Lead investigators

Margaret Whitehead, Professor of Public Health, Division of Public Health, University of Liverpool
Amanda Sowden, CRD, University of York


The joint DWP/DH Work and Health Unit was tasked by the government with tackling the disability‐employment gap, whereby people with chronic health conditions or disabilities have lower employment rates, higher sickness absence rates while in work and greater difficulties returning to work. The ageing of the workforce and the extension of pension age mean that the proportion of people in the workforce with a chronic health condition or disability, or caring for a family member with a disability, will continue to rise in the coming decades, adding to the magnitude of the disability‐employment gap.

Health inequalities exacerbate the problem still further. The existence of steep socioeconomic gradients in chronic conditions means that the disability‐employment gap is much worse for less skilled (routine) occupational groups compared with professional and managerial groups. More disadvantaged groups have higher mortality and morbidity, suffer onset of disability at an earlier age (so have a disability for a longer period during working life), are more likely to have multi‐morbidities (more than one chronic health condition that interact with one another), and are more likely to have a sick family member who needs care.

The top priority of the joint unit was to establish what works to get people with chronic conditions or disabilities back into work and joining the workforce, taking into consideration issues raised by health inequalities, the ageing of the workforce and the needs of carers in the workforce.

Aims and methods

The purpose of the proposed mapping exercise was to identify and map evaluations of interventions that aim to reduce disability‐employment gaps.

Note: the term ‘intervention’ includes national employment and social welfare policies which affect the daily lives and employment of people with chronic conditions or disabilities, as well as the implementation of focussed initiatives.

Priority areas for mapping as discussed with DH were:

  • Pathways into work for those with long‐term conditions and/or disability;
  • Evidence on supporting people with health conditions to stay in work or return from sick leave;
  • Flexible approaches to return to work pathways;
  • The impact of the changing demographic – an ageing workforce and the extension of working lives;
  • How to keep carers in the workforce (in particular women 50 years plus caring for family members).

Themes within these that are of particular interest are:

  • Multi‐morbidities;
  • Barriers and facilitators – wider social factors;
  • Inequalities

The scope of the mapping was limited to:

  • Mapping the extent of the existing literature against a typology of interventions based on their theory of change;
  • Highlighting the gaps in the current literature; and
  • Suggesting areas where there is a need to drill down further in the evidence to add most value.

01/11/2016 – 31/05/2017 (6 months)