The importance of government policies in reducing employment related health inequalities

The current economic recession has caused striking levels of unemployment, underemployment, and job insecurity globally. The International Labour Organization (ILO) estimated that the number of unemployed people was 212 million in 2009, and projects the global unemployment rate in 2010 to be 6.5%, with a confidence interval ranging from 6.1% to 7%. In rich countries in the Organization for Economic Co-operation and Development more than 57 million people, or 10%, are unemployed in 2010,1 the current unemployment rate in Spain is 20%, and in the United States the rate is around 10% using conservative estimates. The ILO has predicted that the impact of the economic crisis on vulnerable employment is likely to have increased the number of working poor—those living on $1.25 (£0.8; €0.9) a day—by 215 million workers between 2008 and 2009, and that in 2009 there were between 1.48 and 1.59 billion vulnerable workers worldwide.2 These developments will increase global health inequalities, and inequalities between social classes within countries because unemployment and underemployment cluster among lower income countries and workers.3 In this article we explore the relation between unemployment, poor working conditions, and health, and argue that governments and public health agencies should recognise that fair employment conditions should be regarded as a human right.