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

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.