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Pathways back to work for people with disabilities

Despite having some of the most progressive social security policies in Europe, the majority of people with disabilities in Norway struggle to get and retain paid work.

Employee who uses a wheelchair

Less than 45% of Norwegians of working age with disabilities that restrict their daily lives are in employment compared with a national average of 75% having jobs in the 16 to 64 age group.

The situation is even worse for those with longer-term impairment, with the number in regular paid work hovering just above the 30% mark in recent years.

To help overcome barriers faced by people with chronic diseases and mental disorders gaining access to the labour market, researchers at the Oslo and Akershus University of Applied Sciences (HiOA) have teamed up with colleagues from nine other European countries in the €1.6million PATHWAYS project co-funded by the European Union Health Programme (2014-2020).

Dr Rune Halvorsen is leading the contribution from HiOA in the three-year EU PATHWAYS project. He has extensive experience of international research programmes and is an expert in disability and employment policy and pioneered research into political participation of socially excluded groups.

Promoting integration

A sociologist and associate professor of international health and social policy, Halvorsen explained the European initiative aims to find examples of best practice from different countries to share in policy briefings for national governments and agencies.

He said: "Our European research project is looking at the most effective ways of promoting integration and reintegration of people with chronic diseases and disabilities into the labour market. This can be an important step in their recovery and we are examining how to remove the obstacles preventing them getting back into employment.

“The EU Health Directorate believes work gives people a more regulated daily routine and can help their mental well-being and avoid their health deteriorating.

“So from a health perspective it is important that people with disabilities and chronic diseases are not excluded from employment and that they do not have to live in poverty.”

Dr Matilde Leonardi, the PATHWAYS project coordinator from Italy, added: “While legislation is often there to support people with disabilities, many countries have no idea where to put, or what to do with, people developing chronic conditions who are already in the workplace.

“Taken together with an ageing working population and the increase in workers with non-communicable diseases, our research highlights the need for innovative strategies to improve the participation of people with chronic diseases in the labour market.”

Much of the original focus of the three-year project was on southern Europe, where the economic crisis of 2008 hit the hardest: Countries like Greece which cannot afford expensive labour market inclusion programmes because of the budget deficits and which face cuts to funding despite understanding that investment to help people with disabilities back to work has long-term these benefits will be repaid in the form of taxes.

Not so rosy in the Nordic countries

But, according to Halvorsen, things are not so rosy in the Nordic countries despite generous levels of social support spending in terms of sickness and disability payments.

"Our research to date shows very disappointing progress being made over the last 20 to 30 years in terms of improving job prospects for people with chronic diseases and mental disorders."

Halvorsen is working with two other HiOA research colleagues, Jon Erik Finnvold and Siri Yde Aksnes, on the PATHWAYS project. The team is surveying people with disabilities including those recovering from cancer and other neurological and cardiovascular diseases to find out what is preventing returning to work after long-term illness.

Aksnes is also carrying out ethnographic fieldwork to identify factors likely to make employers more inclined to offer jobs to people with chronic diseases or other impairments for her PhD project. This is looking at an employer-led programme to reintegrate people in working life, involving a formalised collaboration between private enterprises and vocational rehabilitation enterprises.

The project challenges the idea that labour market inclusion is only a welfare state responsibility.

Norwegian survey data from earlier research demonstrated that employers are less likely to invite someone for an interview if they have a disability or impairment.

“There is a stereotype view among many employers, who often assume people with chronic or mental illnesses will not be able to fit in or they will have reduced working capacity and be less productive, and this is preventing them offering jobs to people with disabilities,” explained Aksnes.

Tripartite agreement – but little progress

Halvorsen added that a tripartite agreement on Inclusive Working Life signed by Norwegian employers, trade unions and the government in 2001 included a focus on inclusion and reintegration of persons with reduced working capacity, but this part of the agreement has seen very little improvement.

“We’ve had legal duties since 2005 to accommodate workplaces for people with reduced working capacity and follow up action plans to ensure a return to working life after sick leave.

“We’ve even got financial incentives and temporary wage subsidies to compensate for lower productivity. So we should have made more progress in the Nordic countries with all our active labour market policy measures,” he said.

Halvorsen believes the PATHWAYS project has particular interest from a Nordic perspective because it aims to identify strategies to improve both the transition to the labour market and retention of paid work when people get ill or develop a disability.

“Specifically, we will address various transitions, including from education to the labour market and from sick leave back into employment. Peoples’ ways in and out of the labour market have different forms,” he said.

Is generous sick leave a barrier to returning to work?

It will also examine whether the generous sick leave available in Norway, which guarantees 100% payment from day one, is a barrier to returning to work.

Halvorsen said: “We will be looking at how flexible social security systems are and whether they allow people to combine work and still be in receipt of any kind of sickness or disability benefits and what the threshold is to combine benefits and paid work.

“For many people it is crucial to have the benefits available as a back-up if they get sick again. A big concern is losing all your benefits if you want to get back into the labour market and having to go through all the medical examinations and red tape again if you turn ill again.”

The PATHWAYS project will examine whether lack of flexibility in the systems in different European countries can be a barrier to people returning to work if they still have health problems.

The research will also look at the self-employed and those running small and medium-sized enterprises, or SMEs, where people have to have their own insurance.

The researchers are currently in the middle of major data collections and surveying patients’ organisations in Europe and asking people directly involved about their experiences and the challenges they face and seeking their recommendations for improving the system.

“We hope the PATHWAYS project will make a significant contribution to making people healthier by helping them reintegrate back into society by re-entering the labour market,” said Halvorsen.

About the project

  • Twelve universities are involved in the study, two from both Spain and Austria and one each from Italy, Norway, Greece, Slovenia, Poland, Germany, Czech Republic, and Belgium.
  • The project is coordinated by Dr Matilde Leonardi from Fondazione IRCSS Istituto Neurologico Carlo Besta, Milan, Italy.
  • HiOA is representing the ‘Nordic’ model of social welfare in the study.
Nic Mitchell Published: Updated:

The PATHWAYS project

The PATHWAYS project began in May 2015 and the most important outcome will be a set of guidelines for professional integration and reintegration strategies. These will be presented in April 2018 to EU and policy makers as well as to the member states and organisations that have taken part in the project.

See www.path-ways.eu for more information about the PATHWAYS project.