Poor health can contribute to job loss and hinder entry into or return to the workforce; conversely, being “unemployed” can lead to deteriorating health. There are multiple reasons for the excess mortality among the unemployed: poor health leading to unemployment, the financial and psychological consequences of long-term unemployment, and the role of unemployment itself as a “catalyst” that reveals or exacerbates health effects. Furthermore, behaviors harmful to health (alcohol, tobacco, and illicit drug abuse) are more common among job seekers than among employed individuals.

As part of Santé publique France’s population health surveillance missions, the SESSE (Epidemiological Surveillance of the Health of Unemployed Persons) program will enable the development and provision of epidemiological health monitoring indicators to public authorities, physicians, healthcare professionals, social partners, and the public for this heterogeneous population across mainland France and the overseas departments and regions (DROM).

Santé publique France is committed to deepening knowledge about the health of the unemployed workforce in order to better characterize and identify the populations most at risk who require preventive measures to improve their health. This project is part of the cross-cutting program on occupational health surveillance and also addresses the issues of Social Inequalities in Health (ISS) and health equity to better account for the social determinants that require intervention. It also contributes to the body of knowledge for implementing prevention interventions that have proven effective.

Objectives

• To describe the various sociodemographic profiles and health status of “unemployed workers” in France by comparing them to other populations.

• Produce indicators of overall mortality and mortality by cause in this population and compare them with the general population and with other employed working-age populations across mainland France and the French overseas departments and regions (DROM), by age group, geographic area, and sex.

• To study the relative risks of death by cause, taking into account other sociodemographic and economic factors as well as living conditions, by age group, geographic area, and sex.

• Produce morbidity indicators by age group, geographic area, and sex.

The results obtained will provide a better understanding of the profiles of unemployed workers most at risk for health issues, in order to propose targeted prevention and health promotion initiatives.

Study Design and Study Population

The analyses are based on existing individual data derived from the linkage of two pre-existing datasets: the Dependent Demographic Sample (EDP) and the National Health Data System (SNDS). The EDP Health dataset is the result of deterministic linkage performed by the Drees.

The EDP data used in this study come from multiple available sources. These include data from the Socio-fiscal file, civil registry files, annual census samples, and the labor force panel. Mortality and causes of death are available in the SNDS, as well as data on healthcare utilization and health events of interest. Health data on hospitalizations, prescriptions, etc., come from multiple sources available within the SNDS, such as the DCIR, the Medical Information Systems Program, and medical causes of death.

The study population of interest consists of individuals included in the EDP Health database, aged 16 to 65, and alive as of January 1, 2008.

Data Privacy and Security

Throughout this study, specific measures were taken to ensure the confidentiality and IT security of the data processed.

All data provided undergoes preliminary processing to remove any information identifying individuals. It is stored on a highly secure server accessible only remotely (CASD) and is processed exclusively by authorized Santé publique France staff.

The published results will in no way allow individuals to be identified, even indirectly.

Information and Rights Regarding Personal Data

In accordance with the provisions of the amended French Data Protection Act and the General Data Protection Regulation (GDPR), you have the right at any time to access and correct your personal data, as well as the right to object to the processing of such data.

To this end, the notice below has been prepared to inform all data subjects and outline the steps they can take to exercise their rights with Santé publique France regarding the use of their personal information for this study.

Prior Reviews and Approvals

The protocol for this study received a favorable opinion from the Statistical Confidentiality Committee on November 30, 2023 (No. 4206-1) and from the Ethics and Scientific Committee for Research, Studies, and Evaluations in the Health Sector (CESREES) on March 14, 2024 (No. 14748182 and authorization from the National Commission on Informatics and Civil Liberties (CNIL) on June 17, 2024 (Decision: DR-2024-145), supplemented on October 28, 2024 (Decision DR 2024-265).

These opinions focus in particular on the scientific quality of the project and its ethical relevance, and verify the measures implemented to ensure the security and confidentiality of personal data processed as part of this monitoring.

When and how will the results be available?

The various phases of analysis will begin as soon as the data becomes available and will continue through November 2027.

All results from this study will be published on the Santé publique France website. They may also be featured in scientific articles.

Partnership and Funding

To conduct this analysis, INSEE provides access to EDP data, and an agreement between Santé publique France and DRES allows for the use of SNDS data linked to this sample. These data are provided free of charge.

Access via the CASD requires a formal agreement. The implementation of the technical infrastructure enabling remote data access and the human resources mobilized to carry out the analysis are fully covered by Santé publique France.