The role of individual and contextual factors in paid employment of workers with a chronic disease

Workers with chronic diseases are at an increased risk of early exit from paid employment. The aim of this thesis was to examine individual and contextual risk factors in early exit from paid employment among workers with common chronic diseases in the Dutch workforce. The results of this thesis show that it is important to not only focus on the disease itself, but to also take unhealthy behaviour and possible other chronic diseases into account. In addition, results show that an unfavourable work or living environment can increase the risk of early exit from paid employment, especially into unemployment and work disability. The findings also suggest that the impact of the psychosocial work environment on early exit from paid employment is rather similar for workers with and without chronic diseases, but differs for workers with depression. Workers with depression do not benefit from more job resources to deal with high job demands at work. Lastly, results of prediction models indicate that risk factors for early exit from paid employment are better examined at the population level rather than at the individual level. Altogether, the results in this thesis support the need for more tailored approaches in supporting workers with chronic diseases at work. This can ultimately contribute to sustainability of the social security system.