Dr Paula Holland

Lecturer in Public Health

Personal Introduction

I joined the Division of Health Research in 2008 as a Lecturer in Public Health. Prior to that I worked as a Research Fellow, focussing on social inequalities in health, at the University of Liverpool (with Professor Margaret Whitehead) and Imperial College, London (with Professors David Blane, George Davey Smith and David Gunnell). For several years my equity work has examined how chronic illness affects individuals’ employment and financial circumstances. While at the University of Liverpool my work for an MRC Special Training Fellowship examined employment and income among people with chronic illness in the UK and among people diagnosed with ischaemic heart disease, musculoskeletal disorders and mental illness in Sweden. At the University of Liverpool I also worked on an international study of gender and social inequalities in labour market participation among disabled and chronically ill people in the UK, Denmark, Norway, Sweden and Canada. The employment consequences of chronic illness are particularly severe among women, low-skilled manual workers and people with low education, particularly in countries like the UK and Canada which, compared to Nordic countries, spend a lower proportion of their GDP on active labour market programmes designed to help disabled people back to work, and have lower levels of welfare benefits for people unable to work.

We know less about precisely why and how people with chronic illness become detached from the labour market, or about the factors that enable them to return to employment. Currently I am conducting a systematic review which will identify and synthesise qualitative research that has focused on the employment experiences of men and women with chronic illness from different socio-economic backgrounds. The results from the review will be used to guide a qualitative pilot study of the employment consequences of chronic illness in the North West. The pilot study will examine how and why people with chronic illness leave employment following onset of chronic illness. It will explore how gender and social class influence the experience of chronic illness and labour market participation, how employers contribute to health-related job loss, and what factors are important in enabling some people with chronic illness to remain in paid work.