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In 2011 in Spain there were 7.6 million persons aged 16-64 who suffered from at least one chronic disease (24.8% of the total of persons in that age range). Amongst them, 3.9 million persons were occupied (i.e. 21.3% of all the occupied in Spain). In particular, back or neck problems were the most recurrent chronic health issue, affecting more than 2 million persons in total. From an age perspective, older workers are more likely to suffer from chronic diseases. On the other hand, initiatives developed by public authorities or social partners to favour the employment situation of people with chronic diseases seem to have been poorly developed in Spain.
There is no clear definition of chronic disease in Portugal.Existing data show that 40.5% of the persons aged 15-64 years have chronic disease. Musculoskeletal problems, heart problems, high blood pressure and blood circulation are the most prevalent chronic diseases. Women are particularly affected by chronic diseases, including among those who are in employment.The Portuguese Labour Code includes a set of measures aiming at protecting and supporting workers with a chronic disease or a disability. And three collective agreements dated of 2012 established clauses to support workers with reduced capacity to work.
Over the past few years, the number of people suffering from chronic diseases in Luxembourg seems to have increased. However, the notion of chronic disease is not clearly defined in Luxembourg and as a consequence, the issue of the employment situation of people with chronic diseases is not very apparent. When dealing with working conditions, the focus is more commonly placed on the broader category of disabled workers.
People with chronic diseases in general are not treated as a specific target group in employment and working conditions policies. These policies and the consequent monitoring are focused on two target groups that are closely related but not identical to people with chronic diseases: people suffering from occupational diseases and people with disabilities. Policies regarding occupational diseases are focused on improving of working conditions and include assistance in treatment of occupational diseases. Persons with disabilities are a target group of employment promotion policies.
In Italy, the Labour Force Survey 2011 ad-hoc module carried out by ISTAT is the only available survey focusing on chronic diseases. The ISFOL quality of work survey investigates their distribution. Participation in employment is lower especially for those with chronic diseases with more than one health problem or functional impairment. The most relevant work-related limitations of workers with chronic diseases are the type of tasks they can perform and the number of working hours they can work. Lack of adequate opportunities is the main problem employees’ with chronic diseases face.
According to the data, the labour force participation rate of people with chronic diseases/illnesses is 27%, which is higher than the 13% participation rate for the total number of people with disabilities. A number of Government and social partner initiatives have been put into effect over the last 10 years to raise awareness and facilitate the retention of employees with a disability/ illness. The fall in the rate of discrimination of people with a disability in the workplace between 2006 and 2011 – while the rate for people without a disability increased – as well as enhanced legislation to protect the employment of people with a disability reveals an increasing awareness of disability/illness at work in general.
Chronic diseases impact about 20% of the population but there is a lack of data and surveys about the employment of people with chronic diseases. Even if the public agency ANACT is very active in this field, employees with chronic disease are still a category of employees which has to face an increasing risk of unemployment, precarious professional career and discrimination.
In Estonia, the concept of incapacity to work is used in the field of social and employment policy. The definition is based on health conditions and people with chronic disease could apply for insurance payment and services. There is large share of people with chronic diseases that are inactive or unemployed. Employment of people with chronic diseases depends on both their willingness to work and also supply of suitable employment and working conditions that could take into account their special needs. The policy measures have enabled inactivity and have not provided enough support for staying in work and return to work.
In Denmark chronic disease is defined as diseases that are recurrent or have a long-term prognosis. In an employment context, the terms disability and work disability, is more used than chronic disease because, the entitlement for social transfers (sickness absence or permanent disability benefits), is based on workability not the diagnose.. The companies are responsible for handling employees with chronic diseases. A report from the Danish National Centre for Social Research shows that in 42% of Danish companies employed at least one disabled person and over 1/3 of these companies offered special conditions for their disabled workers.
People with persisting health-related problems have difficulties to integrate in the labour market in the Czech Republic. Lower employability, worse working conditions and employment positions for people with chronic diseases, missing pro-active employment policies addressing this specific group of workers, and an emphasis on financial compensation result in a tendency of chronically ill persons to opt for disability or early retirement pension.