|Author||Rueda, Sergio Ismael|
|Publisher||University of Toronto; Toronto|
This dissertation consists of four papers aimed at understanding the complex relationship between employment and health. One paper is a systematic review of the return to work literature, while the other three papers used secondary data from three cohorts of people with HIV to examine the association between employment and health-related quality of life. The systematic review looked at longitudinal studies that reported health outcomes associated with return to work in relation to other employment trajectories. This review supported the beneficial effect of return to work on health in a variety of populations, times, and settings, and also found evidence that poor health interferes with the prospects of returning to work. Two other papers looked at the association between employment and health-related quality of life in people with HIV; one paper used a cross-sectional sample of people with HIV, while the other paper used a longitudinal sample of men who have sex with men. These two studies found evidence to support the association between employment and both physical and mental health-related quality of life. They also found that employment had a stronger relationship with physical than mental health, suggesting an adaptation process to the experience of unemployment. Finally, another paper examined the cross-sectional association between job security and quality of life in men and women living with HIV. This study found that job security offered additional mental health quality of life benefits, over and above participation in employment alone, for men living with HIV. On the other hand, women benefited from the availability of work, but the perception of job security failed to offer additional health benefits. The current level of evidence on the relationship between work and health in HIV needs to be strengthened by further research to develop and support practical clinical and policy recommendations.