The effectiveness of interventions in reducing economic inactivity for people with long term health conditions and disabilities in the United Kingdom: a systematic review

Background: Economic inactivity, the proportion of people aged between 16 and 64 years who are not in the labour force, has increased significantly since 2020. Long-term sickness is the most common reason for economic inactivity. In the North of England, economic activity is lower, and levels of poor health in the working age population are higher, than national averages. The international literature reports many interventions designed to reduce economic inactivity including those designed to ameliorate the impact of health conditions on work participation, however, there is a need for high-quality evidence of what works for people with health conditions living in the United Kingdom (UK), and in particular for those living in areas of high deprivation such as the North of England. Methods: We conducted a systematic review preregistered with the open science framework. We searched AMED, ASSIA, Business Source Premier, CINAHL, Cochrane Library, MEDLINE, ProQuest Dissertations & Theses Global, PsycARTICLES, Science Direct, and Scopus to November 2023. Eligibility criteria for selecting studies consisted of experimental and observational studies published or in grey literature that examined the efficacy or effectiveness of interventions in reducing economic inactivity in people with health conditions living in the UK. Two reviewers independently screened abstracts and full texts followed by data extraction and synthesis using the Narrative Synthesis Framework. Results: Twenty-seven reports detailing sixteen unique studies and eight different interventions met the eligibility criteria and were included in the review. There was conflicting evidence for the effectiveness of sanctions on economic inactivity and the most robust evidence for classic individual placement and support although more evidence is needed for time-limited individual placement and support. Included studies highlighted the importance of providing specialist employment advice via skilled and experienced advisors but conflicting evidence on combining employment advice with specific psychological therapies. Conclusions: Overall, we found limited robust evidence of what works in reducing health related economic inactivity, particularly for populations experiencing elevated levels of socio-economic deprivation. Open science framework preregistration: https://osf.io/aucz9.