Rosanne Schaap

242 Chapter 8 General discussion The overall aim of this thesis was to address the importance of improving the health and sustainable employability of workers in a vulnerable position, and to investigate how they can be adequately supported at the workplace by occupational health professionals (OHPs) and their supervisors. Before discussing the main findings of this thesis, I would like to return to the phrase ‘work is healthy’. In essence, having a job is healthier than having no job. However, some workers are placed in a more vulnerable position regarding work and health, because of their (health) problems on multiple life domains and difficulties to (re-)enter the labor market and to be sustainably employed. Therefore, studying how to facilitate sustainable employment of workers in a vulnerable position was an essential part of this thesis. In this chapter, the main findings of this thesis are summarized. Then, the diversity of the target group ‘workers in a vulnerable position’ are described and the main methodological considerations. Thereafter, the findings in this thesis are discussed by the following themes: 1) reflecting on the complexity of systems for workers in a vulnerable position and 2) the role of OHPs and supervisors in these complex systems. Finally, recommendations for research, policy and practice are described. This chapter will end with the main conclusions of this thesis. Main findings Part I: The effects of exit from work among workers in a high and low socioeconomic position The first aim of this thesis was to investigate the differences of exit from work on health between workers with a low socioeconomic (SEP) and workers with a high SEP. Chapter 2 describes the results of a systematic review which indicated that the effects of exit from work on health are more negative among workers with a lower SEP. This group of workers may possess fewer resources (e.g., poorer financial situation, unhealthier living conditions) to deal with the changes in one’s life following exit from work. This could more rapidly result in health declines after exit from work in groups of workers with a lower SEP. These findings emphasized that the promotion of health, especially after exit from work, requires more attention among workers with a lower SEP, as opposed to workers with higher SEP. Moreover, the findings of this review also indicated that there is a higher need to prevent exit from work among workers with a lower SEP, as they might experience more negative consequences of job loss.

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