9 General introduction Research shows that labor force participation is the lowest among this group of workers (18). Moreover, problems on multiple life domains are also more prevalent among workers with a work disability (13, 19), which is in accordance with lower SEP workers, also a major barrier for work participation (15, 19). Given the above, parallels exist between workers with a lower SEP and workers with a work disability; i.e. vulnerable position in the labor market, having problems to (re-)enter the labor market, to be sustainably employed and often facing health problems in combination with problems on other life domains. There is also substantial overlap between workers with a lower SEP and workers with a work disability. A large part of workers with a work disability also has a lower socioeconomic position, as people with a disability more often have a lower educational level or little to no work experience (20). Besides, it is also plausible that lower SEP workers more often have a work disability, as they have lower health status and thereby higher chance to develop disabilities and less educational opportunities (21). Hence, both of these groups have in common that they are in a vulnerable position in the labor market, which increases the risk to drop early out of the labor market. Thus, facilitating sustainable employment and the prevention of job loss is what we aim to achieve in this thesis for workers in a vulnerable position, namely workers with a lower SEP and workers with a work disability. Facilitating sustainable employability of workers in a vulnerable position Sustainable employability can be defined as ‘The extent to which workers can achieve and maintain opportunities for valuable work functioning (capabilities) and enjoy the necessary conditions that allow them to make a valuable contribution through their work, now and in the future, while safeguarding their health and welfare’ (22). Central in this definition are the capabilities, which refers to skills and environmental conditions of an individual to achieve valuable work functioning. This definition emphasizes that individual skills, but also factors in the work and personal environment are important to remain sustainably employed. Individual skills for sustainable employment In the Netherlands, the government partially carries the responsibility for the health and wellbeing of all citizens. In the past 20 years changes have taken place in laws and regulations, reflecting a change from a welfare state to a participation society. Everyone who is considered able, must take responsibility for their own health and well-being. According to opponents of this participation society, too much emphasis is placed on the individual responsibility of citizens (23). However, it is increasingly pointed out that the ability of people to make ‘healthy’ choices is overestimated (23). Not all people are equipped to do that due to a lower health literacy. Health literacy enables people to obtain, understand, appraise, and use information to make decisions and take actions in ways that will have a positive 1
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