"I'm just not right": the physical health of the unemployed.

Medicine's bias is towards physical rather than psychological illness: in his training a doctor spends most time studying physical illness, and he will often go to great lengths to exclude a physical cause for a patient's symptoms, even though he is convinced that the cause is psychological. Readers may therefore be surprised that this article on the physical health of the unemployed comes after two articles on their psychological health, one on mortality, and another on suicide and parasuicide. But this reversal of the usual bias reflects the superiority of research into unemployment and psychological health compared with that into physical health. Despite Britain having more than three million unemployed people nobody has ever started the large longitudinal study that would have been needed to tell us exactly how unemployment affects physical health or, indeed, how much more at risk those in poor physical health are of becoming unemployed. The best studies that we have?those from the Office of Population Censuses and Surveys' longitudinal study1 and from the British Regional Heart Study2?are both spin offs from studies undertaken for other reasons; both therefore offer only partial insights into the problem. Both, too, collected their original data before unemployment in Britain had really taken off. The failure to start a high quality study of this problem is an indictment of politicians, doctors' leaders, and those who decide research priorities. Whether nobody saw the need for such a study or whether a study was proposed and rejected because of the political sensitivity of unemployment I do not know, but a variety of people around the country have suggested that the government has discouraged rather than encouraged research into unemployment and health.