Since the 1990s, most European countries have implemented activation policies targeting the unemployed. During the past decade, the target group for activation policies expanded and currently also includes persons with limitations in their ability to work due to long-term or chronic illness and disabilities. The argument underlying these policies is that labour-market exclusion is the main cause for social marginalization because participation in paid work provides important social and psychological functions that cannot be found elsewhere. Based on an extensive set of quantitative data that combines register data and survey data, and using structural equation modelling, this paper analyses the relationship between chronic illness and social marginalization, and in particular which role labour-market exclusion plays in this relationship. Is labour-market exclusion a crucial factor in explaining why individuals with chronic illnesses face a higher risk of social marginalization if factors such as income and education are also taken into account? From the statistical results, the paper states that individuals with chronic illnesses face a far higher risk of social marginalization, but that this risk is caused by their health limitations and not by their lack of labour-market participation. Contrary to the policies’ logic and the theoretical argument of psycho-social theories originating from the deprivation perspective, no direct, indirect or mediating effects of labour-market exclusion on social marginalization were identified.

中文翻译：

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社会边缘化和慢性病：劳动力市场排斥作用的批判性分析

自 1990 年代以来，大多数欧洲国家都实施了针对失业者的激活政策。在过去十年中，激活政策的目标群体扩大了，目前还包括因长期或慢性疾病和残疾而导致工作能力受限的人。这些政策背后的论点是，劳动力市场排斥是社会边缘化的主要原因，因为参与有偿工作提供了其他地方无法找到的重要社会和心理功能。基于结合登记数据和调查数据的大量定量数据，并使用结构方程模型，本文分析了慢性病与社会边缘化之间的关系，特别是劳动力市场排斥在这种关系中的作用。如果同时考虑收入和教育等因素，劳动力市场排斥是否是解释慢性病患者面临更高社会边缘化风险的关键因素？从统计结果来看，该论文指出，患有慢性病的人面临更高的社会边缘化风险，但这种风险是由他们的健康限制引起的，而不是由于他们缺乏劳动力市场参与。与源自剥夺视角的政策逻辑和心理社会理论的理论论点相反，没有发现劳动力市场排斥对社会边缘化的直接、间接或中介影响。