LNSLNS

We thank Dr Hofmeister for his important contribution and for mentioning the successful intervention conducted by the colleagues in Rostock. Indeed, initial measures—albeit scarce in number—have started to improve physical and psychological aspects of the health of long-term unemployed people, supported by scientific evidence of a positive effect. However, we wish to point out that obesity beyond “increased physical inactivity” is a process with multifactorial causes—some of these factors were briefly mentioned in our article: a lack of motivation in people with depressive problems, difficult access to health services and healthy nutrition, social isolation, and physiological reactions to the permanent stress of long-term unemployment can also be involved. Studies from the Institute for Employment Research (1) have shown that people receiving Basic Social Security (Arbeitslosengeld II) payments are actually very active. Interventions that consider the situation of long-term unemployed people as a whole and adhere to clear quality criteria constitute the main requirement. In the original studies (references 19, 38) cited in the article (2) we go into greater detail in this respect. The principles of setting approach, empowerment, and participation—named by the Federal Centre for Health Education as good practice for health promotion for unemployed people (3), are essential in our experience also. The setting approach entails providing a service locally. Empowerment means enabling people better to recognize health stresses and develop effective approaches for action for and by themselves. Participation means including those affected actively in the processes of finding solutions and decisions; this benefits sustained effects of the measures. For the acceptance of services we deem it important to establish trust and, if possible, personal contact with long-term unemployed persons, for example, by pedagogically trained personnel at the respective institutions (4). Establishing good relationships is the prerequisite for successfully motivating people to adopt health-promoting behaviors.

DOI: 10.3238/arztebl.2013.0678b

On behalf of the authors:

Prof. Dr. med. Peter Angerer

Institut für Arbeitsmedizin und Sozialmedizin, Medizinische Fakultät

Heinrich-Heine- Universität Düsseldorf

peter.angerer@uni-duesseldorf.de

Conflict of interest statement

Dr. Herbig and Prof. Angerer received third-party funding for scientific evaluation of the research project AmigA-M from Germany’s Federal Ministry of Employment and Social Affairs and Jobcenter München (Munich Job Center).

Prof. Dragano declares that no conflict of interest exists.

1.
Beste J, Bethmann A, Trappmann M: ALG-II-Bezug ist nur selten ein Ruhekissen. IAB-Kurzbericht 15. Nürnberg 2010.
2.
Herbig B, Dragano N, Angerer P: Health in the long-term unemployed. Dtsch Arztebl Int 2013; 110(23–24): 413–9 VOLLTEXT
3.
Arbeitsgemeinschaft Gesundheitliche Chancengleichheit:
www.gesundheitliche-chancengleichheit.de/gesundheitsfoerderung-bei-arbeitslosen/gute-praxis/ (last accessed on 31 July 2013).
4.
Heinmüller M, Liel K, Angerer P, Gündel H, Geldermann B,
Gottwald M, Kimil A, Limm H: Gesundheits-Coaching in der
Arbeitsmarktintegration – Evaluation eins Qualifizierungskonzepts. [Health Coaching as a Part of Integration into the Job Market—
Evaluation of a Qualification Concept.] Gesundheitswesen 2013 Jun 18. [Epub ahead of print].
1.Beste J, Bethmann A, Trappmann M: ALG-II-Bezug ist nur selten ein Ruhekissen. IAB-Kurzbericht 15. Nürnberg 2010.
2.Herbig B, Dragano N, Angerer P: Health in the long-term unemployed. Dtsch Arztebl Int 2013; 110(23–24): 413–9 VOLLTEXT
3.Arbeitsgemeinschaft Gesundheitliche Chancengleichheit:
www.gesundheitliche-chancengleichheit.de/gesundheitsfoerderung-bei-arbeitslosen/gute-praxis/ (last accessed on 31 July 2013).
4.Heinmüller M, Liel K, Angerer P, Gündel H, Geldermann B,
Gottwald M, Kimil A, Limm H: Gesundheits-Coaching in der
Arbeitsmarktintegration – Evaluation eins Qualifizierungskonzepts. [Health Coaching as a Part of Integration into the Job Market—
Evaluation of a Qualification Concept.] Gesundheitswesen 2013 Jun 18. [Epub ahead of print].

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