Working poor in Germany: Dimensions of the problem and repercussions for the health-care system

The 'working poor' may not exceed the poverty threshold despite full-time (or even double) employment. The general relationship between poverty and illness is understood, but little is known about specific health implications of the 'working poor' status. The proportion of 'working poor' is increasing in Germany. Poverty-related health problems occur because of a lower standard of nutrition and housing, financial restraints, bad labour conditions, high-risk behaviours, and lack of access to health services. Impaired health status, in turn, adversely affects incomes and wages, raising concern about a vicious circle. Limited health-care resources demand preventive policies to improve employment status and income. Health and economic policy demand specific research on the health implications of precarious employment. In some areas, swift action is required.