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Research problem and specific questions Although In-Work Poverty (IWP) is increasingly prevalent throughout Europe, evidence about its relationship with health is scarce. The combination of work and poverty makes the working poor a distinct group who could experience a variety of negative health-related outcomes. This project investigates the longitudinal effects of IWP on mental disorders, cardiovascular disease (CVD), and mortality among different sub-groups in Sweden.Data and methodThree cohort studies will be conducted using the register-based Swedish Work, Illness, and labour-market Participation (SWIP) cohort. The SWIP cohort contains data from multiple registers, which includes approximately 5.4 million individuals (16–64-year-old) who are registered as living in Sweden in 2005. The two dimensions of the exposure, IWP, will be captured using the SWIP data. The first is a person’s working threshold that determines if they are working or not. The second is the poverty line

a pooled disposable household income below the average (60% of the median) for Sweden. Trajectories of IWP will be used to investigate potential gains and losses associated with entry and exit routes to IWP. The outcomes mental ill-health, CVD and mortality will be taken from the inpatient, pharmaceutical or the death registers. Survival analysis will be used to calculate Hazard Ratios (HR) with 95% Confidence Intervals (CI). An intersectional approach will be used to investigate if the risks of poor health determined by IWP differ between sub-groups based on sex, age or migration status. Societal relevance and utilisation Employment has been viewed as the main tool to elevate poverty in Sweden. However, most people suffering from the current ‘cost-of-living crisis’ are employed. We must look beyond division between people who are included or excluded from the labour market to address poverty and health inequalities in Sweden. This project contributes to the state-of-the-art by investigating associations between IWP and health that are, as yet, unknown. The results will inform strategies aimed at reducing health inequalities among the workforce in Sweden and globally and add to a broader discourse on poverty in Sweden. Plan for project realisation This project will be carried out between January 2024 to December 2026. The project leader and a research assistant will be salaried to work on the project with the mentorship of senior researchers from epidemiology and social policy.