OBJECTIVES: To assess socio-medical status of unemployed persons registered in Germany between 2016 and 2021 regarding medical diagnoses and work ability. STUDY DESIGN: We conducted a secondary data analysis. METHODS: We used t-test to compare means of groups and odds ratio to calculate the probability for work ability. RESULTS: 4.3 million clients were assessed (43.3 ± 13.2 years
52.4 % male). Nearly all clients (96.5 %) received at least one diagnosis. Regarding first and secondary diagnosis, 52.1 % suffered from mental disorders, followed by diseases of the musculoskeletal system and connective tissue (31.4 %), and the circulatory system (10.7 %). Of those with at least one diagnosis 41.7 % were unable to return to work. Clients with mental disorders (first diagnosis) were more likely to be unable to work (68.2 %, n = 958,144) than those with diseases of the musculoskeletal system and connective tissue (16.9 %, n = 237,459) and diseases of the circulatory system (9.4 %, n = 131,513). CONCLUSIONS: Our study provides disease prevalence and work ability based on secondary data of all socio-medical assessments of the German Federal Employment Agency between 2016 and 2021. Further studies should be enhanced by both individual and external factors to provide a broader perspective. Labor market policy instruments should address both, the improvement of re-employment rates and the targeted prevention of diseases among unemployed. It is mandatory to define target populations who suffer from an increased risk for (mental) health problems and to design future labor market instruments.