Obviously, chronic health failure may have a number of negative consequences for those affected. Lower chances of securing paid employment is one of them. As demonstrated by Figure 21, compared to those without any chronic health problem, only about one-fourth as many of those afflicted by a severe longstanding problem are in the labour force. The effect of chronic health problems on labour force participation is similar for all three groups (although we see that the higher labour force participation amongst ex-Gazans outside Jerash noted above also holds for those with chronic health problems). Another consequence of lasting health failure is the greater need for health care — both for regular follow-up and because some of the chronically infirm are more disposed to suffer acute illnesses. Access to affordable quality health services is more difficult for exGazans. Firstly, as explained in chapter 1, due to their non-citizen status, they are less likely to be covered by health insurance schemes and thus typically both pay higher prices for public services and depend on more expensive private services. Secondly, and this is particularly relevant for ex-Gazans in Jerash camp, they are poorer and cannot afford such services. Figure 21 Labour force participation rate by health status, i.e. chronic health failure, among individuals aged 15 and above (n=60,039). Other Palestinain refugees Other ex-Gazans Ex-Gazans, Jerash Severe chronic problem Chronic problem No chronic problem 0 20 40 60 80 Per cent Educational attainment and labour force participation Educational attainment typically has a positive impact on labour force participation rates. This is also the case here, for all three groups of Palestinian refugees and both for women and men (Figure 22). It is most pronounced for women: of ex-Gaza women aged 20 and above in Jerash camp, those who have completed education beyond secondary school (and were not currently enrolled at the time of the survey) are four to five times as likely to be economically active as those with shorter education (at 29% versus 5 to 9%). The trend is similar for ex-Gazans outside Jerash and other Palestinian refugee women. Figure 22 shows the comparably low level of labour force participation for women with secondary or lower education. The picture for men is less clear but a positive overall association between education and labour force participation can be observed: men with higher education are economically active more often than other men. Yet the dip in the curve for men in Jerash camp who have attained secondary schooling without pursuing successfully any education beyond that is somewhat surprising and something we cannot account for. ‘Just getting by’ Ex-Gazans in Jerash and other refugee camps in Jordan 63