Morrell S, Taylor R, Quine S, Kerr C, Western J
Department of Public Health and Community Medicine, Faculty of Medicine, University of Sydney, NSW, Australia.
Soc Sci Med. 1999 Aug;49(3):383-92. doi: 10.1016/s0277-9536(99)00102-1.
Recent studies have demonstrated a link in young populations between unemployment and ill health. The purpose of this study is to correlate mortality with employment status in two cohorts of young Australian males, aged 17-25 years, from 1984 to 1988. Two youth cohorts consisting of an initially unemployed sample (n = 1424 males) and a population sample (n = 4573 males), were surveyed annually throughout the study period. Those lost to follow-up during the survey period were matched with death registries across Australia. Employment status was determined from weekly diaries and death certificates and was designated as: employed or student; unemployed; not in the work force (excluding students). Conditional logistic regression, using age- and cohort- matched cases (deaths) and controls (alive), was used to estimate the odds ratio (OR) of dying with regard to employment status, taking into account potential confounders such as ethnicity, aboriginality, educational attainment, pre-existing health problems, socio-economic status of parents, and other factors. Twenty three male survey respondents were positively matched to death registry records. Compared to those employed or students (referent group), significantly elevated ORs were found to be associated with neither being in the workforce nor a student for all cause, external cause, and external cause mortality other than suicide. Odds ratios were adjusted for age, survey cohort, ethnicity, pre-existing physical and mental health status, education level, and socio-economic status of parent(s). A statistically significant increasing linear trend in odds ratios of male mortality for most cause groups was found across the employment categories, from those employed or student (lowest ORs), through those unemployed, to those not in the workforce (highest ORs). Suicide was higher, but not statistically significantly, in those unemployed or not in the workforce. Suicide also was associated, though not significantly, with the respondent not living with their parents when they were 14 years of age. No association was found between mortality and past unemployment experience, as measured by length of time spent unemployed, or the number of spells of unemployment experienced during the survey. The results of this study underscore the elevated risk to survival in young males as a consequence of being neither employed nor a student.
近期研究表明，在年轻人群体中，失业与健康状况不佳之间存在联系。本研究的目的是关联1984年至1988年两个年龄段为17 - 25岁的澳大利亚年轻男性队列的死亡率与就业状况。两个青年队列，一个最初为失业样本（n = 1424名男性），另一个为总体样本（n = 4573名男性），在整个研究期间每年接受调查。在调查期间失访的人员与澳大利亚各地的死亡登记处进行了匹配。就业状况根据每周日记和死亡证明确定，并分为：就业或学生；失业；不在劳动力队伍中（不包括学生）。使用年龄和队列匹配的病例（死亡者）和对照（存活者）进行条件逻辑回归，以估计在考虑潜在混杂因素（如种族、原住民身份、教育程度、既往健康问题、父母的社会经济地位及其他因素）的情况下，与就业状况相关的死亡比值比（OR）。23名男性调查受访者与死亡登记记录进行了正向匹配。与就业或学生（参照组）相比，发现对于所有原因、外部原因以及除自杀外的外部原因死亡率，不在劳动力队伍中且不是学生的人群的OR显著升高。比值比针对年龄、调查队列、种族、既往身心健康状况、教育水平以及父母的社会经济地位进行了调整。在各就业类别中，发现大多数死因组男性死亡率的比值比存在统计学上显著的上升线性趋势，从就业或学生（最低OR），到失业者，再到不在劳动力队伍中的人（最高OR）。失业或不在劳动力队伍中的人群自杀率较高，但无统计学显著性。自杀还与受访者14岁时未与父母同住有关，虽不显著。在死亡率与过去的失业经历（以失业时长衡量）或调查期间经历的失业次数之间未发现关联。本研究结果强调了年轻男性既未就业也非学生所导致的生存风险升高。
