Metcalfe Chris, Davey Smith George, Sterne Jonathan A C, Heslop Pauline, Macleod John, Hart Carole
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, UK.
Soc Sci Med. 2003 Jan;56(1):1-15. doi: 10.1016/s0277-9536(02)00005-9.
The contemporary labour market is widely regarded as having become more "flexible". It is proposed that such flexibility is a characteristic of employment histories which will have effects on psychosocial status, health-related behaviour, and physical health. Recent increases in flexibility are unlikely to have accumulated over sufficient portions of individual employment histories for any effect on health to be apparent, but a "preview" of these effects may be gained from study of older cohorts. This cross-sectional study is based on data collected in the early 1970s from 5399 men and 945 women in paid work, recruited from 27 workplaces in the west of Scotland. A flexible employment history was defined as one encompassing a large number of changes between jobs. Perceived psychological stress, health behaviour (cigarette smoking, alcohol consumption, physical exercise), physiology (diastolic blood pressure, body mass index, forced expiratory volume, plasma cholesterol concentration) and current health (angina, myocardial ischaemia) were assessed. Those individuals who reported having experienced frequent job change were more likely to smoke, consume greater amounts of alcohol, and perhaps to exercise less. Similar findings were observed in both males and females, and for different age and socio-economic groups. We found no suggestion that this association was due to higher levels of psychosocial stress, and the expected consequences for health were not observed. Interpretation of these findings is not straightforward due to an uncertain direction of causation, and a possible selection bias. However, the observed relationship between frequent job changing and a higher incidence of health risk behaviours, in the absence of a relationship with poorer health, invites further research.
当代劳动力市场被广泛认为变得更加“灵活”。有人提出，这种灵活性是就业经历的一个特征，会对心理社会状况、健康相关行为和身体健康产生影响。近期灵活性的增加不太可能在个人就业经历的足够部分累积起来，以使对健康的任何影响变得明显，但通过对老年队列的研究可能会“预见到”这些影响。这项横断面研究基于20世纪70年代初从苏格兰西部27个工作场所招募的5399名在职男性和945名在职女性收集的数据。灵活的就业经历被定义为包含大量工作变动的经历。对感知到的心理压力、健康行为（吸烟、饮酒、体育锻炼）、生理指标（舒张压、体重指数、用力呼气量、血浆胆固醇浓度）和当前健康状况（心绞痛、心肌缺血）进行了评估。那些报告经历频繁工作变动的个体更有可能吸烟、饮酒量更大，并且可能锻炼较少。在男性和女性以及不同年龄和社会经济群体中都观察到了类似的结果。我们没有发现这种关联是由于心理社会压力水平较高的迹象，也没有观察到对健康的预期后果。由于因果关系方向不确定以及可能存在的选择偏差，对这些结果的解释并不简单。然而，在频繁换工作与较高的健康风险行为发生率之间观察到的关系，在与较差健康状况无关的情况下，值得进一步研究。
