Reine Ieva, Novo Mehmed, Hammarström Anne
Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, SE-901 85 Umeå, Sweden.
BMC Public Health. 2008 May 13;8:159. doi: 10.1186/1471-2458-8-159.
Having secure employment, in contrast to being unemployed, is regarded as an important determinant of health. Research and theories about the negative health consequences of unemployment indicated that transition from unemployment to a paid job could lead to improved health. The objective of this study was to test the hypothesis that obtaining permanent employment after being in an unstable labour market position protects mental health.
A 14-year follow-up of all graduates from compulsory school in an industrial town in northern Sweden was performed at ages 16, 18, 21 and 30 years. Complete data on the cohort were collected for 1044 individuals with the aid of a comprehensive questionnaire. The response rate was 96.4%. The health measurement used in this study was the psychological symptoms analysed by multivariate logistic regression. Those who obtained permanent employment were the focus of the analysis. This group consisted of people who were in an unstable labour market position for a year or more between the ages of 25 and 29, and who had acquired a permanent job one year before and at the time of the investigation.
After controlling for gender as well as for an indicator of health-related selection, possible confounders and mediators, an association was found between the lower probability of psychological symptoms and obtaining permanent employment (OR = 0.35, 95% CI 0.19-0.63) as well as having permanent employment (OR = 0.22, 95% CI 0.10-0.51).
Our findings suggest that transition from an unstable labour market position to permanent employment could be health-promoting, even after controlling for possible confounders and mediators, as well as for an indicator of health-related selection. However, as there are few studies in the field, there is a need for more longitudinal studies in order to further analyse the relationship and to examine possible explanations. The policy implication of our study is that the transformation of unstable labour market positions into permanent employment could contribute to better public health.
与失业相比，拥有稳定工作被视为健康的重要决定因素。关于失业对健康产生负面影响的研究和理论表明，从失业过渡到有薪工作可能会改善健康状况。本研究的目的是检验这样一个假设，即在处于不稳定劳动力市场状况之后获得长期工作能够保护心理健康。
对瑞典北部一个工业城镇所有义务教育毕业生进行了为期14年的随访，随访时间分别为16岁、18岁、21岁和30岁。借助一份综合问卷，收集了1044名个体的完整队列数据。应答率为96.4%。本研究中使用的健康测量指标是通过多变量逻辑回归分析的心理症状。获得长期工作的人是分析的重点。这一组包括在25至29岁之间处于不稳定劳动力市场状况一年或更长时间，并且在调查前一年及调查时已获得长期工作的人。
在控制了性别以及与健康相关的选择指标、可能的混杂因素和中介因素后，发现心理症状发生概率较低与获得长期工作（比值比=0.35，95%置信区间0.19 - 0.63）以及拥有长期工作（比值比=0.22，95%置信区间0.10 - 0.51）之间存在关联。
我们的研究结果表明，即使在控制了可能的混杂因素、中介因素以及与健康相关的选择指标之后，从不稳定劳动力市场状况过渡到长期工作仍可能促进健康。然而，由于该领域的研究较少，需要更多的纵向研究以便进一步分析这种关系并探究可能的解释。我们研究的政策意义在于，将不稳定劳动力市场状况转变为长期工作有助于改善公众健康。
