Waynforth David
School of Medicine, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4229, Australia.
Evol Med Public Health. 2018 Mar 27;2018(1):92-99. doi: 10.1093/emph/eoy009. eCollection 2018.
Jobs for life have become increasingly rare in industrialized economies, and have been replaced by shorter-term employment contracts and freelancing. This labour market change is likely to be accompanied by physiological changes in individuals who have experienced little job stability. Evolved responses to increased environmental instability or stochasticity include increased fat deposition and fight-or-flight responses, such as glucose mobilization and increased blood pressure. These responses may have evolved by natural selection as beneficial to individuals in the short-term, but are damaging in the longer term.
This study tested whether job losses experienced between ages 30 and 42 are associated with increased body weight, hypertension and diabetes diagnosis in the 1970 British Birth Cohort, which consists of all registered births in a one-week period in April 1970.
Each job loss experienced increased the odds of developing diabetes by 1.39 times (CI 1.08-1.80), and of hypertension by 1.28 times (CI 1.07-1.53). Another economic variable, higher personal debt, was associated with all three of these health outcomes: every £100 000 of debt roughly doubled the odds of gaining at least 5 kg between ages 30 and 42.
These associations between job loss and health-risk factors suggest that our changing economy results in increases in the prevalence of risk factors for cardiovascular disease. At a broader level, they are consistent with evolutionary understandings of environmental stochasticity, and are a reminder that economic policy is also health policy.
在工业化经济体中，终身工作越来越罕见，取而代之的是短期雇佣合同和自由职业。这种劳动力市场的变化可能伴随着工作稳定性较差的个体出现生理变化。对环境不稳定性或随机性增加的进化反应包括脂肪沉积增加以及战斗或逃跑反应，如葡萄糖动员和血压升高。这些反应可能通过自然选择在短期内对个体有益，但从长远来看是有害的。
本研究在1970年英国出生队列中测试了30至42岁期间经历的失业是否与体重增加、高血压和糖尿病诊断相关，该队列包括1970年4月某一周内所有登记的出生人口。
每次经历失业会使患糖尿病的几率增加1.39倍（置信区间1.08 - 1.80），患高血压的几率增加1.28倍（置信区间1.07 - 1.53）。另一个经济变量，即较高的个人债务，与所有这三种健康结果相关：每10万英镑的债务大致使30至42岁之间体重至少增加5公斤的几率翻倍。
失业与健康风险因素之间的这些关联表明，我们不断变化的经济导致心血管疾病风险因素的患病率上升。从更广泛的层面来看，它们与对环境随机性的进化理解相一致，并提醒我们经济政策也是健康政策。
