Centre for Health and Society, Institute of Medical Sociology, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany.
INSERM, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.
Int J Epidemiol. 2019 Apr 1;48(2):402-414. doi: 10.1093/ije/dyy235.
With changing employment histories in European labour markets, occupational health research needs to be supplemented by an approach that integrates adverse characteristics of entire employment histories, in terms of precarious, discontinued and disadvantaged employment careers. We analyse associations of adverse employment histories and six measures of health functioning, including affective, physical and cognitive functioning.
We use baseline data from the CONSTANCES study with detailed retrospective data on previous employment histories that are linked to current health functioning among people aged 45-60 years (men = 15 134; women = 16 584). The following career characteristics are assessed (all referring to careers between ages 25 and 45 years): number of jobs with temporary contracts, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion. The measures of health functioning range from depressive symptoms, standing balance, walking speed, lung function, to verbal memory and semantic fluency.
For both men and women, multilevel regressions (participant nested in health-examination centre) revealed that adverse employment histories are associated with poor health functioning later on, in particular persistent disadvantage in terms of low occupational position, repeated periods of unemployment and weak labour-market ties (years out of work). Findings remain consistent after excluding respondents who had a health-related career interruption or already retired before age 45 years and, additionally, after adjusting for age, partnership and education.
Findings call for increased intervention efforts among more disadvantaged groups of the labour market at early-career stages.
随着欧洲劳动力市场就业历史的变化,职业健康研究需要补充一种方法,该方法将整个就业历史的不利特征(包括不稳定、中断和不利的就业生涯)纳入考虑。我们分析了不良就业历史与六种健康功能衡量标准之间的关联,包括情感、身体和认知功能。
我们使用 CONSTANCES 研究的基线数据,这些数据包含详细的回溯性就业历史数据,这些数据与 45-60 岁人群(男性=15134 人;女性=16584 人)当前的健康功能相关联。评估了以下职业特征(均指 25-45 岁之间的职业生涯):临时合同工作数量、工作变动次数、失业期次数、失业年数、职业地位模式和缺乏工作晋升。健康功能衡量标准从抑郁症状、站立平衡、步行速度、肺功能到言语记忆和语义流畅性不等。
对于男性和女性,多层次回归(参与者嵌套在健康检查中心)表明,不良的就业历史与以后较差的健康功能相关,特别是在职业地位较低、反复失业和劳动力市场联系较弱(失业年数)方面的持续劣势。在排除了在 45 岁之前有与健康相关的职业中断或已经退休的受访者,以及在调整年龄、伴侣关系和教育程度后,研究结果仍然一致。
研究结果呼吁在职业生涯早期阶段,针对劳动力市场中处于不利地位的群体增加干预措施。