Department of Sociology and Institute for Empirical Social Science Research, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Pharmacy, Central South University Third Xiangya Hospital, Changsha, Hunan, China.
J Epidemiol Community Health. 2020 May;74(5):428-436. doi: 10.1136/jech-2019-213179. Epub 2020 Feb 21.
Unemployment has been reported to be associated with an increased risk of mortality. While most available studies focused on the effects of temporary unemployment on mortality, it remains unclear whether similar trends can be found in subjects who were never employed or are retirement. Therefore, this study examined the associations between temporary unemployment, never employed and retirement, integrating the risk of all-cause and cause-specific mortality in US adults.
Data from the National Health Interview Survey from 2001 to 2013 Linked Mortality files through 31 December 2015 were used. A total of 282 364 participants aged 18 to 65 years were included. Their employment status was categorised into four groups: employed, never employed, temporary unemployed and retired.
During the mean follow-up time of 8.2 years, 12 645 subjects died from a variety of causes. Compared with employed participants, temporary unemployed, never employed or retired participants faced an increased risk of mortality for all-cause (temporary unemployed HR 1.76, 95% CI 1.67 to 1.86; never employed HR 1.63, 95% CI 1.47 to 1.81; retired HR 1.27, 95% CI 1.17 to 1.37). Cause-specific mortality analysis showed that compared with employed participants, temporary unemployed or never employed participants faced a significantly increased risk of mortality from cancer, cardiovascular disease, chronic lower respiratory disease, diabetes and kidney disease.
This study showed that retired, temporary unemployed and never employed participants aged 18 to 65 years were strongly associated with higher mortality, indicating that both temporary and long-term unemployment are associated with a higher risk of mortality and adversely affect longevity.
已有研究报告指出，失业与死亡率升高有关。虽然大多数现有研究都集中在临时失业对死亡率的影响上，但对于从未就业或已退休的人群是否存在类似趋势尚不清楚。因此，本研究在美国成年人中考察了临时失业、从未就业和退休与全因和特定原因死亡率之间的关联。
本研究使用了 2001 年至 2013 年国家健康访谈调查（National Health Interview Survey）和截至 2015 年 12 月 31 日的死亡链接文件的数据。共纳入了 282364 名年龄在 18 至 65 岁之间的参与者。他们的就业状况分为四组：在职、从未就业、临时失业和退休。
在平均 8.2 年的随访期间，共有 12645 名参与者死于各种原因。与在职参与者相比，临时失业、从未就业或退休的参与者全因死亡率增加（临时失业 HR 1.76，95%CI 1.67 至 1.86；从未就业 HR 1.63，95%CI 1.47 至 1.81；退休 HR 1.27，95%CI 1.17 至 1.37）。特定原因死亡率分析表明，与在职参与者相比，临时失业或从未就业的参与者死于癌症、心血管疾病、慢性下呼吸道疾病、糖尿病和肾病的风险显著增加。
本研究表明，18 至 65 岁的退休、临时失业和从未就业的参与者与更高的死亡率密切相关，这表明临时和长期失业都与更高的死亡率风险相关，并对长寿产生不利影响。
