Center for Research in Occupational Health (CiSAL), Pompeu Fabra University, Barcelona, Spain.
CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
BMC Public Health. 2020 Aug 27;20(1):1306. doi: 10.1186/s12889-020-09396-9.
Previous studies have focused on the relationship between employment pathways and health-related outcomes based on cross-sectional or longitudinal approaches. However, little is known about the cumulative effects of employment status mobility on sickness absence (SA) over time. The aim of the present study was to examine the association between prior labour market participation (LMP) patterns and SA trajectories from a life-course perspective.
This cohort study was based on a sample of 11,968 salaried workers living in Catalonia and affiliated with the Spanish Social Security system, who accumulated more than 15 days on SA in at least one quarter during 2012-2014. Individuals were grouped into three different working life stages: early (18-25 years), middle (26-35 years), and late (36-45 years). To identify LMP patterns, we applied sequence analysis and cluster analysis (2002-2011), and we used latent class growth modelling to identify SA trajectories (2012-2014). Finally, we applied multinomial logistic regression models to assess the relationship between LMP patterns and SA trajectories.
The analyses yielded six LMP patterns: stable employment (value range: 63-81%), increasing employment (5-22%), without long-term coverage (7-8%), decreasing employment (4-10%), fluctuant employment (13-14%), and steeply decreasing employment (7-9%). We also identified four SA trajectories: low stable (83-88%), decreasing (5-9%), increasing (5-11%), and high stable (7-16%). However, the only significant association we identified for LMP patterns and SA trajectories was among young men, for whom an increasing employment pattern was significantly associated with a lower risk for increased days on SA (adjusted odds ratio: 0.21; 95% confidence interval: 0.05-0.96).
SA trajectories are generally not related to prior 10-year LMP patterns at any stage of working life. To disentangle this relationship, future research might benefit from considering working life transitions with a quality-of-work approach framed with contextual factors closer to the SA course.
先前的研究主要基于横断面或纵向方法，关注就业途径与健康相关结果之间的关系。然而，对于就业状况随时间推移的变化对病假（SA）的累积影响知之甚少。本研究旨在从生命历程的角度探讨先前的劳动力市场参与（LMP）模式与 SA 轨迹之间的关联。
这项队列研究基于居住在加泰罗尼亚并隶属于西班牙社会保障系统的 11968 名受薪工人的样本，他们在 2012-2014 年期间至少有一个季度的 SA 累计超过 15 天。个体被分为三个不同的工作生活阶段：早期（18-25 岁）、中期（26-35 岁）和晚期（36-45 岁）。为了识别 LMP 模式，我们应用了序列分析和聚类分析（2002-2011 年），并使用潜在类别增长建模来识别 SA 轨迹（2012-2014 年）。最后，我们应用了多项逻辑回归模型来评估 LMP 模式与 SA 轨迹之间的关系。
分析产生了六种 LMP 模式：稳定就业（范围值：63-81%）、就业增加（5-22%）、长期无覆盖（7-8%）、就业减少（4-10%）、波动就业（13-14%）和就业急剧减少（7-9%）。我们还确定了四种 SA 轨迹：低稳定（83-88%）、减少（5-9%）、增加（5-11%）和高稳定（7-16%）。然而，我们确定的 LMP 模式与 SA 轨迹之间的唯一显著关联是在年轻男性中，对于他们来说，就业增加模式与 SA 天数增加的风险降低显著相关（调整后的优势比：0.21；95%置信区间：0.05-0.96）。
SA 轨迹通常与任何工作生活阶段的先前 10 年 LMP 模式无关。为了厘清这种关系，未来的研究可能受益于考虑工作生活过渡，采用更接近 SA 过程的质量工作方法和背景因素。
