Peking University School of Economics, Beijing, China; University of Washington, Department of Economics, WA, USA.
University of Washington School of Public Health, Department of Health Systems and Population Health, Seattle, WA, USA; University of Washington School of Public Health, Department of Epidemiology, Seattle, WA, USA.
Prev Med. 2023 Apr;169:107471. doi: 10.1016/j.ypmed.2023.107471. Epub 2023 Mar 2.
Precarious employment has increased in the United States and is now recognized as an important social determinant of health. Women are disproportionately employed in precarious jobs and are largely responsible for caretaking, which could deleteriously affect child weight. We utilized data from the National Longitudinal Survey of Youth adult and child cohorts (1996-2016; N = 4453) and identified 13 survey indicators to operationalize 7 dimensions of precarious employment (score range: 0-7, 7 indicating the most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relations, and training. We estimated the association between maternal precarious employment and incident child overweight/obesity (BMI ≥85th percentile) using adjusted Poisson models. Between 1996 and 2016, the average age-adjusted precarious employment score among mothers was 3.7 (Standard Error [SE] = 0.02) and the average prevalence of children with overweight/obesity was 26.2% (SE = 0.5%). Higher maternal precarious employment was associated with a 10% higher incidence of children having overweight/obesity (Confidence Interval: 1.05, 1.14). A higher incidence of childhood overweight/obesity may have important implications at the population-level, due to the long-term health consequences of child obesity into adulthood. Policies to reduce employment precariousness should be considered and monitored for impacts on childhood obesity.
不稳定性就业在美国有所增加,现在被认为是健康的一个重要社会决定因素。女性在不稳定的工作中就业不成比例,而且在很大程度上负责照顾,这可能对儿童的体重产生不利影响。我们利用了美国青年纵向调查成人和儿童队列(1996-2016 年;N=4453)的数据,并确定了 13 个调查指标,将不稳定就业的 7 个维度(得分范围:0-7,7 表示最不稳定)操作化:物质回报、工作时间安排、稳定性、工人权利、集体组织、人际关系和培训。我们使用调整后的泊松模型估计了母亲不稳定就业与儿童超重/肥胖(BMI≥85 百分位数)的发病之间的关联。在 1996 年至 2016 年间,母亲的平均年龄调整后不稳定就业得分是 3.7(标准误差 [SE] = 0.02),儿童超重/肥胖的平均患病率是 26.2%(SE = 0.5%)。母亲不稳定就业程度越高,儿童超重/肥胖的发病率就会增加 10%(置信区间:1.05,1.14)。由于儿童肥胖对成年后的长期健康后果,儿童超重/肥胖发生率的增加可能会对人群层面产生重要影响。应该考虑减少就业不稳定的政策,并对其对儿童肥胖的影响进行监测。