Individual employment histories and subsequent cause specific hospital admissions and mortality: a prospective study of a cohort of male and female workers with 21 years follow up.(Statistical Data Included)

It is a widely held view that the labour market is demanding increased levels of flexibility, and that this is causing greater psychosocial stress among employees. [1] Such stress may affect health, either through neuroendocrine pathways, or through increases in behaviours linked with poor health. [2] Previously we presented evidence linking an unstable employment history, as measured by a greater number of job changes and shorter duration of current job, with a greater prevalence of smoking and greater alcohol consumption, in male and female workers. [3 4] Despite this, we did not observe clear detrimental effects of such instability on health related physiological measures (body mass index, diastolic blood pressure, cholesterol, and lung function), nor on current cardiovascular health (electrocardiogram determined ischaemia and reported symptoms of angina).

Finding work is easier for healthy persons, and those persons who need to find work repeatedly will be particularly likely to drop out of the workforce if their health deteriorates. Consequently, an occupational cohort, upon which our previous work was based, is least likely to include people of poor health with an unstable work history. If such people are underrepresented, attempts to determine the association between health and individual work histories will mislead. This study links the same cohort to information on the hospitalisations and deaths experienced over a 21 year follow up period. While those people whose health deteriorated before the enrolment of this cohort must remain poorly represented, these prospective data permit unbiased observation of those cases who experienced ill health subsequently, whether or not this resulted in an exit from the workforce. We hypothesise that an employment history characterised by frequent job changes, whatever the motivation for those changes, will require the person to be more focused on work, and less focused on maintaining personal health, with …