The European Journal of Public Health Advance Access published online on May 31, 2008
The European Journal of Public Health, doi:10.1093/eurpub/ckn037
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Employment trajectory as determinant of change in health-related lifestyle: the prospective HeSSup study
Pekka Virtanen1, Jussi Vahtera2, Ulla Broms3,4, Lauri Sillanmäki3, Mika Kivimäki5 and Markku Koskenvuo3
1 Tampere School of Public Health, University of Tampere, Finland
2 Finnish Institute of Occupational Health, Turku, Finland
3 Department of Public Health, University of Helsinki, Finland
4 Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland
5 Department of Epidemiology and Public Health, University College London, the United Kingdom
Correspondence: Pekka Virtanen, Tampere School of Public Health, 33014 University of Tampere, Finland, tel: +358-3-35516007, fax: +358-3-35516057, e-mail: pekka.j.virtanen{at}uta.fi
Received December 17, 2007 , accepted April 18, 2008
Background: Changes in employment status may be associated with changes in health-related lifestyle, but population level research of such associations is very limited. This study aimed to determine associations between lifestyle and five employment trajectories, i.e. ‘stable’, ‘unstable’, ‘upward’ ‘downward’ and ‘chronic unemployment’. Methods: A cohort of 10 100 employees was followed up for 5 years. Associations of the employment trajectories with changes in smoking, alcohol drinking, body weight, physical activity and sleep duration were assessed with analysis of variance for repeated measures and pairwise post hoc comparisons. Results: Smoking was the only lifestyle component that was not associated with employment trajectory. In both genders, sleep duration decreased during chronic unemployment and among those on a downward employment trajectory. In men, alcohol consumption also increased in these two groups and body weight increased in the latter group. In women, physical activity decreased among those on a downward trajectory. In contrast, an upward labour market trajectory was associated with healthy or no changes in lifestyle both in men and women. Conclusion: Changes in lifestyle may contribute to development of the health gradients between the employed and unemployed, whereas unstable employment versus permanent employment does not incur risk of unhealthy lifestyle changes. In order to prevent widening of employment-related health inequalities, passages into employment should be facilitated and opportunities for health promotion should be improved among those trapped in or moving towards the labour market periphery.
Keywords: alcohol drinking, career mobility, sleep, smoking, unemployment