title: An uncertain future: the health effects of threats to employment security in white-collar men and women.
abstract: OBJECTIVE
  This study examined changes in the health status of civil servants whose employment security was threatened.
  
  
  METHODS
  Data were derived from a longitudinal cohort of 10,308 men and women, office staff in 20 British civil service departments. Physiological measurements, self-reported morbidity, and health-related behaviors for 530 members of the department under threat were compared with those of 19 other departments, during the period of uncertainty and during stable employment 5 years earlier.
  
  
  RESULTS
  From a position of advantage or no difference at baseline, self-reported morbidity and physiological risk factors tended to increase among respondents from the threatened department compared with those from other departments. For both sexes, increases were significant for body mass index (P < .001) and sleeping 9 or more hours (odds ratio [OR] = 1.88; 95% confidence interval [CI] = 1.3, 2.8; P < .01); modest but significant increases were seen in ischemia (OR = 1.45; 95% CI = 1.0, 2.1) and cholesterol concentration (0.08 mmol/L; 95% CI = 0.01, 0.14). Among women only, a significant relative increase in blood pressure (P < .01) was recorded. Over the same period health-related behaviors changed little.
  
  
  CONCLUSIONS
  Threats to employment security have adverse consequences for health status that are unexplained by health selection or health-related behaviors.
authors.affiliation: Department of Epidemiology and Public Health, University College London Medical School, England. j.ferrie@public-health.ucl.ac.uk
authors.forename: J E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: M J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: M G
authors.initials: MG
authors.lastname: Marmot
authors.forename: S A
authors.initials: SA
authors.lastname: Stansfeld
authors.forename: G D
authors.initials: GD
authors.lastname: Smith
mesh_terms: D000328:Adult; D005260:Female; D006077:Government Agencies; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications*; D014478:Unemployment / Q000523:psychology*; D006113:United Kingdom