title: When aspirations and achievements don't meet. A longitudinal examination of the differential effect of education and occupational attainment on declines in self-rated health among Canadian labour force participants.
abstract: BACKGROUND
  To examine the association of a mismatch between educational qualifications and occupational attainment and subsequent declines in self-rated health (SRH) in a longitudinal nationally representative Canadian population sample.
  
  
  METHODS
  This study used longitudinal data from 4045 healthy, working respondents of the Canadian National Population Health Survey. Respondents were categorized as either qualified, overqualified, or underqualified based on the match between their education and the skills required for their current occupation over a 2-year period. Logistic regression analysis estimated the odds of decline in SRH over the following 4-year period, using the match between occupation and education as the main independent variable. Analyses were controlled for a number of confounding variables including health behaviours, mental health, self-esteem, job control, and demographic information.
  
  
  RESULTS
  Relative to respondents with university education working in occupations for which they were qualified, respondents with university education, working in occupations for which they were overqualified had a significant risk of decline in SRH between 1996 and 2000, even after adjusting for a number of potential confounders (OR = 2.08, 95% CI 1.11-3.91). In respondents with secondary education or less, differences in occupational attainment were not associated with differences in the odds of decline in SRH.
  
  
  CONCLUSIONS
  The effect of occupational attainment on health is important for individuals who have invested the most time in their education. Conversely, differential occupational attainment is not associated with differences in the odds of decline in health for participants with lower levels of education.
authors.affiliation: Institute for Work and Health, 481 University Avenue, Toronto, Ontario M5G 2E9, Canada. psmith@iwh.on.ca
authors.forename: Peter
authors.initials: P
authors.lastname: Smith
authors.forename: John
authors.initials: J
authors.lastname: Frank
mesh_terms: D000328:Adult; D002170:Canada / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009790:Occupations / Q000706:statistics & numerical data*; D012923:Social Class; D012959:Socioeconomic Factors