title: Labor market trajectories and health: a four-year follow-up study of initially fixed-term employees.
abstract: With the growth of atypical employment, there is increasing concern about the potential health-damaging effects of unstable employment. This prospective study of Finnish public-sector employees in 1998-2002 examined labor market trajectories and changes in health. At entry, all participants had a fixed-term job contract. Trajectories were measured by exposure to unstable employment during follow-up, destination employment status at the end of follow-up, and the way in which these elements were combined. Nonoptimal self-rated health at baseline was associated with high exposure to unstable employment and unemployment as the destination. After adjustment for health and psychological distress at baseline, a trajectory with stable employment as the destination was associated with a decreased risk of psychological distress at follow-up (odds ratio = 0.68, 95% confidence interval: 0.46, 0.98), whereas a trajectory toward the labor market periphery was related to increased risk of nonoptimal health (odds ratio = 2.54, 95% confidence interval: 1.47, 4.39) when compared with remaining in fixed-term employment. A significant dose-response relation was seen between the measure combining exposure to instability with destination employment status and nonoptimal health. This longitudinal study provides evidence of health-related selection into employment trajectories and suggests that the trajectories themselves carry different health risks.
authors.affiliation: Medical School, University of Tampere, FN-33014 Tampere, Finland. pekka.virtanen@uta.fi
authors.forename: Pekka
authors.initials: P
authors.lastname: Virtanen
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Virpi
authors.initials: V
authors.lastname: Liukkonen
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jane
authors.initials: J
authors.lastname: Ferrie
mesh_terms: D000328:Adult; D002322:Career Mobility; D016001:Confidence Intervals; D004651:Employment / Q000145:classification / Q000523:psychology* / Q000639:trends; D005260:Female; D005387:Finland; D006304:Health Status; D006801:Humans; D017533:Marital Status; D009790:Occupations; D011446:Prospective Studies; D012044:Regression Analysis; D013315:Stress, Psychological