[Job insecurity, unemployment and health: results from the health examination centers of the French General Health Insurance].
BACKGROUND
Job insecurity has increased over the last 30 years. Socioeconomic changes have led to various insecure employment categories, including fixed term employment, part time employment and government sponsored jobs. This study was aimed at investigating relationships between employment status and health.


METHODS
The study population was composed of 767,184 people, aged 26 to 59 years, examined between 2003 and 2005 in the Health Examination Centers of the French General Health Insurance. Employment status was defined using insecure employment (combining permanent/fixed-term contracts and part-time/full time), government sponsored jobs and duration of unemployment (from <6 months to > or =3 years). Health indicators were poor perceived health, smoking, lack of gynecological follow-up, obesity, untreated caries and high blood pressure. Data were analysed by logistic regression (odds ratios [OR]) adjusted on age, occupational social class and education level, the reference category being permanent full time contracts (OR=1).


RESULTS
Significant level-dependent relations with health were observed between non permanent versus permanent employments, part time versus full time. Most OR of unemployed people were higher than those of having employment and increased with duration of unemployment. For example, for poor perceived health in men, OR ranged between 1.00 and 1.68 (95%CI 1.57-1.78) according to job insecurity categories, and between 1.75 (95%CI 1.67-1.83) and 2.80 (95%CI 2.72-2.89) according to duration of unemployment. For obesity in women, OR increased from 1.00 to 1.48 (95%CI 1.37-1.60) in active women and from 1.35 (95%CI 1.27-1.44) to 1.77 (95%CI 1.70-1.84) in unemployed.


CONCLUSIONS
This study showed quantitative relationships between job insecurity, unemployment and health. In particular, workers having government-sponsored jobs and long-time unemployed people were at high risk of health problems.
Centre technique d'appui et de formation des centres d'examens de santé (Cetaf), Saint-Etienne cedex 02, France. jean-jacques.moulin@cetaf.cnamts.fr
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Moulin
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Labbe
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Sass
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Gerbaud
D000328:Adult; D003430:Cross-Sectional Studies; D003731:Dental Caries / Q000150:complications / Q000453:epidemiology; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006077:Government Agencies / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007348:Insurance, Health / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D014478:Unemployment / Q000706:statistics & numerical data*; D016526:Workload / Q000706:statistics & numerical data