Assessing the contribution of unstable employment to mortality in posttransition Russia: prospective individual-level analyses from the Russian longitudinal monitoring survey.
OBJECTIVE
We used the Russia Longitudinal Monitoring Survey (RLMS) to investigate associations between employment, socioeconomic position, and mortality.


METHODS
Data were from working-age respondents in 8 rounds (1994-2003) of the RLMS. We measured associations between education, occupation, unemployment, and insecure employment and mortality with Cox proportional hazards analyses.


RESULTS
Of 4465 men and 4158 women who were currently employed, 251 men and 34 women died. A third of employed respondents experienced wage arrears, and 10% experienced compulsory leave and payment in consumer goods. Insecure employment, more common among the less-educated and manual workers, fluctuated with macroeconomic measures. Mortality was significantly associated with payment in consumer goods among men (hazard ratio [HR] = 1.46; 95% confidence interval [CI] = 1.03, 2.07), compulsory unpaid leave among women (HR = 3.79; 95% CI = 1.82, 7.88), and male unemployment (HR = 1.88; 95% CI = 1.38, 2.55). Associations with death within 1 year of entry were generally somewhat stronger than the association with mortality over the whole study period.


CONCLUSIONS
Unemployment and job insecurity predicted mortality, suggesting that they contributed to Russia's high mortality during the transition from communism.
Perlman
Francesca
F
London School of Hygiene and Tropical Medicine, Keppel Street, London, UK. francesca.perlman@lshtm.ac.uk
Bobak
Martin
M
D000293:Adolescent; D000328:Adult; D016001:Confidence Intervals; D003625:Data Collection; D004651:Employment / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009790:Occupations / Q000706:statistics & numerical data; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012426:Russia; D012923:Social Class; D013997:Time Factors; D014478:Unemployment / Q000706:statistics & numerical data; D055815:Young Adult
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