title: History of labour market attachment as a determinant of health status: a 12-year follow-up of the Northern Swedish Cohort.
abstract: OBJECTIVE
  The present study aims at using trajectory analysis to measure labour market attachment (LMA) over 12 years and at examining whether labour market tracks relate to perceived health status.
  
  
  METHODS
  Data were retrieved from a 26-year prospective cohort study, the Northern Swedish Cohort.
  
  
  METHODS
  All ninth grade students (n=1083) within the municipality of Luleå in northern Sweden were included in the baseline investigation in 1981. The vast majority (94%) of the original cohort participated at the fourth follow-up. In this study, 969 participants were included.
  
  
  METHODS
  Perceived health status (psychological distress and non-optimal self-rated health) at age 42 and the data obtained from questionnaires.
  
  
  RESULTS
  We have identified four tracks in relation to LMA across the 12-year period: 'permanent', 'high level', 'strengthening' and 'poor level' of attachment. LMA history relates to psychological distress. High level (OR 1.55 (95% CI 1.06 to 2.27)), strengthening (OR 1.95 (95% CI 1.29 to 2.93)) and poor attachment (OR 3.14 (95% CI 2.10 to 4.70) involve higher OR for psychological distress compared with permanent attachment. The overall p value remained significant in the final model (p=0.001). Analyses regarding non-optimal self-rated health displayed a similar pattern but this was not significant in the final model.
  
  
  CONCLUSIONS
  Our results suggest that health status in mid-life, particularly psychological distress, is related to patterns of LMA history, to a large part independently of other social risk factors and previous health. Consideration of heterogeneity and time in LMA might be important when analysing associations with perceived health.
authors: Department of Public Health and Clinical Medicine, Family Medicine, Umeå University, Umeå, Sweden.
authors: Anna-Karin
authors: AK
authors: Waenerlund
authors: Per E
authors: PE
authors: Gustafsson
authors: Anne
authors: A
authors: Hammarström
authors: Pekka
authors: P
authors: Virtanen
keywords: Epidemiology; Occupational & Industrial Medicine; Public Health