Life Course Trajectories of Labour Market Participation among Young Adults Who Experienced Severe Alcohol-Related Health Outcomes: A Retrospective Cohort Study.
BACKGROUND
Long-term employment trajectories of young problem drinkers are poorly understood.


METHODS
We constructed retrospective labour market participation histories at ages 18-34 of 64 342 persons born in 1969-1982. Beginning from the year of each subject's 18th birthday, we extracted information from the records of Statistics Finland on educational attainment, main type of economic activity, months in employment, and months in unemployment for a minimum of seven years (range 7-16 years). We used information on the timing of alcohol-related hospitalizations and deaths in the same period to define problem drinkers with early onset limited course, early onset persistent course, and late onset problem drinking.


RESULTS
Early onset limited course problem drinkers improved their employment considerably by age, whereas early onset persistent problem drinkers experienced a constant decline in their employment by age. From the age of 18 to 34, early onset persistent problem drinkers were in employment merely 12% of the time, in comparison with 39% among the early onset limited course problem drinkers, and 58% among the general population.


CONCLUSIONS
These results indicate that young adults who were retrospectively defined as having early onset persistent course problem drinking were extensively marginalized from the labour market early on during their life course, and that their employment trajectory was significantly worse compared to other problem drinkers.
Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland.
Tapio
T
Paljärvi
Population Research Unit, University of Helsinki, Helsinki, Finland; Max Planck Institute for Demographic Research, Rostock, Germany.
Pekka
P
Martikainen
Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.
Tiina
T
Pensola
Population Research Unit, University of Helsinki, Helsinki, Finland.
Taina
T
Leinonen
Population Research Unit, University of Helsinki, Helsinki, Finland; Centre of Maritime Health and Society, University of Southern Denmark, Esbjerg, Denmark.
Kimmo
K
Herttua
Alcohol and Drugs Unit, National Institute for Health and Welfare, Helsinki, Finland.
Pia
P
Mäkelä
D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D000437:Alcoholism / Q000453:epidemiology* / Q000401:mortality; D004651:Employment; D005260:Female; D005387:Finland / Q000453:epidemiology; D006760:Hospitalization; D006801:Humans; D008297:Male; D009026:Mortality; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014478:Unemployment; D055815:Young Adult