title: Employment situation and risk of death among middle-aged Japanese women.
abstract: BACKGROUND
  Few studies have examined the health effects of employment situation among women, taking social and economic conditions into consideration. The objective of this research was to investigate the association of employment situation (full-time or part-time employee and self-employed) with mortality risk in women over a 20-year follow-up period. Additionally, we examined whether the association between employment situation and mortality in women differed by education level and marital status.
  
  
  METHODS
  We investigated the association of employment situation with mortality among 16,692 women aged 40-59 years enrolled in the Japan Collaborative Cohort Study. Multivariate HRs and 95% CIs for total deaths by employment situation were calculated after adjustment for age, disease history, residential area, education level, marital status and number of children. We also conducted subgroup analysis by education level and marital status.
  
  
  RESULTS
  Multivariate HRs for mortality of part-time employees and self-employed workers were 1.48 (95% CI, 1.25 to 1.75) and 1.44 (95% CI, 1.21 to 1.72), respectively, with reference to women working full-time. Subgroup analysis by education level indicated that health effects in women according to employment situation were likely to be more evident in the low education-level group. Subgroup analysis by marital status indicated that this factor also affected the association between employment situation and risk of death.
  
  
  CONCLUSIONS
  Among middle-aged Japanese women, employment situation was associated with mortality risk. Health effects were likely to differ by household structure and socioeconomic conditions.
authors.affiliation: Osaka University Global Collaboration Center, Osaka, Japan Department of Public Health, Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Honjo
authors.affiliation: Department of Public Health, Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Iso
authors.affiliation: Department of Public Health, Faculty of Medicine, Juntendo University, Tokyo, Japan.
authors.forename: Ai
authors.initials: A
authors.lastname: Ikeda
authors.affiliation: Department of Preventive Medicine and Community Health, University of Occupational and Environmental Health, Kitakyushu, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: Department of Public Health, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Tamakoshi
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends; D004522:Educational Status; D004651:Employment / Q000145:classification / Q000191:economics / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D005783:Gender Identity; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008137:Longitudinal Studies; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012959:Socioeconomic Factors; D016387:Women's Health / Q000191:economics / Q000639:trends*
keywords: EMPLOYMENT; GENDER; SOCIAL EPIDEMIOLOGY