Impact of change in job status on mortality for newly onset type II diabetes patients: 7 years follow-up using cohort data of National Health Insurance, Korea.
OBJECTIVE
This study investigates the relationship between change in job status and mortality of newly diagnosed type II diabetes patients by gender.


METHODS
Newly onset of individuals diagnosed with type II diabetes in the years 2003 and 2004, had 7 years follow-up using National Health Insurance Corporation (NHIC) sample cohort data. The individuals diagnosed with type II diabetes within this period were 14,861. After adjusting for age, initial income group, insulin treatment and medical service utilization, hazard ratio was analyzed using Cox's proportional hazard model.


RESULTS
Mortality hazard ratio of continuously unemployed individuals is 3.78 times higher in males and 9.78 times higher in females than in those who keep their jobs. Also, individuals with a change in job status (e.g. from industrial worker to unemployed or self-employed), the mortality hazard ratio is 2.24 times higher in males and 5.23 times higher in females than in those who keep their jobs. The impact of change in job status change is largest for the middle class males. The middle class males has the higher mortality hazard ratio, 6.14 times in maintain unemployed and 4.12 times in change his job (industrial worker to unemployed or self-employer) than maintain one's job.


CONCLUSIONS
The continuous unemployment and the loss of job are related to risk of death in diabetic patients. The impact of unemployed is stronger than job change (loss or change). The impact of job status change is largest for the middle class man.
NHIC Ilsan Hospital, Ilsan, Korea; School of Medicine, Graduate school of public health, Korea University, Seoul, Korea.
Donggyo
D
Shin
Department of Health Business Administration, Woosong University, Daejeon, Korea.
Ji Man
JM
Kim
School of Medicine, Graduate school of public health, Korea University, Seoul, Korea; Institute for Occupational & Environmental Health, Korea University, Seoul, Korea.
Tinyami Erick
TE
Tandi
Department of Preventive Medicine & Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea. Electronic address: ecpark@yuhs.ac.
Eun-Cheol
EC
Park
D000328:Adult; D000368:Aged; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
Diabetes; Economic status; Hazard ratio; Job status change; Mortality