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American Journal of Epidemiology 2005 161(9):840-846; doi:10.1093/aje/kwi107
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved

ORIGINAL CONTRIBUTIONS

Labor Market Trajectories and Health: A Four-Year Follow-up Study of Initially Fixed-Term Employees

Pekka Virtanen1,2, Jussi Vahtera3, Mika Kivimäki4,5, Virpi Liukkonen6, Marianna Virtanen4 and Jane Ferrie7

1 Medical School, University of Tampere, Tampere, Finland
2 Department of General Practice, Pirkanmaa Hospital District, Tampere, Finland
3 Finnish Institute of Occupational Health, Turku, Finland
4 Finnish Institute of Occupational Health, Helsinki, Finland
5 Faculty of Behavioural Sciences, Department of Psychology, University of Helsinki, Helsinki, Finland
6 School of Public Health, University of Tampere, Tampere, Finland
7 Department of Epidemiology and Public Health, University College London, London, United Kingdom

Correspondence to Dr. Pekka Virtanen, Medical School, University of Tampere, FIN-33014 Finland (e-mail: pekka.j.virtanen{at}uta.fi).

With the growth of atypical employment, there is increasing concern about the potential health-damaging effects of unstable employment. This prospective study of Finnish public-sector employees in 1998–2002 examined labor market trajectories and changes in health. At entry, all participants had a fixed-term job contract. Trajectories were measured by exposure to unstable employment during follow-up, destination employment status at the end of follow-up, and the way in which these elements were combined. Nonoptimal self-rated health at baseline was associated with high exposure to unstable employment and unemployment as the destination. After adjustment for health and psychological distress at baseline, a trajectory with stable employment as the destination was associated with a decreased risk of psychological distress at follow-up (odds ratio = 0.68, 95% confidence interval: 0.46, 0.98), whereas a trajectory toward the labor market periphery was related to increased risk of nonoptimal health (odds ratio = 2.54, 95% confidence interval: 1.47, 4.39) when compared with remaining in fixed-term employment. A significant dose-response relation was seen between the measure combining exposure to instability with destination employment status and nonoptimal health. This longitudinal study provides evidence of health-related selection into employment trajectories and suggests that the trajectories themselves carry different health risks.

career mobility; employment; health; prospective studies; unemployment


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