The Link Between A Secure Job & Reduction in Mortality

Summary

The study conducted in Sweden explores the impact of transitioning from precarious to standard employment on mortality rates. Precarious employment is characterized by insecurity, inadequate income, and lack of rights and protection. The researchers used Swedish register data and conducted a series of trials from 2005 to 2016. They categorized individuals into two groups: those who remained in precarious employment and those who shifted to standard employment. The study found that transitioning from precarious to standard employment reduced the risk of death by 20% over 12 years. Workers who shifted to standard employment and remained in it for 12 years had a 30% lower risk of death. The study highlights the importance of decent work, employment security, and adequate income in reducing the risk of premature mortality. The results support the need for interventions to reduce employment insecurity and increase workers' rights and protection.

Reference Pages: 4, 7, 3, 1

Findings

🔍 Main Findings of the Study:

Transitioning from precarious to standard employment reduces the risk of premature death by 20% on average.

Long-term stability in standard employment further decreases the risk of death by 30%.

Both men and women benefit from improved employment conditions.

The study emphasizes the importance of decent work, such as employment security and adequate income levels, in reducing the risk of premature mortality.

Interventions to reduce employment insecurity and income inadequacy while increasing workers' rights and protection are necessary to improve population health.

Key Terms

• Precarious employment: It refers to work that is characterized by employment insecurity, income inadequacy, and lack of rights and protection.

• Standard employment: It refers to stable and secure employment that provides adequate income, rights, and protection.

• Causal effect: In the context of this study, it refers to the impact of transitioning from precarious to standard employment on all-cause mortality, indicating a cause-and-effect relationship.

• All-cause mortality: It refers to the overall risk of death from any cause, regardless of the specific cause or underlying health conditions.

• Employment security: It refers to the stability and protection offered by a job, including factors like job permanency, income adequacy, and legal rights and protections.

Methodology

The study utilized Swedish register data and emulated a series of 12 target trials starting from 2005 to 2016. The researchers classified individuals into two groups: those who remained in precarious employment and those who transitioned to standard employment. All-cause mortality was measured from 2006 to 2017. The study used g-methods to control for confounding variables and adjust for time-varying factors. The results were analyzed using per-protocol analysis, which censored individuals who changed their employment status during the follow-up period. This enabled the researchers to assess the causal effect of transitioning from precarious to standard employment on mortality rates. The study considered factors such as sex and age to evaluate any differences in the impact of employment status on mortality.

Limitations

One limitation of the study is its reliance on yearly exposure measurements, which may not capture changes in employment status throughout the year. The study focused only on salaried workers and excluded self-employed individuals, limiting the generalizability of the findings. The low adherence among individuals remaining in precarious employment also posed a limitation, affecting the accuracy of the 12-year mortality risk estimates. Additionally, while the study adjusted for social disadvantage factors that could impact mortality risk, there may still be unobserved effects of social disadvantage among workers in precarious employment. Nevertheless, the study used high-quality register data, controlled for confounding variables, and minimized bias to provide valuable insights into the relationship between employment status and mortality rates.

Source: https://jech.bmj.com/content/early/2023/08/23/jech-2023-220734

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