International Journal of Public Health

, Volume 63, Issue 4, pp 435–446 | Cite as

The association of unemployment with glucose metabolism: a systematic review and meta-analysis

  • Tuulia Varanka-Ruuska
  • Nina Rautio
  • Heli Lehtiniemi
  • Jouko Miettunen
  • Sirkka Keinänen-Kiukaanniemi
  • Sylvain Sebert
  • Leena Ala-Mursula



Unemployment has been linked with poor health. We hypothesized that being unemployed is associated with disorders of glucose metabolism and performed a systematic review and meta-analysis of the literature to ascertain the relationship.


We searched the databases of Scopus, Medline Ovid and Web of Science for population-based original studies for past 20 years. Random effects meta-analyses were used to estimate odds ratios (OR) with 95% confidence intervals (CI) for prediabetes and type 2 diabetes among the unemployed as compared to those employed, separately for men and women when possible.


Out of 981 articles found, 12 articles were included in the systematic review and eight articles in the meta-analyses. Unemployment was associated with 1.6-fold odds for prediabetes (OR 1.58; 95% CI 1.07–2.35), and 1.7-fold odds for type 2 diabetes (OR 1.72; 95% CI 1.14–2.58) in the total sample. The corresponding associations for type 2 diabetes were also found stratified for men (OR 1.53; 95% CI 1.47–1.60) and women (OR 1.60; 95% CI 1.33–1.92).


Unemployment is associated with prediabetes and type 2 diabetes, global concerns of public health with potential for prevention.


Unemployment Glucose metabolism Prediabetes Type 2 diabetes Systematic review Meta-analysis 


Compliance with ethical standards

Conflict of interest

Author Tuulia Varanka-Ruuska declares she has no conflicts of interest. Author Nina Rautio declares she has no conflicts of interest. Author Heli Lehtiniemi declares she has no conflicts of interest. Author Jouko Miettunen declares he has no conflicts of interest. Author Sirkka Keinänen-Kiukaanniemi declares she has no conflicts of interest. Author Sylvain Sebert declares he has no conflicts of interest. Author Leena Ala-Mursula declares she has no conflicts of interest.

Ethical approval

This article is based on a secondary analysis of existing literature and does not contain any studies with human participants nor animals conducted by the authors. Obtaining approval by an ethics committee is not required under national regulations. Good scientific standards have been followed according to MOOSE guidelines.


This project has received funding from the Academy of Finland (#268336) and the European Union’s Horizon 2020 research and innovation program (under Grant agreement no. 633595) for the DynaHEALTH action. The funders had no role in study design, data analysis, data interpretation and writing of the paper.

Supplementary material

38_2017_1040_MOESM1_ESM.docx (43 kb)
Supplementary material 1 (DOCX 43 kb)
38_2017_1040_MOESM2_ESM.docx (29 kb)
Supplementary material 2 (DOCX 29 kb)


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Copyright information

© Swiss School of Public Health (SSPH+) 2017

Authors and Affiliations

  • Tuulia Varanka-Ruuska
    • 1
    • 2
  • Nina Rautio
    • 1
    • 3
  • Heli Lehtiniemi
    • 1
  • Jouko Miettunen
    • 1
    • 4
  • Sirkka Keinänen-Kiukaanniemi
    • 1
    • 3
    • 4
    • 5
  • Sylvain Sebert
    • 1
    • 6
    • 7
  • Leena Ala-Mursula
    • 1
  1. 1.Center for Life Course Health ResearchUniversity of OuluOuluFinland
  2. 2.Kallio Primary Health Care UnitYlivieskaFinland
  3. 3.Unit of Primary Health CareOulu University HospitalOuluFinland
  4. 4.Medical Research Center OuluOulu University Hospital and University of OuluOuluFinland
  5. 5.Health Center of OuluOuluFinland
  6. 6.Biocenter OuluUniversity of OuluOuluFinland
  7. 7.Department of Genomics of Complex DiseasesImperial College LondonLondonUK

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