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Mortality gradient across the labour market core–periphery structure: a 13-year mortality follow-up study in north-eastern France

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Abstract

Purpose

This study explores mortality related to temporary employment, about which very little is known to date.

Methods

In 1996, a health survey was carried out in the French region of Lorraine, and all members of 8,000 randomly chosen households were followed up for mortality over a 13-year period. Mortality of subjects in relation to their employment situation at baseline was analysed using a Cox survival regression.

Results

In comparison with permanent workers, for unemployed men, we found age and occupation-adjusted hazard ratios (HR) of 4.1 for all-causes of death and 3.9 for non-violent causes, and for male temporary workers a HR of 2.2 for both all-causes and non-violent causes of death. Bad health, tobacco smoking and alcohol misuse explained 17 % of the excess risk for the unemployed and 41 % of that for temporary workers.

Conclusion

The observation of large mortality inequalities across the labour market core–periphery structure has important policy implications, particularly in terms of prevention focused on unhealthy behaviours among male unemployed and temporary workers.

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Acknowledgments

Lorhandicap study group: N. Chau, F. Guillemin, J.-F. Ravaud, J. Sanchez, S. Guillaume, J.P. Michaely, C. Otero Sierra, B. Legras, A. Dazord, M. Choquet, L. Méjean, N. Tubiana-Rufi, J. P. Meyer, Y. Schléret and J. M. Mur. The authors would like to thank D. Saouag, M. Weiss, M. Depesme-Cuny and B. Phélut for their help during the survey. The work was supported by a Grant from the Pôle Européen de Santé.

Conflict of interest

The authors declare that they have no conflict of interest.

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Correspondence to M. Khlat.

Appendix

Appendix

See Table 4.

Table 4 Comparison between the study sample and the general population (Lorraine region of the north-eastern France, Census 1999) (%)

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Khlat, M., Legleye, S., Falissard, B. et al. Mortality gradient across the labour market core–periphery structure: a 13-year mortality follow-up study in north-eastern France. Int Arch Occup Environ Health 87, 725–733 (2014). https://doi.org/10.1007/s00420-013-0915-4

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