Self-reported job insecurity and health in the Whitehall II study: potential explanations of the relationship
Introduction
Most studies that have examined the effects of self-reported job insecurity on health have documented consistent adverse effects on measures of psychological morbidity. Evidence of adverse effects of self-reported job insecurity on other measures of morbidity is starting to accumulate, with reasonably consistent results being obtained for a number of health outcomes in both cross-sectional and longitudinal studies (Platt, Pavis, & Akram, 1998; De Witte, 1999; Ferrie, 2001; Amick III et al., 1998). However, while evidence of the adverse effects of self-reported job insecurity on self-reported mental and physical morbidity is beginning to accumulate, work examining potential explanations of the association between job insecurity and health remains patchy (Platt et al., 1998; Kivimaki, Vahtera, Pennti, & Ferrie, 2000a; McDonough, 2000).
Previous work in the Whitehall II study of British civil servants has shown self-reported job insecurity to be associated with poor self-rated health and minor psychiatric morbidity (Ferrie, Shipley, Stansfeld, & Marmot, 2002). A series of qualitative interviews with 38 British civil servants, whose current job was insecure, indicated a range of potential explanations of the job insecurity–health relationship (Marmot, Ferrie, Newman, & Stansfeld, 2001). These included: demographic, personal, material and behavioural characteristics, other psychosocial features of the work environment and job satisfaction. The aim of this paper is to examine the potential of these factors to explain associations between self-reported job insecurity and health.
Section snippets
Whitehall II study
The target population for the Whitehall II study was all London-based office staff, aged 35–55, working in 20 Civil Service departments. With a response rate of 73%, the final cohort consisted of 10,308: 6895 men and 3413 women (Marmot et al., 1991). The true response rate is higher, however, because around 4% of those invited were not eligible for inclusion. Although mostly white-collar, respondents covered a wide range of grades from office support to permanent secretary.
Baseline screening
Results
Health outcomes: Self-reported job insecurity was strongly associated with poor self-rated health (p⩽0.005) and the two measures of minor psychiatric morbidity, GHQ score and depression (p⩽0.001), in both sexes (Table 1). Although there was only a weak association with longstanding illness in the analyses presented in Table 1, the association among women was somewhat stronger, p=0.04, in the restricted dataset used for the analyses presented in Table 3.
Potential explanatory factors:
Discussion
Methodological considerations: The major limitation of this study is that it is partially cross-sectional in design. Analysis of data collected on individuals at baseline screening, a phase of secure employment 11 years earlier, together with data collected at Phase 5 allowed us to control for the effects of previous health status on current job insecurity and for other confounding factors such as age and socioeconomic position. This enabled the study to separate morbidity associated with job
Acknowledgements
The work presented in this article was supported by the United Kingdom Economic and Social Research Council (L128251046). The Whitehall II study has been supported by grants from the Medical Research Council; British Heart Foundation; Health and Safety Executive; Department of Health; National Heart Lung and Blood Institute (HL36310), US, NIH: National Institute on Aging (AG13196), US, NIH; Agency for Health Care Policy Research (HS06516); and the John D and Catherine T MacArthur Foundation
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