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Is the core-periphery labour market structure related to perceived health? Findings of the Northern Swedish Cohort.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Family Medicine.
2011 (English)In: BMC Public Health, ISSN 1471-2458, Vol. 11, 956- p.Article in journal (Refereed) Published
Abstract [en]

Background: There is controversy as to whether peripheral employment is related to poor health status or not. This study aims at examining whether 1) the accumulation of time in peripheral labour market positions is associated with psychological distress and poor or average self-rated health; 2) the proposed association is different among women than among men.

Method: Participants in the 1995 and 2007 follow-up surveys of the Northern Swedish Cohort (n = 985) completed self-administered questionnaires about psychological and general health and about employment positions during the follow-up years. Associations between 12 year peripheral labour market positions (no, low, medium and high exposure) and health were examined using logistic regression.

Results: Exposure to peripheral employment was positively related to psychological distress in both women and men (p-values for trend < 0.001). Adjustment for sociodemographics and psychological distress at baseline, as well as for unemployment and being out of the labour market at the follow-up, resulted in attenuation of the odds ratios, particularly in the group with high exposure to peripheral employment, although results remained significant in men in the fully adjusted model. Women and men with high exposure to peripheral employment had high odds of poor or average self-rated health, but the association was rendered non-significant after adjustment for the covariates.

Conclusions: Our findings suggest that exposure to peripheral employment positions has an impact particularly on mental health, partly due to the over-representation of other unfavourable social and employment conditions among those with substantial exposure to peripheral employment.

Place, publisher, year, edition, pages
2011. Vol. 11, 956- p.
Keyword [en]
Cohort, Employment, Health, Psychological distress, Public health
National Category
Family Medicine
URN: urn:nbn:se:umu:diva-55044DOI: 10.1186/1471-2458-11-956ISI: 000302467500001OAI: diva2:525230
Available from: 2012-05-07 Created: 2012-05-07 Last updated: 2013-09-13Bibliographically approved
In thesis
1. Temporary employment and illness
Open this publication in new window or tab >>Temporary employment and illness
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Tillfälliga anställningar och ohälsa
Abstract [en]

Background: It is debated whether temporary employment compared to permanent employment entails an elevated risk of illness or not, as the empirical studies have not shown a unified picture. Since a significant part of the Swedish workforce is currently working under temporary employment contracts, it is important for public health research to pay close attention to what the implications in terms of illness might be. Therefore the aim of this thesis was to explore the relationship between temporary employment and illness.

Methods: This thesis was based on data from the Northern Swedish Cohort, consisting of all pupils in grade 9 in Luleå in 1981 (n=1083). The cohort was followed with extensive questionnaires. The latest follow-up was performed in year 2007, when 94% participated. To analyse the quantitative questionnaire data, logistic regression and trajectory analysis were used. A qualitative method, Grounded Theory, was also applied in this thesis to analyse interviews performed in 2011, with a strategic selection of 12 participants from the cohort.

Results: Quantitative data showed that temporary employees had overall higher odds ratios for illness in terms of psychological distress and non-optimal self-rated health compared to permanent employees. This general difference in odds ratios was evident irrespective of how temporary employment was measured as well as after control for earlier health status and confounders. The qualitative analysis gained insight into temporary employment as social processes of: underling the driving force for employment; working hard for a job. The structural conditions emerged in terms of, being used and exploited on the labour market and these conditions were related to the individual strategies of adaptation and coping. In the intersection of agency, structural conditions and adaption, emotional and bodily reactions emerged, such as being worn out, worried and wrathful.

Conclusion: Illness is unevenly distributed between temporary and permanent employees, with temporary employees being the unfavourable group. Striving for good and evenly distributed health conditions in the population, policy makers should aim at reducing the number of employees working in temporary contracts. In addition, there is a need to improve surveillance of the health situation among temporary employees and to reduce unfavourable conditions, such as job and financial insecurity and unemployment, among temporary employees.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2013. 71 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1592
Temporary employment, psychological distress, self-rated health, illness, logistic regression, trajectory analysis, grounded theory
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
urn:nbn:se:umu:diva-80095 (URN)978-91-7459-724-0 (ISBN)
Public defence
2013-10-04, Sal 135, Byggnad 9A, Norrlands Universitetssjukhus, Umeå, 13:00 (Swedish)
FAS, Swedish Council for Working Life and Social Research
Available from: 2013-09-13 Created: 2013-09-09 Last updated: 2013-09-13Bibliographically approved

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