Mortality following unemployment in Canada, 1991–2001

BMC Public Health

Kristan J Aronson³  Peter M Smith⁶  Benjamin C Amick⁴  Michael Tjepkema¹  Russell Wilkins¹  Jacob Etches⁵  Amber Bielecky⁵  Cameron A Mustard² 

[1] Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada;Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada;Department of Community Health and Epidemiology, Queen’s University, Kingston, Ontario, Canada;School of Public Health, University of Texas, Houston, Texas, USA;Institute for Work & Health, 481 University Ave, Suite 800, Toronto, Ontario, Canada;School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

关键词: Occupational health;    Mortality;    Unemployment;   

Others  :  1162240
DOI  :  10.1186/1471-2458-13-441

 received in 2013-01-18, accepted in 2013-04-30,  发布年份 2013

【 摘 要 】

Background

This study describes the association between unemployment and cause-specific mortality for a cohort of working-age Canadians.

Methods

We conducted a cohort study over an 11-year period among a broadly representative 15% sample of the non-institutionalized population of Canada aged 30–69 at cohort inception in 1991 (888,000 men and 711,600 women who were occupationally active). We used cox proportional hazard models, for six cause of death categories, two consecutive multi-year periods and four age groups, to estimate mortality hazard ratios comparing unemployed to employed men and women.

Results

For persons unemployed at cohort inception, the age-adjusted hazard ratio for all-cause mortality was 1.37 for men (95% confidence interval (CI): 1.32-1.41) and 1.27 for women (95% CI: 1.20-1.35). The age-adjusted hazard ratio for unemployed men and women was elevated for all six causes of death: malignant neoplasms, circulatory diseases, respiratory diseases, alcohol-related diseases, accidents and violence, and all other causes. For unemployed men and women, hazard ratios for all-cause mortality were equivalently elevated in 1991–1996 and 1997–2001. For both men and women, the mortality hazard ratio associated with unemployment attenuated with age.

Conclusions

Consistent with results reported from other long-duration cohort studies, unemployed men and women in this cohort had an elevated risk of mortality for accidents and violence, as well as for chronic diseases. The persistence of elevated mortality risks over two consecutive multi-year periods suggests that exposure to unemployment in 1991 may have marked persons at risk of cumulative socioeconomic hardship.

【 授权许可】

   
2013 Mustard et al.; licensee BioMed Central Ltd.

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