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Future uncertainty and socioeconomic inequalities in health: the Whitehall II study

Author

Listed:
  • Ferrie, Jane E.
  • Shipley, Martin J.
  • Stansfeld, Stephen A.
  • Davey Smith, George
  • Marmot, Michael

Abstract

Over the past 20 years, socioeconomic inequalities in mortality have widened, while job security and financial security have decreased. This paper examines the Whitehall II study, a longitudinal study of white-collar British civil servants. In the Whitehall II cohort socioeconomic gradients in morbidity and cardiovascular risk factors at Phase 5 (1997-99) were generally steeper than at Phase 1 (1985-88). We examine the contribution of job and financial insecurity to these at Phase 5 in 6770 women and men, all of whom were white-collar civil servants at Phase 1. Steep, inverse employment grade gradients were observed for all health measures at Phase 5, except cholesterol and systolic blood pressure in women. Gradients in the sub-population of non-employed participants tended to be steeper than gradients for participants in employment, although, with the exception of self-rated health and General Health Questionnaire (GHQ) score in men, differences were non-significant. Steep gradients in job insecurity were observed among employed participants (p[less-than-or-equals, slant]0.01), and in financial insecurity among both employed and non-employed participants (p[less-than-or-equals, slant]0.001), particularly non-employed men. With the exception of depression, adjustment for job insecurity had little effect on the employment grade gradients in morbidity. However, financial insecurity contributed substantially to gradients in self-rated health, longstanding illness, and depression in both employed and non-employed men, and additionally to GHQ score and diastolic blood pressure in the latter. Adjustment for financial insecurity in non-employed women substantially attenuated gradients in self-rated health, GHQ score and depression. These findings imply that the specific effects of job insecurity in this cohort may be less important than the more general effects of financial insecurity in determining inequalities in health.

Suggested Citation

  • Ferrie, Jane E. & Shipley, Martin J. & Stansfeld, Stephen A. & Davey Smith, George & Marmot, Michael, 2003. "Future uncertainty and socioeconomic inequalities in health: the Whitehall II study," Social Science & Medicine, Elsevier, vol. 57(4), pages 637-646, August.
  • Handle: RePEc:eee:socmed:v:57:y:2003:i:4:p:637-646
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    Cited by:

    1. Tipper, Adam, 2010. "Economic models of the family and the relationship between economic status and health," Social Science & Medicine, Elsevier, vol. 70(10), pages 1567-1573, May.
    2. Chang, Sungwon & Gholizadeh, Leila & Salamonson, Yenna & DiGiacomo, Michelle & Betihavas, Vasiliki & Davidson, Patricia M., 2011. "Health span or life span: The role of patient-reported outcomes in informing health policy," Health Policy, Elsevier, vol. 100(1), pages 96-104, April.
    3. McAllister, Susan & Derrett, Sarah & Audas, Rick & Herbison, Peter & Paul, Charlotte, 2013. "Do different types of financial support after illness or injury affect socio-economic outcomes? A natural experiment in New Zealand," Social Science & Medicine, Elsevier, vol. 85(C), pages 93-102.
    4. Arifa Arif & Muhammad Zia-uD-din & Iqra Iqbal & Syed Danish Raza Naqvi, 2017. "The Impact of Mediating Role of Job Security between Work-Family Conflict and Employee Welfare Service," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 7(6), pages 326-341, June.
    5. Alyson van Raalte & Pekka Martikainen & Mikko Myrskylä, 2014. "Lifespan Variation by Occupational Class: Compression or Stagnation Over Time?," Demography, Springer;Population Association of America (PAA), vol. 51(1), pages 73-95, February.
    6. Kim, Il-Ho & Muntaner, Carles & Vahid Shahidi, Faraz & Vives, Alejandra & Vanroelen, Christophe & Benach, Joan, 2012. "Welfare states, flexible employment, and health: A critical review," Health Policy, Elsevier, vol. 104(2), pages 99-127.

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