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

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.