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. 2022 Sep 14;22(1):1744.
doi: 10.1186/s12889-022-14137-1.

Fixed-term contract positions, unemployment and mental ill health: a Danish cohort study

Harald Hannerz  1 , Hermann Burr  2 , Helle Soll-Johanning  3 , Martin Lindhardt Nielsen  4 , Anne Helene Garde  3   5 , Mari-Ann Flyvholm  3
Affiliations

Fixed-term contract positions, unemployment and mental ill health: a Danish cohort study

Harald Hannerz et al. BMC Public Health. .

Abstract

Background: Both perceived job insecurity and unemployment has been associated with an increased risk of developing mental ill health. It has, moreover, been proposed that an insecure employment may be as detrimental as unemployment itself.

Objective: To estimate incidence rate ratios (RRs) of (i) redeemed prescriptions for psychotropic drugs and (ii) psychiatric hospital treatment due to mood, anxiety, or stress-related disease, among fixed-term contract workers (as an operationalization of insecure job) vs. unemployed, in the general population of Denmark.

Methods: Data on baseline employment status were drawn from the Danish Labor Force Surveys in the years 2001-2013. Participants (10,265 fixed-term contract workers and 7926 unemployed) were followed for up to 5 years in national registers (2439 cases of psychotropic drug use, 71,516 person years; 311 cases of psychiatric hospital treatment, 86,790 person years). Adjusted RRs were obtained by Poisson regression. We aspired to minimize health selection effects by (i) exclusion of survey participants who received sickness benefits, social security cash benefits, psychiatric hospital treatment or a prescription for psychotropic drugs, within 1-year prior to baseline (n = 11,693), (ii) adjustment for age, gender, level of education, calendar year, disposable family income and maternity/paternity benefits within 1-year prior to baseline.

Results: The adjusted RR for fixed-term contract workers vs. unemployed was 0.98 (99.5% CI: 0.87-1.11) for psychotropic drugs and 0.93 (99.5% CI: 0.67-1.30) for psychiatric hospital treatment.

Conclusion: The present study did not find significant differences in the risk of developing mental ill health between fixed-term contract workers and unemployed, and thus suggests that fixed-term contracts may be as detrimental as unemployment.

Trial registration: International Registered Report Identifier (IRRID): DERR2-10.2196/24392.

Keywords: Cohort study; Fixed-term employment; Psychiatric hospital treatment; Psychotropic drugs; Unemployment.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
Directed acyclic graph for some possible associations between the included variables. Maternity/paternity benefits are used as an indicator of recent childbirth
Fig. 2
Fig. 2
Flow-chart for inclusions and exclusions of the primary analysis
See this image and copyright information in PMC

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