Job insecurity is associated with psychological distress, adverse
physical symptoms, and poor self-rated health. But, whether job
insecurity is associated with coronary heart disease (CHD) is unclear.
Researchers analyzed data from 174,000 working adults who were
participating in 17 prospective studies in the U.S. and Europe.
Participants were free of CHD at baseline. Job insecurity was assessed
using a global question regarding level of insecurity in the current
job or with questions regarding fear of layoff or unemployment;
answers were dichotomized as high versus low job insecurity. Incident
CHD was ascertained from hospital records or death registries.
During mean follow-up of nearly 10 years, 1900 incident CHD-related
events (e.g., myocardial infarction, coronary death) occurred.
Adjusted for multiple variables (i.e., age, sex, socioeconomic status,
smoking, alcohol use, physical activity, and CHD risk factors), high
job insecurity was associated with significant 20% higher risk for CHD
compared with low job insecurity.
In this meta-analysis, high self-reported job insecurity was
associated with excess risk for incident CHD. However, the study has
important limitations. First, as the authors note, job insecurity
measured at a single point does not distinguish short-term from long-
term job insecurity, which might have different health effects.
Second, the findings do not prove causality; residual confounders
(e.g., psychiatric disorders) might account for some of the association.
Virtanen M et al. Perceived job insecurity as a risk factor for
incident coronary heart disease: Systematic review and meta-analysis.
BMJ 2013 Aug 8; 347:f4746. (http://dx.doi.org/10.1136/bmj.f4746)
Abstract/FREE Full Text
Paul S. Mueller, MD, MPH, FACP reviewing Virtanen M et al. BMJ 2013