Serious health events following involuntary job loss in New Zealand meat processing workers.

BACKGROUND The association between unemployment and poor health outcomes is well documented. Significant debate exists as to whether unemployment causes ill health or whether those with poor health find it harder to obtain and maintain employment. Factory closure studies are well placed to comment on causation. The objective of this study was to investigate associations between involuntary job loss, mortality and serious illness. METHODS An 8-year follow-up of workers from two meat-processing plants in the Hawkes Bay region of New Zealand. A cohort (n = 1945) made redundant in 1986 was compared with a cohort (n = 1767) from the neighbouring plant that remained open until 1994. Incidence rates for mortality, cancer registrations and admissions to public hospitals were derived from record linkage with routinely collected national data. RESULTS Follow-up for the period 1986-1994 was 96% complete for both plants. Among the cohort made redundant in 1986, there was an increased risk of serious self-harm which led to hospitalization or death (adjusted for age, sex and ethnicity relative risk [RR] = 2.47; 95% CI: 1.04-5.89) compared to the employed cohort. The RR of admission to hospital with a mental health diagnosis was 1.17 (95% CI: 0.68-2.01). There were no other statistically significant findings. CONCLUSIONS This study has most of the features of an 'ideal' factory closure study, in that it achieved near-complete follow-up of a large workforce made redundant and a similar employed workforce for 8 years. We found that exposure to involuntary job loss increased the risk of mental distress leading to serious self-harm. No other association was found.

[1]  A. Cantor,et al.  Extending SAS Survival Analysis Techniques for Medical Research , 1997 .

[2]  A. Beautrais Suicides and serious suicide attempts: two populations or one? , 2001, Psychological Medicine.

[3]  D B Rubin,et al.  Multiple imputation in health-care databases: an overview and some applications. , 1991, Statistics in medicine.

[4]  M. T. Damsgaard,et al.  Hospital admissions before and after shipyard closure. , 1989, BMJ.

[5]  Alfred Slote Termination: The Closing at Baker Plant , 1977 .

[6]  N. Beale,et al.  Job-loss and family morbidity: a study of a factory closure. , 1985, The Journal of the Royal College of General Practitioners.

[7]  S. Cobb,et al.  Changes in reported illness and illness behavior related to termination of employment: a preliminary report. , 1972, International journal of epidemiology.

[8]  D. Cook,et al.  Unemployment pre-dates symptoms of depression and anxiety resulting in medical consultation in young men. , 1999, International journal of epidemiology.

[9]  D. Cook,et al.  Loss of employment and mortality , 1994, BMJ.

[10]  P. Martikainen,et al.  The association between unemployment and mortality: causation or selection? , 1995 .

[11]  L. Niskanen,et al.  Rapidly declining mental well-being during unemployment , 1996 .

[12]  S. Platt,et al.  Unemployment and suicidal behaviour: a review of the literature. , 1984, Social science & medicine.

[13]  L. Fagin,et al.  Hospital Admissions Before and After Shipyard Closure , 1990, British Journal of Psychiatry.

[14]  D. Jones,et al.  Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples. , 1987, British medical journal.

[15]  Howard B. Newcombe,et al.  Handbook of record linkage: methods for health and statistical studies, administration, and business , 1988 .

[16]  P. Grambsch,et al.  Modeling Survival Data: Extending the Cox Model , 2000 .

[17]  S. Cobb,et al.  The Experience of Losing a Job: Reported Changes in Health, Symptoms and Illness Behavior , 1975, Psychosomatic medicine.

[18]  Alan D. Lopez,et al.  Adult mortality in developed countries: from description to explanation. , 1995 .

[19]  M. Jahoda,et al.  Employment and Unemployment: A Social-Psychological Analysis , 1982 .

[20]  P. Bethwaite,et al.  Unemployment and the public health. , 1990, The New Zealand medical journal.

[21]  D. Cook,et al.  A critical review of the effect of factory closures on health. , 1991, British journal of industrial medicine.

[22]  P. Martikainen,et al.  Excess mortality of unemployed men and women during a period of rapidly increasing unemployment , 1996, The Lancet.

[23]  P. Davis,et al.  The impact of the new subsidy regime in general practice in New Zealand. , 1994, Health policy.

[24]  L. Iversen,et al.  Psychological Weil‐Being Among Unemployed and Employed People After a Company Closedown: A Longitudinal Study , 1988 .

[25]  Stanislav V. Kasl,et al.  Termination: The consequences of job loss , 1977 .

[26]  M. Bartley Unemployment and ill health: understanding the relationship. , 1994, Journal of epidemiology and community health.