Occupational and behavioural factors in the explanation of social inequalities in premature and total mortality: a 12.5-year follow-up in the Lorhandicap study

Abstract

The respective contribution of occupational and behavioural factors to social disparities in all-cause mortality has been studied very seldom. The objective of this study was to evaluate the role of occupational and behavioural factors in explaining social inequalities in premature and total mortality in the French working population. The study population consisted of a sample of 2,189 and 1,929 French working men and women, who responded to a self-administered questionnaire in mid-1996, and were followed up until the end of 2008. Mortality was derived from register-based information and linked to the baseline data. Socioeconomic status was measured using occupation. Occupational factors included biomechanical and physical exposures, temporary contract, psychological demands, and social support, and behavioural factors, smoking, alcohol abuse, and body mass index. Significant social differences were observed for premature and total mortality. Occupational factors reduced the hazard ratios of mortality for manual workers compared to managers/professionals by 72 and 41%, from 1.88 (95% CI: 1.17-3.01) to 1.25 (95% CI: 0.74-2.12) for premature mortality, and from 1.71 (95% CI: 1.18-2.47) to 1.42 (95% CI: 0.95-2.13) for total mortality. The biggest contributions were found for biomechanical and physical exposures, and job insecurity. The role of behavioural factors was very low. Occupational factors played a substantial role in explaining social disparities in mortality, especially for premature mortality and men. Improving working conditions amongst the lowest social groups may help to reduce social inequalities in mortality.

The role of occupational activities and work environment in occupational injury and interplay of personal factors in various age groups among Indian and French coalminers

“…A 2-year period was chosen to have a sufficient number of occupational injuries. Occupational factors were assessed by the use of a 14-item biomechanical exposure scale and a 4-item physical exposure scale (Table 1) [18]. These biomechanical and physical exposures had scale reliability coefficients (Cronbach's α coefficients) of 0.89 and 0.57, respectively.…”

“…They are known as strong potential contributors to social inequalities in accidents, health and mortality [3,11,17,18]. Most employers hire workers and cannot provide them with a safe working environment.…”

Work strain in midlife and 28-year work ability trajectories

“…This in turn may lead older employees to rate their workload as more stressful and threatening than younger employees (39). Furthermore, there is reason to believe that poor quality of working life predicts mortality (7,8,11,12) and disability in old age (25). von Bonsdorff et al Baseline differences in work strain according to work ability in this study may indicate that employees in low-strain work are likely to report better subsequent work ability and that those experiencing high work strain in midlife are likely to report poor work ability in later life.…”

“…According to recent Finnish research, a fourth of employees rate their work as physically demanding (9). Psychological job strain has been linked to an early exit from working life (10) and mortality (11,12), and jobs characterized by high demands and low control and social support are significant predictors of coronary heart disease (13,14).…”

Educational inequalities in major depressive and generalized anxiety disorders: results from the French national SIP study

“…This explained fraction has commonly been used in the literature to evaluate the contribution of a factor or a set of factors in the explanation of social inequalities in health outcomes [25][26][27]. As the data were weighted, the Jackknife method was used as a resampling technique to obtain 95% CI for the explained fractions [28].…”