BMJ 1995;311:1264-1269 (11 November)

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Health effects of anticipation of job change and non-employment: longitudinal data from the Whitehall II study

Jane E Ferrie, research fellow,a Martin J Shipley, senior lecturer in medical statistics,a M G Marmot, professor,a Stephen Stansfeld, senior lecturer in social and community psychiatry,a George Davey Smith, professor of clinical epidemiology b

a Department of Epidemiology and Public Health, University College London Medical School, London WC1E 6BT, b Department of Social Medicine, University of Bristol, Bristol BS8 2PR

Correspondence to: Ms Ferrie.

Abstract

Objective: To assess the effect of anticipating job change or non-employment on self reported health status in a group of middle aged male and female white collar civil servants.
Design: Longitudinal cohort study (Whitehall II study). Questionnaire data on self reported health status and health behaviour were obtained at initial screening and four years later, during the period when employees of the department facing privatisation were anticipating job change or job loss.
Setting: London based office staff in 20 civil service departments.
Subjects: 666 members of one department threatened with early privatisation were compared with members of the 19 other departments.
Main outcome measures: Self reported health status measures and health related behaviours, before and during anticipation of privatisation.
Results: In comparison to the remainder of the cohort, the profile of health related behaviours of cohort members who faced privatisation was more favourable, both before and during anticipation of privatisation. There were no significant differences in the changes in health behaviours between cohort members moving into a period of job insecurity and the remainder of the cohort. Self reported health status, however, tended to deteriorate among employees anticipating privatisation when compared with that of the rest of the cohort.
Conclusions: The application of a longitudinal design, allowing the same individuals to be followed from job security into anticipation, provides more robust evidence than has previously been available that anticipation of job loss affects health even before employment status has changed.

Key messages

  • Key messages

  • Self reported health status measures for middle aged civil servants anticipating job change or job loss showed significant deterioration, relative to a group remaining in secure employment; this relative decline in health status could not be accounted for by changes in health related behaviours

  • The consequences of such changes are relevant not only to the civil service but also to the privatisation of other public services and the rationalisation programmes being carried out in the private sector in Britain and elsewhere

  • The increasing levels of job insecurity created by changes in the nature of employment relationships may lead to greater ill health in the general population, beyond the direct effects of unemployment


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