TitleJob insecurity and risk of diabetes: a meta-analysis of individual participant data.
Publication TypeJournal Article
Year of Publication2016
AuthorsFerrie, JE, Virtanen, M, Jokela, M, Madsen, IEH, Heikkilä, K, Alfredsson, L, Batty, GD, Bjorner, JB, Borritz, M, Burr, H, Dragano, N, Elovainio, M, Fransson, EI, Knutsson, A, Koskenvuo, M, Koskinen, A, Kouvonen, A, Kumari, M, Nielsen, ML, Nordin, M, Oksanen, T, Pahkin, K, Pejtersen, JH, Pentti, J, Salo, P, Shipley, MJ, Suominen, SB, Tabák, A, Theorell, T, Väänänen, A, Vahtera, J, Westerholm, PJM, Westerlund, H, Rugulies, R, Nyberg, ST, Kivimäki, M
Corporate AuthorsIPD-Work Consortium
Date Published12/2016
KeywordsAlcohol Drinking, Australia, Cohort Studies, Databases, Factual, Diabetes Mellitus, Employment, Europe, Exercise, Humans, Incidence, Multivariate Analysis, Obesity, Odds Ratio, Risk Factors, Smoking, Social Class, United States

BACKGROUND: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes.

METHODS: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate.

RESULTS: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09-1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01-1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I = 24%, p = 0.2; multivariable-adjusted model: I = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04-1.35).

INTERPRETATION: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity.

Alternate JournalCMAJ
PubMed ID27698195
PubMed Central IDPMC5135521
Grant ListRG/13/2/30098 / / British Heart Foundation / United Kingdom
MR/K026992/1 / / Medical Research Council / United Kingdom
P01 AG020166 / AG / NIA NIH HHS / United States
MR/K013351/1 / / Medical Research Council / United Kingdom
U19 AG051426 / AG / NIA NIH HHS / United States