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Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors.

Magnusson Hanson, LL; Rod, NH; Vahtera, J; Virtanen, M; Ferrie, J; Shipley, M; Kivimäki, M; (2020) Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors. Psychoneuroendocrinology , 118 , Article 104706. 10.1016/j.psyneuen.2020.104706. Green open access

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Abstract

Job insecurity has been linked to increased risk of coronary heart disease (CHD), but underlying mechanisms remain uncertain. Our aim was to assess the extent to which this association is mediated through life style, physiological, or psychological factors. A total of 3917 men and women free from CHD provided data on job insecurity in the Whitehall II cohort study in 1997-1999. The association between job insecurity and CHD was decomposed into a direct and indirect effect mediated through unhealthy behaviors (smoking, high alcohol consumption, physical inactivity), sleep disturbances, 'allostatic load', or psychological distress. The counterfactual analyses on psychological distress indicated a marginally significant association between job insecurity and incident CHD (hazard ratio (HR) 1.32; 95 % confidence interval (CI) 1.00-1.75). This association was decomposed into a direct (HR 1.22, 95 %CI 0.92-1.63) and indirect association (1.08, 95 %CI 1.01-1.15), suggesting that about 30 % of the total relationship was mediated by psychological distress. No mediation was indicated via health behaviors, sleep disturbances, or allostatic load, although job insecurity was related to disturbed sleep and C-reactive protein, which, in turn were associated with CHD. In conclusion, our results suggest that psychological distress may play a role in the relation between job insecurity and CHD.

Type: Article
Title: Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors.
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.psyneuen.2020.104706
Publisher version: https://doi.org/10.1016/j.psyneuen.2020.104706
Language: English
Additional information: © 2020 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Keywords: Allostatic load, Cardiovascular disease, Depressive symptoms, Job insecurity, Mechanisms, Sleep
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/10100376
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