Socio-professional trajectories and mortality in France, 1976-2002
Being in low socioeconomic position is associated with increased mortality risk from various causes of death. To better disentangle this association, previous studies considered different dimensions of socioeconomic trajectories across the life-course. However, life-course models were applied using only two or three stages of life. Here, we examined simultaneously different dimensions of the whole professional trajectory and its association with cause-specific mortality.
METHODS:
We used a large sample (390 149 men, 308 193 women) of the data resulted by the linkage of individual’s annual occupations (collected in 1976-2002 from a representative sample of the French salaried population of semi-public and private sectors) with the causes of deaths registries. Two new professional trajectory indicators, the duration of spent-time in occupational categories and the transition rates between occupational categories, were defined respectively as measures of socioeconomic cumulative exposure and social mobility dimension.
RESULTS:
Spending more years in an occupational category was strongly associated with men and women's mortality, especially cardiovascular mortality. An increase in the time spent in clerk class increased men’s cardiovascular mortality risk compared to that in upper class (HR: 1.92(1.39-2.65) for 10 years). Similarly, it tripled women’s cardiovascular mortality risk compared to upper class (HR: 3.22(1.43-7.27) for 10 years). Men with high rate of transitions between occupational categories had about 1.3-fold increased risk of all-cause, cardiovascular, cancer and external causes mortality compared to those with low rate of transitions. Among women, the same association was observed, but only for all-cause and external causes mortality.
CONCLUSIONS:
Strong associations between professional trajectories and mortality from different causes of death were found. Long exposure to lower socioeconomic conditions was associated with increased mortality risk from various causes of death. The results also suggested graded associations between having more transitions in professional trajectory and mortality.