Mortality inequalities by occupational status and type of job in men and women: results from the Rome Longitudinal Study.
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ABSTRACT: OBJECTIVES:Socioeconomic inequalities have a strong impact on population health all over the world. Occupational status is a powerful determinant of health in rich societies. We aimed at investigating the association between occupation and mortality in a large metropolitan study. DESIGN:Cohort study. SETTING:Rome, capital of Italy. PARTICIPANTS:We used the Rome Longitudinal Study, the administrative cohort of residents in Rome at the 2001 general census, followed until 2015. We selected residents aged 15-65 years at baseline. For each subject, we had information on sex, age and occupation (occupational status and type of job) according to the Italian General Census recognition. MAIN OUTCOME MEASURES:We investigated all-cause, cancer, cardiovascular and accidental mortality, major causes of death in the working-age population. We used Cox proportional hazards models to investigate the association between occupation and all-cause and cause-specific mortality in men and women. RESULTS:We selected 1?466?726 subjects (52.1% women). 42?715 men and 29?915 women died during the follow-up. In men, 47.8% of deaths were due to cancer, 26.7% to cardiovascular causes and 6.4% to accidents, whereas in women 57.8% of deaths were due to cancer, 19.3% to cardiovascular causes and 3.5% to accidents. We found an association between occupational variables and mortality, more evident in men than in women. Compared with employed, unemployed had a higher risk of mortality for all causes with an HR=1.99 (95% CI 1.92 to 2.06) in men and an HR=1.49 (95% CI 1.39 to 1.60) in women. Compared with high-qualified non-manual workers, non-specialised manual workers had a higher mortality risk (HR=1.68, 95%?CI 1.59 to 1.77 and HR=1.30, 95%?CI 1.20 to 1.40, for men and women, respectively). CONCLUSIONS:This study shows the importance of occupational variables as social health determinants and provides evidence for policy-makers on the necessity of integrated and preventive policies aimed at improving the safety of the living and the working environment.
SUBMITTER: Paglione L
PROVIDER: S-EPMC7282329 | biostudies-literature | 2020 Jun
REPOSITORIES: biostudies-literature
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