Precarious employment at a young age and alcohol-related health problems

BACKGROUND: Precarious employment, a known determinant of poor health, is increasing in prevalence, particularly among young adults, where the long-term health consequences are not fully understood. The aim is to examine the effects of precarious employment at a young age on later alcohol-related health problems. METHODS: We used register-based data from the Swedish Work, Illness, and Labor-market Participation (SWIP) cohort to follow a cohort of 367 655 young adults aged 27 years between 2000-2003. Register data on labour market establishment (precarious employment, sub-standard employment, unemployment, and standard employment) was collected three years after graduation from school. The Swedish index of alcohol-related diagnoses was used to define the outcome, which was collected during a 26-year follow-up. Alcohol-related morbidity and mortality was combined into the outcome of alcohol-related health problems and collected from the National Patient Registers and Cause of Death Register. Cox Regression models were used to obtain hazard ratios (HR) with 95% confidence intervals (CI). RESULTS: The preliminary results suggest, after adjusting for important covariates (e.g. sex, parents highest level of socioeconomic status and prior mental and alcohol-related health problems), that young adults who were precariously employed three years after graduation from school were at an increased risk of alcohol-related health problems compared to young adults with standard employment (HR 1.49, 95% CI: 1.37, 1.61). Young adults in long-term unemployment had an even higher risk (HR 2.05, 95%CI: 1.89, 2.22). CONCLUSIONS: In Sweden, a nationwide register-based study with a long-term follow-up suggests that young adults with lower labour market attachment when entering the labour market are at an increased risk of later alcohol-related health problems. KEY MESSAGES: • Exposure to precarious employment at labour market establishment can have long-term determinantal consequences on later well-being. • Policies targeting the transition from school to the workforce are needed to ensure decent employment conditions for the vulnerable group of young adults.