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Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden : an emulation of a target trial
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Matilla-Santander, Nuria, Matthews, Anthony A., Gunn, Virginia, Muntaner, Carles, Kreshpaj, Bertina, Wegman, David H., Sánchez-Martínez, Néstor, Hernando-Rodriguez, Julio C., Albin, Maria, Balogh, Rebeka, Davis, Letitia and Bodin, Theo (2023) Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden : an emulation of a target trial. Journal of Epidemiology & Community Health . doi:10.1136/jech-2023-220734 ISSN 0143-005X. (In Press)
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Official URL: https://doi.org/10.1136/jech-2023-220734
Abstract
Background: We aimed at estimating the causal effect of switching from precarious to standard employment on the 6-year and 12-year risk of all-cause mortality among workers aged 20-55 years in Sweden. Methods: We emulated a series of 12 target trials starting every year between 2005 and 2016 using Swedish register data (n=251 273). We classified precariously employed individuals using a multidimensional approach at baseline as (1) remaining in precarious employment (PE) (73.8%) and (2) shifting to standard employment (26.2%). All-cause mortality was measured from 2006 to 2017. We pooled data for all 12 emulated trials and used covariate-adjusted pooled logistic regression to estimate intention-to-treat and per-protocol effects via risk ratios (RRs) and standardised risk curves (the parametric g-formula). Results: Shifting from precarious to standard employment decreases the 12-year risk of death by 20% on the relative scale (RR: 0.82, 95% CI: 0.73; 0.93), regardless of what happens after the initial shift. However, we estimated a 12-year risk reduction of 30% on the relative scale for workers shifting from precarious to standard employment and staying within this employment category for the full 12 years (RR: 0.71, 95% CI: 0.54; 0.95). Conclusions: This study finds that shifting from low to higher-quality employment conditions (ie, stable employment, sufficient income levels and high coverage by collective agreements) decreases the risk of death. Remaining in PE increases the risk of premature mortality. Our results emphasise the necessity of ensuring decent work for the entire working population to accomplish the 2030 Agenda for Sustainable Development.
| Item Type: | Journal Article | ||||||
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| Subjects: | H Social Sciences > HB Economic Theory H Social Sciences > HD Industries. Land use. Labor |
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| Divisions: | Faculty of Social Sciences > Institute for Employment Research | ||||||
| SWORD Depositor: | Library Publications Router | ||||||
| Library of Congress Subject Headings (LCSH): | Precarious employment -- Health aspects -- Sweden, Temporary employment -- Health aspects -- Sweden, Employees -- Mortality -- Sweden, Occupational mortality | ||||||
| Journal or Publication Title: | Journal of Epidemiology & Community Health | ||||||
| Publisher: | BMJ Group | ||||||
| ISSN: | 0143-005X | ||||||
| Official Date: | 23 August 2023 | ||||||
| Dates: |
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| DOI: | 10.1136/jech-2023-220734 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | In Press | ||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||
| Date of first compliant deposit: | 1 September 2023 | ||||||
| Date of first compliant Open Access: | 1 September 2023 | ||||||
| RIOXX Funder/Project Grant: |
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