Unemployment and type 2 diabetes
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Markku Larmas auditorium H1091
Topic of the dissertation
Unemployment and type 2 diabetes
Doctoral candidate
Licenciate of Medicine, Specialist physician in occupational health Tuulia Varanka-Ruuska
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Population Health
Subject of study
Occupational health
Opponent
Associate professor Merja K. Laine, University of Helsinki
Custos
Professor Leena Ala-Mursula, University of Oulu
Unemployment and type 2 diabetes
Type 2 diabetes (T2D) is a growing global epidemic with incidence peaking in working age. Biological, psychological, and social factors interplay in the aetiology of T2D. Known risk factors of T2D are unhealthy lifestyle and obesity. Stress-related eating and drinking have been associated with obesity. Prolonged stress has been suggested to be linked to the onset of T2D, and unemployment is a prevalent stressor in working life. Some studies have observed that unemployment may increase the risk of T2D, and T2D may increase the risk of unemployment, but the evidence is inconsistent. The purpose of this thesis was to determine if unemployment and T2D are associated in middle-aged general population.
This thesis is compiled from a meta-analysis of the previous literature on T2D and unemployment and three cohort studies utilising Northern Finland Birth Cohort 1966. Measurements of glucose metabolism, survey data and national registers were combined. Regression models were used to evaluate how unemployment in three years predicts glucose metabolism, how T2D predicts exit from working life in the following two years, and how the preceding 30-year longitudinal employment trajectories between ages 16 to 45 are associated with T2D at age 46.
Unemployment was associated with 1.6-fold odds for prediabetes, and 1.7-fold odds for T2D in the meta-analysis. Men with unemployment exceeding one year in a three-year follow-up had 1.6-fold odds for prediabetes and 2.6-fold odds for T2D compared to continuously employed men. On the other hand, men and women with T2D were at 1.2-fold risk for unemployment days in the following two years. Men and women belonging to floundering employment trajectories with accumulated likelihood of unemployment, had 2.4- and 2.6-fold odds for T2D at the age of 46, respectively, even after adjustments for birth weight or childhood socioeconomic status.
The results of this thesis provide support for an association between unemployment and T2D. Information on prolonged unemployment or unstable employment history could be useful for clinicians in targeting screening for T2D, often undiagnosed for several years, for early detection and adequate care.
This thesis is compiled from a meta-analysis of the previous literature on T2D and unemployment and three cohort studies utilising Northern Finland Birth Cohort 1966. Measurements of glucose metabolism, survey data and national registers were combined. Regression models were used to evaluate how unemployment in three years predicts glucose metabolism, how T2D predicts exit from working life in the following two years, and how the preceding 30-year longitudinal employment trajectories between ages 16 to 45 are associated with T2D at age 46.
Unemployment was associated with 1.6-fold odds for prediabetes, and 1.7-fold odds for T2D in the meta-analysis. Men with unemployment exceeding one year in a three-year follow-up had 1.6-fold odds for prediabetes and 2.6-fold odds for T2D compared to continuously employed men. On the other hand, men and women with T2D were at 1.2-fold risk for unemployment days in the following two years. Men and women belonging to floundering employment trajectories with accumulated likelihood of unemployment, had 2.4- and 2.6-fold odds for T2D at the age of 46, respectively, even after adjustments for birth weight or childhood socioeconomic status.
The results of this thesis provide support for an association between unemployment and T2D. Information on prolonged unemployment or unstable employment history could be useful for clinicians in targeting screening for T2D, often undiagnosed for several years, for early detection and adequate care.
Last updated: 18.12.2024