Adverse employment histories and allostatic load: associations over the working life

J Epidemiol Community Health. 2022 Apr;76(4):374-381. doi: 10.1136/jech-2021-217607. Epub 2021 Oct 8.


Background: Most studies on the health impact of occupational stress use single-point measures of stress at work. This study analyses the associations of properties of entire employment trajectories over an extended time period with a composite score of allostatic load (AL).

Methods: Data come from the French CONSTANCES cohort, with information on adverse employment histories between ages 25 and 45 and a composite score of AL (based on 10 biomarkers, range 0-10) among people aged 45 or older (47 680 women and 45 035 men). Data were collected by questionnaires (including retrospective employment histories) or by health examinations (including blood-based biomarkers). We distinguish six career characteristics: number of temporary jobs, number of job changes, number of unemployment periods, years out of work, mode occupational position and lack of job promotion.

Results: For both men and women, results of negative binomial regressions indicate that adverse employment histories are related to higher levels of AL, particularly histories that are characterised by a continued disadvantaged occupational position, repeated periods of unemployment or years out of work. Findings are adjusted for partnership, age and education, and respondents with a health-related career interruption or early retirement are excluded.

Conclusions: Our study highlights physiological responses as a mechanism through which chronic stress during working life is linked to poor health and calls for intervention efforts among more disadvantaged groups at early stages of labour market participation.

Keywords: employment; life course epidemiology; occupational health; work stress.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Allostasis*
  • Employment
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retirement
  • Retrospective Studies
  • Unemployment