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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.154815v1 99/10/1818    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Perlman, F. Articles by Bobak, M. PubMed PubMed Citation Articles by Perlman, F. Articles by Bobak, M. Related Collections Epidemiology Occupational Health Socioeconomic Factors Mortality Alcohol

Francesca Perlman, MBBS, PhD and Martin Bobak, MD, PhD

At the time of this research, Francesca Perlman and Martin Bobak were with the Department of Epidemiology and Public Health, University College London, England.

Correspondence: Correspondence should be sent to Dr. Francesca Perlman, London School of Hygiene and Tropical Medicine, Keppel St, London WC2E 7HT, UK (e-mail: francesca.perlman{at}lshtm.ac.uk). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We used the Russia Longitudinal Monitoring Survey (RLMS) to investigate associations between employment, socioeconomic position, and mortality.

Methods. Data were from working-age respondents in 8 rounds (1994–2003) of the RLMS. We measured associations between education, occupation, unemployment, and insecure employment and mortality with Cox proportional hazards analyses.

Results. Of 4465 men and 4158 women who were currently employed, 251 men and 34 women died. A third of employed respondents experienced wage arrears, and 10% experienced compulsory leave and payment in consumer goods. Insecure employment, more common among the less-educated and manual workers, fluctuated with macroeconomic measures. Mortality was significantly associated with payment in consumer goods among men (hazard ratio [HR] = 1.46; 95% confidence interval [CI] = 1.03, 2.07), compulsory unpaid leave among women (HR = 3.79; 95% CI = 1.82, 7.88), and male unemployment (HR = 1.88; 95% CI = 1.38, 2.55). Associations with death within 1 year of entry were generally somewhat stronger than the association with mortality over the whole study period.

Conclusions. Unemployment and job insecurity predicted mortality, suggesting that they contributed to Russia's high mortality during the transition from communism.