Abstract
The aim of this study was to investigate the association of alcohol consumption and problem drinking on transitions between work, unemployment, sickness absence and social benefits. Participants were 86,417 men and women aged 18–60 years who participated in the Danish National Health Survey in 2010. Information on alcohol consumption (units per week) and problem drinking (CAGE-C score of 4–6) was obtained by questionnaire. The primary outcome was labour market attachment. Information on labour market attachment was obtained from the national administrative registers during a 5-year follow-up period. Using Cox proportional hazards models, we estimated hazard ratios (HR) for transitions between work, unemployment, sickness absence and social benefits. Analyses were adjusted for potential confounders associated with demography, health, and socio-economy. High alcohol consumption and problem drinking was associated with higher probability of unemployment, sickness absence and social benefits among participants employed at baseline compared with participants who consumed 1–6 drinks/week. High alcohol consumption and problem drinking was associated with lower probability of returning to work among participants receiving sickness absence at baseline compared with participants who consumed 1–6 drinks/week and with non-problem drinkers: HRs were 0.75 (0.58–0.98) for 35+ drinks per week and 0.81 (0.65–1.00) for problem drinking (CAGE-C score of 4–6). Similar trends for weekly alcohol consumption and problem drinking were observed among participants who were unemployed at baseline. In summary, problem drinking has adverse consequences for labour market participation and is associated with higher probability of losing a job and a lower chance of becoming employed again.
Highlights
Study design and participantsFor most people, work is the main source of financial support and ensures that basic needs, such as being able to maintain a home and support a family, are met
We aim to investigate the association of weekly alcohol consumption and problem drinking on the transition between different labour market endpoints in order to identify effective prevention strategies and reduce exclusion within society
Among participants receiving sickness absence at baseline, we found a lower hazard ratios (HR) of returning to work among abstainers and consumers of 35+ drinks per week with an HR of 0.78 and 0.75 when compared with those who had 1–6 drinks per week
Summary
Study design and participantsFor most people, work is the main source of financial support and ensures that basic needs, such as being able to maintain a home and support a family, are met. Knowledge of risk factors for job loss and barriers for getting back to work is a great public health concern. While associations between alcohol and health outcomes have been extensively studied, less is known about the impact of alcohol on labour market transitions such as becoming unemployed or getting back to work after being unemployed—i.e., downward social selection. Some studies indicate that heavy drinking and alcohol problems are associated with an increased risk of being laid off [22, 23] but associations between the full spectrum of alcohol consumption and risk of unemployment are unknown, as is the impact of alcohol on the probability of getting back to work
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