Junior civil service can damage health

November 15, 1996

LOW-RANKING civil servants are much more likely to die before their professional and executive level counterparts, a long-term study has found.

The research shows that work itself, not just socioeconomic factors, may cause health inequalities.

Michael Marmot and Martin Shipley, of University College London's medical school, published their findings in the British Medical Journal last week.

The investigation followed 18,001 men up to the age of 89, continuing research involving Whitehall workers aged 40 to 69 years that began in 1967. They were divided into four job grades: administrative, professional/executive, clerical, and other, for unskilled manual workers.

The researchers found that grade of employment was linked with mortality. Up to age 64, there was a 212 per cent higher mortality for those in the lowest category compared with the higher grades. Although the difference declined after retirement, the mortality rate for the lower grades was still 86 per cent higher. "Though grade is a measure of position in the occupational hierarchy, it reflects more than experience of work. It relates to educational and social background, status, self-esteem, and income and associated living conditions," Professor Marmot and Mr Shipley wrote.

Car ownership was also examined, as a non-work based socio-economic measure. It was shown to predict mortality in the original Whitehall study.

Lack of a car was associated with a 57 per cent higher mortality before retirement and 34 per cent after retirement.

The conclusions were that important socioeconomic links to mortality remain after retirement, at least up to age 89, and in absolute terms increased with age.

Differences in mortality based on a measure of occupational status decreased after retirement, but those based on a non-work measure such as car ownership seem to decline less.

"This suggests that work itself may play an important part in generating social inequalities in health in men of working age," the researchers commented.

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