Health effects of anticipation of job change and non-employment: longitudinal data from the Whitehall II study

OBJECTIVE: To assess the effect of anticipating job change or non-employment on self reported health status in a group of middle aged male and female white collar civil servants. DESIGN: Longitudinal cohort study (Whitehall II study). Questionnaire data on self reported health status and health behaviour were obtained at initial screening and four years later, during the period when employees of the department facing privatisation were anticipating job change or job loss. SETTING: London based office staff in 20 civil service departments. SUBJECTS: 666 members of one department threatened with early privatisation were compared with members of the 19 other departments. MAIN OUTCOME MEASURES: Self reported health status measures and health related behaviours, before and during anticipation of privatisation. RESULTS: In comparison to the remainder of the cohort, the profile of health related behaviours of cohort members who faced privatisation was more favourable, both before and during anticipation of privatisation. There were no significant differences in the changes in health behaviours between cohort members moving into a period of job insecurity and the remainder of the cohort. Self reported health status, however, tended to deteriorate among employees anticipating privatisation when compared with that of the rest of the cohort. CONCLUSIONS: The application of a longitudinal design, allowing the same individuals to be followed from job security into anticipation, provides more robust evidence than has previously been available that anticipation of job loss affects health even before employment status has changed.