Future uncertainty and socioeconomic inequalities in health: the XXXX .

@entity1 @entity308 @entity1605 @entity165
Over the past 20 years, socioeconomic inequalities in mortality have widened, while job security and financial security have decreased. This paper examines the @entity1605 , a longitudinal study of white-collar British civil servants. In the Whitehall II cohort socioeconomic gradients in morbidity and cardiovascular risk factors at Phase 5 (1997-99) were generally steeper than at Phase 1 (1985-88). We examine the contribution of job and financial insecurity to these at Phase 5 in 6770 @entity1 and @entity1 , all of whom were white-collar civil servants at Phase 1. Steep, inverse employment grade gradients were observed for all health measures at Phase 5, except @entity165 and systolic blood pressure in @entity1 . Gradients in the sub-population of non-employed @entity1 tended to be steeper than gradients for @entity1 in employment, although, with the exception of self-rated health and General Health Questionnaire (GHQ) score in @entity1 , differences were non-significant. Steep gradients in job insecurity were observed among employed @entity1 (p<or=0.01), and in financial insecurity among both employed and non-employed @entity1 (p<or=0.001), particularly non-employed @entity1 . With the exception of @entity308 , adjustment for job insecurity had little effect on the employment grade gradients in morbidity. However, financial insecurity contributed substantially to gradients in self-rated health, longstanding illness, and @entity308 in both employed and non-employed @entity1 , and additionally to GHQ score and diastolic blood pressure in the latter. Adjustment for financial insecurity in non-employed @entity1 substantially attenuated gradients in self-rated health, GHQ score and @entity308 . These findings imply that the specific effects of job insecurity in this cohort may be less important than the more general effects of financial insecurity in determining inequalities in health.
