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Cause-specific mortality by occupational skill level in Canada: a 16-year follow-up study
M Tjepkema1, R Wilkins, A Long
1Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada. michael.tjepkema@statcan.gc.ca
Chronic Diseases and Injuries in Canada
|August 31, 2013
Summary
Occupational skill level significantly impacts mortality rates in Canada. Unskilled workers face higher risks for various causes of death compared to professionals, highlighting socioeconomic disparities in health outcomes.
Area of Science:
- Public Health
- Epidemiology
- Sociology of Health
Background:
- Mortality data by occupation is not routinely collected in Canada.
- Occupational skill level is a key determinant of socioeconomic status and health outcomes.
- Previous research has indicated a gradient in mortality rates across different socioeconomic groups.
Purpose of the Study:
- To analyze cause-specific mortality rates across occupational skill levels in Canada.
- To provide detailed, cause-specific mortality indicators based on occupation.
- To investigate the relationship between occupational skill level and mortality risk.
Main Methods:
- Utilized a 15% sample of the 1991 Canadian Census linked to 16 years of mortality data (1991-2006).
- Included 2.3 million individuals aged 25-64 at cohort inception, with 164,332 deaths recorded.
- Occupations were classified using the National Occupation Classification into five skill levels. Age-standardized mortality rates (ASMRs) and rate ratios (RRs) were calculated.
Main Results:
- A clear gradient in mortality rates was observed, with highest rates in unskilled occupations and lowest in professional occupations.
- All-cause mortality rate ratios (RRs) for men decreased with increasing skill level (1.16 to 1.83 compared to professionals).
- Significant mortality gradients were found for various causes, including HIV/AIDS, diabetes, suicide, and cancers, with RRs > 2 for lowest vs. highest skill levels.
Conclusions:
- Mortality gradients by occupational skill level are evident for most causes of death in Canada.
- These findings provide crucial, previously unavailable cause-specific baseline mortality indicators.
- The results underscore the impact of socioeconomic factors, specifically occupational skill, on health and mortality.
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