Employment status and health after privatisation in white collar civil servants: prospective cohort study

Objectives To determine whether employment status after job loss due to pri vatisation influences health and use of health services and whether financi al strain, psychosocial measures, or health related behaviours can explain any findings. Design Data collected before and 18 months after privatisation. Setting One department of the civil service that was sold to the private se ctor, Participants 666 employees during baseline screening in the department to b e privatised. Main outcome measures Health and health service outcomes associated with in secure re-employment, permanent exit from paid employment, and unemployment after privatisation compared with outcomes associated with secure re-emplo yment Results Insecure re-employment and unemployment were associated with relati ve increases in minor psychiatric morbidity (mean difference 1.56 (95% conf idence intervals interval 1.0 to 2.2) and 1.25 (0.6 to 2.0) respectively) a nd having four or more consultations with a general practitioner in the pas t year (odds ratio 2.04 (1.1 to 3.8) and 2.39 (1.3 to 4.7) respectively). H ealth outcomes for respondents permanently out of paid employment closely r esembled those in secure re-employment, except for a substantial relative i ncrease in longstanding illness (2.25; 1.1 to 4.4), Financial strain and ch ange in psychosocial measures and health related behaviours accounted for l ittle of the observed associations. Adjustment for change in minor psychiat ric morbidity attenuated the association between insecure re-employment or unemployment and general practitioner consultations by 26% and 27%, respect ively. Conclusions Insecure re-employment and unemployment after privatisation res ult in increases in minor psychiatric morbidity and consultations with a ge neral practitioner, which are possibly due to the increased minor psychiatr ic morbidity.