TY - JOUR T1 - Job insecurity and risk of diabetes: a meta-analysis of individual participant data JF - Canadian Medical Association Journal JO - CMAJ SP - E447 LP - E455 DO - 10.1503/cmaj.150942 VL - 188 IS - 17-18 AU - Jane E. Ferrie AU - Marianna Virtanen AU - Markus Jokela AU - Ida E.H. Madsen AU - Katriina Heikkilä AU - Lars Alfredsson AU - G. David Batty AU - Jakob B. Bjorner AU - Marianne Borritz AU - Hermann Burr AU - Nico Dragano AU - Marko Elovainio AU - Eleonor I. Fransson AU - Anders Knutsson AU - Markku Koskenvuo AU - Aki Koskinen AU - Anne Kouvonen AU - Meena Kumari AU - Martin L. Nielsen AU - Maria Nordin AU - Tuula Oksanen AU - Krista Pahkin AU - Jan H. Pejtersen AU - Jaana Pentti AU - Paula Salo AU - Martin J. Shipley AU - Sakari B. Suominen AU - Adam Tabák AU - Töres Theorell AU - Ari Väänänen AU - Jussi Vahtera AU - Peter J.M. Westerholm AU - Hugo Westerlund AU - Reiner Rugulies AU - Solja T. Nyberg AU - Mika Kivimäki A2 - , Y1 - 2016/12/06 UR - http://www.cmaj.ca/content/188/17-18/E447.abstract N2 - Background: Job insecurity has been associated with certain health outcomes. We examined the role of job insecurity as a risk factor for incident diabetes.Methods: We used individual participant data from 8 cohort studies identified in 2 open-access data archives and 11 cohort studies participating in the Individual-Participant-Data Meta-analysis in Working Populations Consortium. We calculated study-specific estimates of the association between job insecurity reported at baseline and incident diabetes over the follow-up period. We pooled the estimates in a meta-analysis to produce a summary risk estimate.Results: The 19 studies involved 140 825 participants from Australia, Europe and the United States, with a mean follow-up of 9.4 years and 3954 incident cases of diabetes. In the preliminary analysis adjusted for age and sex, high job insecurity was associated with an increased risk of incident diabetes compared with low job insecurity (adjusted odds ratio [OR] 1.19, 95% confidence interval [CI] 1.09–1.30). In the multivariable-adjusted analysis restricted to 15 studies with baseline data for all covariates (age, sex, socioeconomic status, obesity, physical activity, alcohol and smoking), the association was slightly attenuated (adjusted OR 1.12, 95% CI 1.01–1.24). Heterogeneity between the studies was low to moderate (age- and sex-adjusted model: I2 = 24%, p = 0.2; multivariable-adjusted model: I2 = 27%, p = 0.2). In the multivariable-adjusted analysis restricted to high-quality studies, in which the diabetes diagnosis was ascertained from electronic medical records or clinical examination, the association was similar to that in the main analysis (adjusted OR 1.19, 95% CI 1.04–1.35).Interpretation: Our findings suggest that self-reported job insecurity is associated with a modest increased risk of incident diabetes. Health care personnel should be aware of this association among workers reporting job insecurity. ER -