Background : The fall of Communism in Russia in 1991 was followed by socioeconomic instability and an unprecedented increase in mortality, particularly amongst the least educated. Insecure employment, a known determinant of health, was widespread during this time, but its role in the Russian mortality crisis has not been studied. I aimed to describe insecure employment in post-transition Russia, and whether it predicted mortality or explained the socioeconomic mortality gradient.
Methods: Data from seven rounds (1994–2001) of the Russia Longitudinal Monitoring Survey, a multi-centre panel study, were used. Employed respondents aged over 18 were studied. Deaths reported by a household member, wage arrears, compulsory leave, payment in goods, education (three categories), and occupation (five categories) were measured. Relationships between education, occupation, and unstable employment were studied. Cox proportional hazards analysis was used to study the association between measures of job insecurity and mortality, and whether insecure employment explained the occupational and educational mortality gradients.
Results: Data for 3498 (51.7%) males and 3274 (48.3%) females were analysed: 193 men and 38 women died. More than one-third of respondents experienced wage arrears, and 10% experienced compulsory leave and payment in consumer goods. Insecure employment fluctuated over time with changes in macroeconomic measures, and was more common in less educated individuals and in manual workers. Mortality was significantly associated with payment in consumer goods in men [1.72 (1.20–2.49)], and with compulsory unpaid leave in women [30 days or less: 2.57 (1.06–6.22); more than 30 days: 5.65 (2.17–14.69)]. Wage arrears did not predict mortality. Significant mortality gradients in relation to occupation and education were not explained by insecure employment.
Conclusions: Job insecurity was widespread in post-transition Russia, especially amongst disadvantaged groups. Measures of insecure employment predicted death somewhat inconsistently, however, and did not explain the socioeconomic gradient in mortality.