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IJE Advance Access published online on March 31, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi047
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Accepted January 31, 2005

Original paper

When aspirations and achievements don't meet. A longitudinal examination of the differential effect of education and occupational attainment on declines in self-rated health among Canadian labour force participants

Peter Smith 1* and John Frank 2

1 Institute for Work and Health, Toronto, Canada; Institute of Medical Science, University of Toronto, Canada
2 Institute for Work and Health, Toronto, Canada; Canadian Institutes of Health Research, Institute of Population and Public Health, Toronto, Canada; Department of Public Health Sciences, University of Toronto, Canada

* To whom correspondence should be addressed.
Peter Smith, E-mail: psmith{at}iwh.on.ca


  Abstract

Background To examine the association of a mismatch between educational qualifications and occupational attainment and subsequent declines in self-rated health (SRH) in a longitudinal nationally representative Canadian population sample.

Methods This study used longitudinal data from 4045 healthy, working respondents of the Canadian National Population Health Survey. Respondents were categorized as either qualified, overqualified, or underqualified based on the match between their education and the skills required for their current occupation over a 2-year period. Logistic regression analysis estimated the odds of decline in SRH over the following 4-year period, using the match between occupation and education as the main independent variable. Analyses were controlled for a number of confounding variables including health behaviours, mental health, self-esteem, job control, and demographic information.

Results Relative to respondents with university education working in occupations for which they were qualified, respondents with university education, working in occupations for which they were overqualified had a significant risk of decline in SRH between 1996 and 2000, even after adjusting for a number of potential confounders (OR = 2.08, 95% CI 1.11-3.91). In respondents with secondary education or less, differences in occupational attainment were not associated with differences in the odds of decline in SRH.

Conclusions The effect of occupational attainment on health is important for individuals who have invested the most time in their education. Conversely, differential occupational attainment is not associated with differences in the odds of decline in health for participants with lower levels of education.

Keywords: Overqualified; status inconsistency; occupation; education; self-rated health; longitudinal; National Population Health Survey; socioeconomic status.
A Commentary has been commissioned to accompany this article and will appear with this paper in the printed issue.
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