Objective: To study predictors and consequences of unemployment.
Design: Prospective cohort study.
Setting: 11 construction companies in southern Finland.
Participants: 586 male employees, aged 40-59 years at baseline in 1991 and not retired during a 4 year follow up.
Main outcome measures: Long term unemployment, stress symptoms, disease, alcohol consumption, exercise activity, and body mass index.
Results: In a multiple logistic regression model, long term unemployment (>24 months v </=24 months) was predicted by age 50-54 years v 40-44 years (odds ratio 2.0, 95% confidence interval 1.1 to 3.7), </=3 years' employment in the present job (3.1, 1.9 to 5.1), previous unemployment (2.1, 1.2 to 3.8), being single (1.8, 1.1 to 3. 1), current smoking (2.6, 1.4 to 4.7), high alcohol consumption (2.1, 1.1 to 4.3), body mass index <23 kg/m(2 )v 23-29 kg/m(2 )(2.4, 1.3 to 4.4), frequent stress symptoms (2.0, 1.2 to 3.2), mental disorders (7.8, 1.5 to 40.0), and skin diseases (2.0, 1.0 to 3.9). Workers who were unemployed long term reported increased stress (2.1, 1.2 to 3.5) but fewer incident diseases (0.6, 0.4 to 0.9), decreased alcohol consumption (2.9, 1.6 to 5.2), increased exercise (1.9, 1.2 to 3.0), and increased body mass index (2.3, 1.3 to 4.0) compared with the rest of the cohort.
Conclusions: The workers' perceptions of work did not predict unemployment. Health based selection to long term unemployment was shown. Smoking and high alcohol consumption predated unemployment, but favourable lifestyle changes were observed among the unemployed workers. Stress predicted unemployment, which further increased the stress.