How does job insecurity and workplace activity limitations relate to rheumatic disease symptom trajectories in young adulthood? A longitudinal study

Background Workplace and labor market conditions are associated with the health of the working population. A longitudinal study was conducted among young adults with rheumatic disease to examine workplace activity limitations and job insecurity and their relationship with disease symptom trajectories. Methods Three online surveys were administered to young adults with rheumatic disease over 27-months. Self-reported pain, fatigue and disease activity were collected. Workplace activity limitations and job insecurity were measured. Group-based discrete mixture models determined pain, fatigue, and disease activity trajectory groups. Robust Poisson regression models were fitted to examine the relationship among workplace activity limitations, job insecurity and trajectory group membership. Results 124 participants (mean age=29 years±4.5) with rheumatic disease were recruited. At baseline, participants reported considerable workplace activity limitations (10.35±5.8) and 36% indicated job insecurity. We identified two latent rheumatic disease symptom trajectory groups. The first had severe persistent pain, fatigue, or disease activity; the second had less severe disease symptoms over time. Greater workplace activity limitations were associated with an increased relative risk of membership in the persistent severe pain (RR=1.02, 95%CI 1.01-1.03), fatigue (RR=1.02, 95%CI 1.01-1.03) and disease activity trajectory groups (RR=1.02, 95%CI 1.01-1.03). Job insecurity was associated with an increased relative risk of membership in the persistent severe pain (RR=1.14, 95%CI 1.04-1.25) and disease activity trajectory groups (RR=1.11, 95%CI 1.00-1.22). Conclusion Workplace activity limitations and job insecurity represent working conditions that are associated with the health of young adults with rheumatic disease and should be examined as potential targets for intervention.