Article Text

Download PDFPDF
Original research
Newly diagnosed disease and job loss: a nationwide longitudinal study among middle-aged Japanese
  1. Midori Takada1,2,
  2. Takahiro Tabuchi2,
  3. Hiroyasu Iso1
  1. 1 Public Health, Department of Social Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Japan
  2. 2 Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
  1. Correspondence to Professor Hiroyasu Iso, Public Health, Department of Social Medicine, Osaka University Faculty of Medicine Graduate School of Medicine, Suita, Osaka 565-0871, Japan; iso{at}


Objectives Since previous studies have only used past or current medical history of disease, there is no information on newly diagnosed disease in relation to job loss. Our objective was therefore to investigate whether newly diagnosed chronic disease increased job loss among middle-aged Japanese.

Methods We analysed data on 31 403 Japanese workers aged 50–59 years from a nationally representative longitudinal study. We defined two types of job loss; later job loss (within 1 year of disease diagnosis) and concurrent/later job loss (at around the time of diagnosis and within 1 year of diagnosis). Generalised estimating equation models were used to calculate ORs for job loss among current workers after a new-diagnosis of chronic disease (diabetes, hypertension, hyperlipidaemia, heart disease, stroke and cancer), using a discrete-time design and adjusting for demographic, socioeconomic and health behavioural factors. We used inverse probability weighting to account for non-response at follow-up.

Results ORs for concurrent/later job loss were 1.17 (95% CI 1.03–1.31) for diabetes, 1.01 (95% CI 0.93–1.09) for hypertension, 1.01 (95% CI 0.94–1.09) for hyperlipidaemia, 1.21 (95% CI 1.06–1.40) for heart disease, 1.48 (95% CI 1.21–1.81) for stroke and 1.38 (95% CI 1.17–1.62) for cancer diagnosed patients. The corresponding ORs for later job loss were 1.14 (95% CI 0.96–1.35), 1.00 (95% CI 0.90–1.12), 0.98 (95% CI 0.88–1.08), 1.24 (95% CI 1.02–1.49), 1.16 (95% CI 0.86–1.55) and 1.39 (95% CI 1.11–1.73).

Conclusions New diagnosis of diabetes, heart disease, cancer and stroke increased the risk of job loss; loss was concurrent for diabetes mellitus and stroke, and concurrent/later for cancer and heart disease. Our results provide fundamental information for employment support for patients with chronic disease.

  • epidemiology
  • public health
  • longitudinal studies
  • occupational health practice

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors MT performed the statistical analysis and wrote the first draft. All authors contributed to further drafts and approved the final manuscript.

  • Funding This work was supported by the Japan Society for the Promotion of Science KAKENHI under grant 18H03062.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The analysis of national survey data was considered to be exempt from the need for ethical review according to the Japanese government’s Ethical Guidelines for Epidemiological Research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available. Not applicable.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.