The impact of layoffs on dietary and drinking behaviors across the life course: Evidence from China (1989 - 2011)

Abstract

Existing research on the health impact of job loss has predominantly focused on developed economies, often overlooking how these effects manifest in developing countries, particularly over the long term. To address this gap, our study explores the impact of layoffs on dietary diversity and alcohol consumption among workers during China’s economic transitions from 1989 to 2011. Using longitudinal data from the China Health and Nutrition Survey spanning over two decades and applying fixed-effects models, we analyzed the temporal and career-stage-specific effects of job loss. Our results indicate that layoffs led to a significant reduction in dietary diversity, a key indicator of dietary quality and food insecurity, with the effect being most pronounced shortly after job loss and tapering off over time. In contrast, alcohol consumption increased following layoffs. Mid-career workers experienced the greatest decline in dietary diversity, late-career workers faced increased risks of alcohol consumption, and early-career workers were more likely to engage in heavy drinking. These findings highlight the complex interplay between financial constraints, psychological stress, and lifestyle choices. This study highlights that layoffs adversely affect workers at all career stages, though the specific health behaviors impacted differ by career stage. Our findings provide valuable evidence for the development of policies and interventions tailored to different worker groups and offer insights into the dynamics of transitional and post-transitional China.

Keywords

Layoff / Dietary diversity / Drinking behavior / Heavy drinking behavior / Life-course approach / State-owned enterprises / China

References

[1] Åberg F., Byrne C.D., Pirola C.J., Männistö V., & Sookoian S. (2023). Alcohol consumption and metabolic syndrome: Clinical and epidemiological impact on liver disease. Journal of Hepatology, 78(1):191-206. https://doi.org/10.1016/j.jhep.2022.08.030

[2] Abruzzese A., Mignani I., & Cocucci S.M. (1995). Nutritional status in apples and June drop. Cover Journal of the American Society for Horticultural Science, 120(1):71-74. https://doi.org/10.21273/JASHS.120.1.71

[3] Allison P.D. (2009). Fixed Effects Regression Models. United States: SAGE Publications, Inc; 2009. https://doi.org/10.4135/9781412993869

[4] Arimond M., & Ruel M.T. (2004). Dietary diversity is associated with child nutritional status: Evidence from 11 demographic and health surveys. Journal of Nutrition, 134(10):2579-2585. https://doi.org/10.1093/jn/134.10.2579

[5] Azadbakht L., Mirmiran P., Esmaillzadeh A., & Azizi F. (2006). Dietary diversity score and cardiovascular risk factors in Tehranian adults. Public Health Nutrition, 9(6):728-736. https://doi.org/10.1079/phn2005887

[6] Baumann I. (2015). Decreased well-being after job loss: Testing omitted causes. LIVES Working Paper, 36:1-33. https://doi.org/10.12682/lives.2296-1658.2015.36

[7] Bian Y. (2002). Chinese social stratification and social mobility. Annual Review of Sociology, 28(1):91-116. https://doi.org/10.1146/annurev.soc.28.110601.140823

[8] Bloemen H., Hochguertel S., & Zweerink J. (2018). Job loss, firm-level heterogeneity and mortality: Evidence from administrative data. Journal of Health Economics, 59:78-90. https://doi.org/10.1016/j.jhealeco.2018.03.005

[9] Bottan N., Hoffmann B., & Vera-Cossio D. (2020). The unequal impact of the coronavirus pandemic: Evidence from seventeen developing countries. PLoS One, 15(10):e0239797. https://doi.org/10.1371/journal.pone.0239797

[10] Brand J.E., Levy B.R., & Gallo W.T. (2008). Effects of layoffs and plant closings on subsequent depression among older workers. Research on Aging, 30(6):701-721. https://doi.org/10.1177/0164027508322574

[11] Browning M., Moller Dano A., & Heinesen E. (2006). Job displacement and stress-related health outcomes. Health Economics, 15(10):1061-1075. https://doi.org/10.1002/hec.1101

[12] Burgard S.A., Brand J.E., & House J.S. (2007). Toward a better estimation of the effect of job loss on health. Journal of Health and Social Behavior, 48(4):369-384. https://doi.org/10.1177/002214650704800403

[13] Catalano R., Goldman-Mellor S., Saxton K., Margerison- Zilko C., Subbaraman M., LeWinn K., et al. (2011). The health effects of economic decline. Annual Review of Public Health, 32(1):431-450. https://doi.org/10.1146/annurev-publhealth-031210-101146

[14] Chai Y. (2014). From socialist danwei to new danwei: A daily-life-based framework for sustainable development in urban China. Asian Geographer, 31(2):183-190. https://doi.org/10.1080/10225706.2014.942948

[15] Chan S., & Stevens A.H. (2001). Job loss and employment patterns of older workers. Journal of Labor Economics, 19(2):484-521. https://doi.org/10.1086/319568

[16] Chen R.C.Y., Chang Y.H., Lee M.S., & Wahlqvist M.L. (2011). Dietary quality may enhance survival related to cognitive impairment in Taiwanese elderly. Food & Nutrition Research, 55. https://doi.org/10.3402/fnr.v55i0.7387

[17] Cheng Z., & Beresford M. (2012). Layoffs in China’s city of textiles: Adaptation to change. Journal of Contemporary Asia, 42(2):155-181. https://doi.org/10.1080/00472336.2012.668347

[18] Chiu S.W.K., & Hung E.P.W. (2004). Good governance or muddling through? Layoffs and employment reform in socialist China. Communist and Post-Communist Studies, 37(3):395-411. https://doi.org/10.1016/j.postcomstud.2004.06.006

[19] Couch K., Jolly N., & Placzek D.W. (2011). Earnings losses of displaced workers and the business cycle: An analysis with administrative data. Economics Letters, 111(1):16-19. https://doi.org/10.1016/j.econlet.2011.01.015

[20] Cui X., Dunning D.G., & An N. (2017). Satisfaction among early and mid-career dentists in a metropolitan dental hospital in China. Journal of Healthcare Leadership, 9:35-45. https://doi.org/10.2147/JHL.S137071

[21] Davis D. (1992). Job mobility in post-Mao cities: Increases on the margins. The China Quarterly, 132:1062-1085.

[22] Dong K. (2009). Medical insurance system evolution in China. China Economic Review, 2009; 20(4):591-597. https://doi.org/10.1016/j.chieco.2009.05.011

[23] Drydakis N. (2015). The effect of unemployment on self-reported health and mental health in Greece from 2008 to 2013: A longitudinal study before and during the financial crisis. Social Science & Medicine, 128:43-51. https://doi.org/10.1016/j.socscimed.2014.12.025

[24] Elder G.H. Jr. (ed.). (1985). Perspectives on the life course. In: Life Course Dynamics:Trajectories and Transitions, 1968-1980. United States: Cornell University Press, p. 23-49.

[25] Fiori F., Rinesi F., Spizzichino D., & Di Giorgio G. (2016). Employment insecurity and mental health during the economic recession: An analysis of the young adult labour force in Italy. Social Science and Medicine, 153:90-98. https://doi.org/10.1016/j.socscimed.2016.02.010

[26] Gallo W.T., Bradley E.H., Falba T.A., Dubin J.A., Cramer L.D., Bogardus S.T. Jr., et al. (2004). Involuntary job loss as a risk factor for subsequent myocardial infarction and stroke: Findings from the health and retirement survey. American Journal of Industrial Medicine, 45(5):408-416. https://doi.org/10.1002/ajim.20004

[27] Gallo W.T., Bradley E.H., Siegel M., & Kasl S.V. (2000). Health effects of involuntary job loss among older workers: Findings from the health and retirement survey. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 55(3):S131-S140. https://doi.org/10.1093/geronb/55.3.S131

[28] Goel S., Sharma A., & Garg A. (2018). Effect of alcohol consumption on cardiovascular health. Current Cardiology Reports, 20(4):19. https://doi.org/10.1007/s11886-018-0962-2

[29] Golden S.D., & Perreira K.M. (2015). Losing jobs and lighting up: Employment experiences and smoking in the Great Recession. Social Science & Medicine, 138:110-118. https://doi.org/10.1016/j.socscimed.2015.06.003

[30] Gu E.X. (1999). From permanent employment to massive lay-offs: The political economy of ‘transitional unemployment’ in urban China (1993-8). Economy and Society, 28(2):281-299. https://doi.org/10.1080/03085149900000006

[31] Gürbüz N., Uluişik S., Frary A., Frary A., & Doğanlar S. (2018). Health benefits and bioactive compounds of eggplant. Food Chemistry, 268:602-610. https://doi.org/10.1016/j.foodchem.2018.06.093

[32] Huang Y.C., Wahlqvist M.L., Kao M.D., Wang J.L., & Lee M.S. (2015). Optimal dietary and plasma magnesium statuses depend on dietary quality for a reduction in the risk of all-cause mortality in older adults. Nutrients, 7(7):5664-5683. https://doi.org/10.3390/nu7075244

[33] Hussong A.M., Levy S., & Curran P. (2001). Specifying the relations between affect and heavy alcohol use among young adults. Journal of Abnormal Psychology, 110(3):449-461. https://doi.org/10.1037/0021-843X.110.3.449

[34] Im P.K., Wright N., Yang L., Chan K.H., Chen Y., Guo Y., et al. (2023). Alcohol consumption and risks of more than 200 diseases in Chinese men. Nature Medicine, 29(6):1476-1486. https://doi.org/10.1038/s41591-023-02383-8

[35] Jahoda M., Lazarsfeld P.F., & Zeisel H. (1971). Marienthal: The Sociography of an Unemployed Community. United States: Transcation Publishers.

[36] Kalleberg A.L. (2009). Precarious work, insecure workers: Employment relations in transition. American Sociological Review, 74(1):1-22. https://doi.org/10.1177/000312240907400101

[37] Kennedy G., Ballard T., & MarieClaude D. (2013). Guidelines for Measuring Household and Individual Dietary Diversity. Food and Agriculture Organization of the United Nations. Available from: https://www.fao.org/4/i1983e/i1983e00.pdf [Last accessed on 2024 Dec 20].

[38] Khlat M., Sermet C., & Le Pape A. (2004). Increased prevalence of depression, smoking, heavy drinking, and use of psycho-active drugs among unemployed men in France. European Journal of Epidemiology, 19(5):445-451. https://doi.org/10.1023/B:EJEP.0000027356.71414.bd

[39] Lai G. (2001). Job stress in the era of market reforms:Manufacturing workers in urban Shanghai. In: So A.Y., Lin N., & Poston D. (The Chinese Triangle of Mainland China,eds.). Taiwan, and Hongkong:Comparative Institutional Analysis. United States: Greenwood, 79-99.

[40] Leino-Arjas P., Liira J., Mutanen P., Malmivaara A., & Matikainen E. (1999). Predictors and consequences of unemployment among construction workers: Prospective cohort study. BMJ, 319(7210):600-605. https://doi.org/10.1136/bmj.319.7210.600

[41] Leonard K.E., & Eiden R.D. (2007). Marital and family processes in the context of alcohol use and alcohol disorders. Annual Review of Clinical Psychology, 3:285-310. https://doi.org/10.1146/annurev.clinpsy.3.022806.091424

[42] Li X., Zheng S., & Wu G. (2021). Nutrition and functions of amino acids in fish. Advances in Experimental Medicine and Biology, 1285:133-168. https://doi.org/10.1007/978-3-030-54462-1_8

[43] Li Y., Mao Y., Zhang Y., Cai S., Chen G., Ding Y., et al. (2014). Alcohol drinking and upper aerodigestive tract cancer mortality: A systematic review and meta-analysis. Oral Oncology, 50(4):269-275. https://doi.org/10.1016/j.oraloncology.2013.12.015

[44] Lin N., & Bian Y. (1991). Getting ahead in urban China. American Journal of Sociology, 97(3):657-688. https://doi.org/10.1086/229816

[45] Lippmann S. (2008). Rethinking risk in the new economy: Age and cohort effects on unemployment and re-employment. Human Relations, 61(9):1259-1292. https://doi.org/10.1177/0018726708094912

[46] Liu R., Chen L., Zhang F., Zhu R., Lin X., Meng X., et al. (2019). Trends in alcohol intake and the association between socio-demographic factors and volume of alcohol intake amongst adult male drinkers in China. International Journal of Environmental Research and Public Health, 2019; 16(4):573. https://doi.org/10.3390/ijerph16040573

[47] Liu S. (2003). Cultures within culture: Unity and diversity of two generations of employees in state-owned enterprises. Human Relations, 56(4):387-417. https://doi.org/10.1177/0018726703056004001

[48] Lu J. (2009). Employment discrimination in China - The current situation and principle challenges. Hamline Law Review, 32:133.

[49] Lu X.Y. (1989). Rethinking the peasant problem. Sociol Res (Shehuixue Yanjiu), 6:1-14.

[50] Maclean J.C. (2015). The lasting effects of leaving school in an economic downturn on alcohol use. ILR Review, 68(1):120-152. https://doi.org/10.1177/0019793914556243

[51] McManus A., & Newton W. (2011). Seafood, Nutrition and Human Health: A Synopsis of the Nutritional Benefits of Consuming Seafood. Perth: Centre of Excellence Science, Seafood & Health, Curtin Health Innovation Research Institute, Curtin University of Technology.

[52] Meng Q., Fang H., Liu X., Yuan B., & Xu J. (2015). Consolidating the social health insurance schemes in China: Towards an equitable and efficient health system. The Lancet, 386(10002):1484-1492. https://doi.org/10.1016/S0140-6736(15)00342-6

[53] Mossakowski K.N. (2008). Is the duration of poverty and unemployment a risk factor for heavy drinking? Social Science and Medicine, 67(6):947-955. https://doi.org/10.1016/j.socscimed.2008.05.019

[54] Newman K.S. (1988). The Experience of Downward Mobility in the American Middle Class. United States: Vintage Books.

[55] Nithya D.J., & Bhavani R.V. (2018). Dietary diversity and its relationship with nutritional status among adolescents and adults in rural India. Journal of Biosocial Science, 50(3):397-413. https://doi.org/10.1017/S0021932017000463

[56] Nizalova O., & Norton E.C. (2021). Long-term effects of job loss on male health: BMI and health behaviors. Economics & Human Biology, 43:101038. https://doi.org/10.1016/j.ehb.2021.101038

[57] Otsuka R., Kato Y., Nishita Y., Tange C., Nakamoto M., Tomida M., et al. (2016). Dietary diversity and 14-year decline in higher-level functional capacity among middle-aged and elderly Japanese. Nutrition, 32(7):784-789. https://doi.org/10.1016/j.nut.2016.01.022

[58] Passam H.C., Karapanos I.C., Bebeli P.J., & Savvas D. (2007). A review of recent research on tomato nutrition, breeding and post-harvest technology with reference to fruit quality. The European Journal of Plant Science and Biotechnolog, 1(1):1-21.

[59] Pearlin L.I. (1989). The sociological study of stress. Journal of Health and Social Behavior, 30(3):241-256. https://doi.org/10.2307/2136956

[60] Pearlin L.I., Menaghan E.G., Lieberman M.A., & Mullan J.T. (1981). The stress process. Journal of Health and Social Behavior, 22(4):337-356. https://doi.org/10.2307/2136676

[61] Popkin B.M., Du S., Zhai F., & Zhang B. (2010). Cohort profile: The China Health and Nutrition Survey-monitoring and understanding socio-economic and health change in China, 1989-2011. International Journal of Epidemiology, 39(6):1435-1440. https://doi.org/10.1093/ije/dyp322

[62] Rah J.H., Akhter N., Semba R.D., de Pee S., Bloem M.W., Campbell A.A., et al. (2010). Low dietary diversity is a predictor of child stunting in rural Bangladesh. European Journal of Clinical Nutrition, 64(12):1393-1398. https://doi.org/10.1038/ejcn.2010.171

[63] Rathnayake K.M., Madushani P., & Silva K. (2012). Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka. BMC Research Notes, 5:469. https://doi.org/10.1186/1756-0500-5-469

[64] Rawat R., McCoy S.I., & Kadiyala S. (2013). Poor diet quality is associated with low CD4 count and anemia and predicts mortality among antiretroviral therapy-naive HIV-positive adults in Uganda. Journal of Acquired Immune Deficiency Syndromes, 62(2):246-253. https://doi.org/10.1097/QAI.0b013e3182797363

[65] Ruhm C.J. (2005). Healthy living in hard times. Journal of Health Economics, 24(2):341-363. https://doi.org/10.1016/j.jhealeco.2004.09.007

[66] Schmieder J.F., von Wachter T., & Bender S. (2010). The Effects of Unemployment Insurance on Labor Supply and Search Outcomes: Regression Discontinuity Estimates from Germany. IAB-Discussion Paper, No. 4/2010.

[67] Schmitz H. (2011). Why are the unemployed in worse health? The causal effect of unemployment on health. Labour Economics, 18(1):71-78. https://doi.org/10.1016/j.labeco.2010.08.005

[68] Schröder M. (2013). Jobless now, sick later? Investigating the long-term consequences of involuntary job loss on health. Advances in Life Course Research, 18(1):5-15. https://doi.org/10.1016/j.alcr.2012.08.001

[69] Schunck R., & Rogge B.G. (2010). Unemployment and its association with health-relevant actions: Investigating the role of time perspective with German census data. International Journal of Public Health, 55(4):271-278. https://doi.org/10.1007/s00038-009-0075-1

[70] Singh G., Saghafi M., Ehrlich S., & De Noble A. (2010). Perceptions of self-employment among mid-career executives in the People’s Republic of China. Journal of Career Assessment, 18(4):393-408. https://doi.org/10.1177/1069072710374579

[71] Solinger D.J. (1999). Demolishing partitions: Back to beginnings in the cities? The China Quarterly, 159:629-639. https://doi.org/10.1017/S0305741000003125

[72] Solinger D.J. (2001). Why we cannot count the “unemployed.” The China Quarterly, 167:671-688. https://doi.org/10.1017/S0009443901000377

[73] Solinger D.J. (2002). Labour market reform and the plight of the laid-off proletariat. The China Quarterly, 170:304-326. https://doi.org/10.1017/S0009443902000207

[74] Song Q. (2017). Aging and separation from children: The health implications of adult migration for elderly parents in rural China. Demographic Research, 37(55):1761-1792. https://doi.org/10.4054/DemRes.2017.37.55

[75] Standing G. (2011). The Precariat: The New Dangerous Class. Bloomsbury Academic.

[76] Stevens A.H., & Schaller J. (2011). Short-run effects of parental job loss on children’s academic achievement. Economics of Education Review, 30(2):289-299. https://doi.org/10.1016/j.econedurev.2010.10.002

[77] Stier H., & Endeweld M. (2015). Employment transitions and labor market exits: Age and gender in the Israeli labor market. Research in Social Stratification and Mobility, 41:92-102. https://doi.org/10.1016/j.rssm.2015.01.002

[78] Strayer R.J., Friedman B.W., Haroz R., Ketcham E., Klein L., LaPietra A.M., et al. (2023). Emergency department management of patients with alcohol intoxication, alcohol withdrawal, and alcohol use disorder: A white paper prepared for the American Academy of Emergency Medicine. Journal of Emergency Medicine, 64(4):517-540. https://doi.org/10.1016/j.jemermed.2023.01.010

[79] Strully K.W. (2009). Job loss and health in the U.S. Labor market. Demography, 46(2):221-246. https://doi.org/10.1353/dem.0.0050

[80] Su W., & Wang J. (2019). Potato and food security in China. The American Journal of Potato Research, 96(2):100-101. https://doi.org/10.1007/s12230-018-09709-0

[81] Sullivan D., & von Wachter T. (2009). Job displacement and mortality: An analysis using administrative data. The Quarterly Journal of Economics, 124(3):1265-1306. https://doi.org/10.1162/qjec.2009.124.3.1265

[82] Swindale A., & Bilinsky P. (2006). Household Dietary Diversity Score (HDDS) for Measurement of Household Food Access: Indicator Guide, Version 2. FANTA Project. Washington, DC: Food and Nutrition Technical Assistance Project, Academy for Educational Development.

[83] Tuithof M., Ten Have M., van den Brink W., Vollebergh W., & de Graaf R. (2014). The relationship between excessive alcohol consumption and alcohol use disorders according to DSM-IV and DSM-5. Alcoholism: Clinical and Experimental Research, 38(1):249-256. https://doi.org/10.1111/acer.12248

[84] Verger E.O., Le Port A., Borderon A., Bourbon G., Moursi M., Savy M., et al. (2021). Dietary diversity indicators and their associations with dietary adequacy and health outcomes: A systematic scoping review. Advances in Nutrition, 12(5):1659-1672. https://doi.org/10.1093/advances/nmab009

[85] Virtanen P., Vahtera J., Broms U., Sillanmäki L., Kivimäki M., & Koskenvuo M. (2008). Employment trajectory as determinant of change in health-related lifestyle: The prospective HeSSup study. European Journal of Public Health, 18(5):504-508. https://doi.org/10.1093/eurpub/ckn037

[86] Walls H., & Matita M. (2023). Trade-offs between addressing food security and dietary diversity. BMJ Global Health, 8(12):e014354. https://doi.org/10.1136/bmjgh-2023-014354

[87] Weaver C.N. (2015). Worker’s expectations about losing and replacing their jobs: 35 years of change. Monthly Labor Review, 138:1. https://doi.org/10.21916/mlr.2015.1

[88] Xu H., Xiao S., & Chen J. (2002). Analysis of suicidal thoughts among lay-off workers from state-owned enterprises and determinants. Chinese Mental Health Journal, 16(2):96-99.

[89] Xu X., Zhu Y., Zheng X., & Xie L. (2015). Does beer, wine or liquor consumption correlate with the risk of renal cell carcinoma? A dose-response meta-analysis of prospective cohort studies. Oncotarget, 6(15):13347-13358. https://doi.org/10.18632/oncotarget.3749

[90] Zhang H., Sun C., Wang Z., & Che B. (2021). Seafood consumption patterns and affecting factors in urban China: A field survey from six cities. Aquaculture Reports, 19:100608. https://doi.org/10.1016/j.aqrep.2021.100608

[91] Zhong L., Chen W., Wang T., Zeng Q., Lai L., Lai J., et al. (2022). Alcohol and health outcomes: An umbrella review of meta-analyses based on prospective cohort studies. Front Public Health, 10:859947. https://doi.org/10.3389/fpubh.2022.859947

[92] Zhou X., Brandon N., & Moen P. (1997). Institutional change and job-shift patterns in urban China, 1949 to 1994. American Sociological Review, 62(3):339-365. https://doi.org/10.2307/2657310

[93] Zimmer Z., Wen M., & Kaneda T. (2010). A multi-level analysis of urban/rural and socioeconomic differences in functional health status transition among older Chinese. Social Science & Medicine, 71(3):559-567. https://doi.org/10.1016/j.socscimed.2010.03.048