J Epidemiol Community Health 56:693-699 doi:10.1136/jech.56.9.693
  • Research report

Selection from fixed term to permanent employment: prospective study on health, job satisfaction, and behavioural risks

  1. M Virtanen1,
  2. M Kivimäki2,
  3. M Elovainio3,
  4. J Vahtera4
  1. 1Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2Department of Psychology, University of Helsinki, Finland
  3. 3National Research and Development Centre for Welfare and Health, Helsinki, Finland
  4. 4Finnish Institute of Occupational Health, Turku, Finland
  1. Correspondence to:
 M Virtanen, Finnish Institute of Occupational Health, Department of Psychology, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland;
  • Accepted 5 January 2002


Study objective: To examine health, job satisfaction, and behavioural risks as antecedents of selection from fixed term to permanent employment.

Design: Prospective cohort study of change in employment contract during a two year period. Self reported health, recorded sickness absence, job satisfaction, behavioural risks, demographics, and occupational characteristics were assessed at baseline.

Setting: Hospital staff in two Finnish hospital districts.

Participants: A cohort of 526 hospital employees (54 men, 472 women) aged 20 to 58 years with a fixed term job contract at baseline.

Main results: During the follow up period, 137 became permanently employed. Men, employees in higher positions, full time workers, and those with five to eight years in the employ of the hospital were more likely to become permanently employed. After adjusting for these factors, obtaining a permanent job contract was predicted by self rated good health (odds ratio (OR) 3.90; 95% confidence intervals (CI) 1.34 to 11.36), non-caseness of psychological distress (OR 1.80; 95% CI 1.01 to 3.20), high job satisfaction (OR 1.86; CI 1.17 to 2.94), and non-sedentary life style (OR 2.64; CI 1.29 to 5.41), compared with the rest of the cohort.

Conclusions: Investigation of fixed term employees yields new information about selective mechanisms in employment mobility. Good health seems to promote the chances for a fixed term employee to reach a better labour market status. These results correspond to earlier research on selective mechanisms in other forms of employment mobility and provide a partial explanation for the socioeconomic gradient of health.


  • Contributors
 MV with MK and ME formulated the hypothesis and designed, checked and collated the data. MV was the principal author of the paper, providing all the data analyses. MK, the coordinator of the project, ME and JV advised in the interpretation and presentation of the results and co-authored to the writing of the paper.

  • Funding: the study was supported by grants from the Academy of Finland (project no 44968), the Finnish Work Environment Fund (project no 97316) and the hospitals in the districts of Varsinais-Suomi and Kanta-Häme, Finland.

  • Conflicts of interest: none.

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