abstract: 'ObjectivesTo estimate the strength of association between having an

  inflexible job and health-related quality of life and healthcare

  utilisation; and to explore heterogeneity in the effects by gender, age

  and area-level deprivation.DesignRetrospective cross-sectional

  study.SettingSeven waves of the English General Practice Patient Survey

  between 2012 and 2017.Participants1 232 884 people aged 16-64 years and

  in full-time employment. We measured job inflexibility by inability to

  take time away from work during usual working hours to seek medical

  care.Primary and secondary outcome measuresHealth-related quality of

  life (EQ-5D-5L); number of months since the respondent last saw a

  general practitioner (GP) or nurse; use of out-of-hours general practice

  in the past 6 months. We used regression analyses to estimate the

  strength of association between outcomes and having an inflexible job,

  adjusting for person and area-level characteristics.ResultsOne-third of

  respondents reported job inflexibility. The probability of job

  inflexibility was higher at younger ages and in more deprived areas. Job

  inflexibility was associated with lower EQ-5D-5L utility scores of 0.017

  (95\% CI 0.016 to 0.018) for women and 0.016 (95\% CI 0.015 to 0.017)

  for men. Women were more affected than men in the mental health domain.

  The reduction in health-related quality of life associated with having

  an inflexible job was greater for employees who were older or lived in

  more deprived areas. Having an inflexible job was associated with a

  longer time since the last visit to their GP of 0.234 (95\% CI 0.201 to

  0.268) months for women and 0.199 (95\% CI 0.152 to 0.183) months for

  men.ConclusionsInequalities in the prevalence of inflexible jobs

  contribute to inequalities in health. One mechanism may be through

  reduced access to healthcare. Policymakers and employers should ensure

  that all employees have sufficient job flexibility to protect their

  health.'
affiliation: 'Moss, C (Corresponding Author), Univ Manchester, Ctr Primary Care \&
  Hlth Serv Res, Sch Hlth Sci, Hlth Org Policy \& Econ HOPE, Manchester, England.

  Moss, Charlie; Munford, Luke Aaron; Sutton, Matt, Univ Manchester, Ctr Primary Care
  \& Hlth Serv Res, Sch Hlth Sci, Hlth Org Policy \& Econ HOPE, Manchester, England.

  Sutton, Matt, Univ Melbourne, Melbourne Inst Appl Econ \& Social Res, Melbourne,
  Vic, Australia.'
article-number: e062942
author: Moss, Charlie and Munford, Luke Aaron and Sutton, Matt
author-email: charlie.moss@manchester.ac.uk
author_list:
- family: Moss
  given: Charlie
- family: Munford
  given: Luke Aaron
- family: Sutton
  given: Matt
da: '2023-09-28'
doi: 10.1136/bmjopen-2022-062942
files: []
issn: 2044-6055
journal: BMJ OPEN
keywords: 'public health; occupational \& industrial medicine; primary care; social

  medicine'
keywords-plus: 'WORKPLACE INTERVENTION; WORKTIME CONTROL; WORKING HOURS; TIME CONTROL;

  RECOVERY; FATIGUE'
language: English
month: DEC
number: '12'
number-of-cited-references: '32'
orcid-numbers: 'Moss, Charlie/0000-0002-4694-378X

  Munford, Luke/0000-0003-4540-6744

  Sutton, Matt/0000-0002-6635-2127'
papis_id: b05e1cf32ecd75ec2dbd6832bb643d55
ref: Moss2022associationsinflexib
times-cited: '2'
title: 'Associations between inflexible job conditions, health and healthcare utilisation
  in England: retrospective cross-sectional study'
type: Article
unique-id: WOS:000896654600015
usage-count-last-180-days: '1'
usage-count-since-2013: '2'
volume: '12'
web-of-science-categories: Medicine, General \& Internal
year: '2022'