Are area-level measures of employment associated with health behaviours and outcomes?

Accessible employment suited to residents’ needs is an important equity issue and social determinant of health and wellbeing, and a balanced jobs-housing ratio within a region has the potential to provide health benefits. This paper aims to provide evidence on the associations between employment and health, and the potential pathways, as well as identifying spatial indicators that can be used to measure urban employment, a construct of liveability. We used 2011 census data to create and test two area-level spatial measures of urban employment with geo-coded population health behaviour and outcome data (2011 VicHealth survey) in 5206 employed adults living in urban Victoria, Australia. Those living in areas with higher levels of local employment had reduced odds of a longer commute (OR 0.87). The odds of a longer commute time was also greater for those who lived in an area where more people commuted to work by private vehicle (OR 1.20), and less for those who lived in local areas where more people travelled to work by public transport (OR 0.85) or active travel (OR 0.80). The odds of reporting longer sitting times was less for those who lived in a local area where more people commuted to work by private vehicle (OR 0.65). Those who had a longer commute times, regardless of travel mode, had greater odds of reporting more sitting during a typical weekday (OR 1.67). In turn, those who spent more time sitting had significantly greater odds of reporting poorer self-rated health (OR 1.34). Such work provides evidence to policy-makers to help build the argument for which area-level attributes are needed to support urban employment across a region.