Abstract
Globally, cardiometabolic diseases (CMDs) are major health issues that affect the health of workforce. This study aimed to investigate the impact of employment status on transition from a healthy state to cardiometabolic multimorbidity in Chinese population. Data from China Health and Retirement Longitudinal Study (2011-2020) was utilised. Analytical sample comprised 7,681 men and women (≥ 45 years) free of CMDs at baseline. A multistate model was applied to investigate the impact of baseline employment status on the transition rates from a healthy state to cardiometabolic mono-morbidity and subsequently to multimorbidity. Inverse probability weighting was applied to account for the complex survey design. During an average follow-up time of 5.7 years, 3,324 (43.28%) participants developed one or more CMDs. After adjusting for age and sex, compared to non-agricultural employees, non-agricultural retirees had significantly higher risks and agricultural self-employed workers had only marginally higher risk of CMDs. After further adjustment for sociodemographic factors, health behaviours, and BMI, non-agricultural retirees remained significantly associated with a higher rate of transition from a healthy state to cardiometabolic mono-morbidity [HR 1.24 (95% CI 1.01-1.54)] compared to non-agricultural employees. There was no statistically significant increase in transition to multimorbidity risk in any group. Control of CMDs in Chinese older population should consider people's employment characteristics.