Adverse working conditions and immigrants' physical health and depression outcomes: a longitudinal study in Greece

Could Better-Quality Employment Improve Population Health? Findings From a Scoping Review of Multi-Dimensional Employment Quality Research and a Proposed Research Direction

BACKGROUND

Precarious employment, a specific part of the conceptual spectrum of employment quality (EQ), has been established as an important risk to individual and population health and well-being when compared to a standard employment circumstance. There remains a need, however, to explore whether and how EQ might be used as a tool to not only protect but also advance population health and well-being.

METHODS

The purposes of this scoping review were to assess the analytic treatment of the multiple dimensions of EQ and the stances researchers take to characterize the state of knowledge of EQ that supports the idea that better EQ is a health-promoting factor. Quantitative, qualitative, and mixed-methods primary studies that included at least three of the seven conceptually-informed EQ dimensions were eligible. Studies were assessed for EQ dimensions represented, how dimensions were treated analytically, the pathogenic, ambivalent, or salutogenic stances used by investigators, and what each might tell us about how to leverage aspects of better-quality employment to improve population health.

RESULTS

A total of 78 studies were included; 54 of these treated EQ dimensions in an interrelated way. Of the analytically interrelated studies, none had an explicit salutogenic stance. Some evidence suggests that a handful of EQ types might present an equal or reduced risk of poor health than the standard employment relationship, frequently used as a historic gold standard.

CONCLUSION

Research with a salutogenic stance might build our understanding of whether and how employment could be used to advance our collective well-being.

Migrant Work Conditions and Health Status-A Longitudinal Study on 'Dirty Work' Among Undocumented and Newly Regularized Workers

Migrant workers, particularly undocumented migrants, may be constrained to accept 'dirty work'. This term refers to poorly paid jobs with long working hours and significant exposure to various risks, potentially affecting their health. While many scholars discuss the health-related risks associated with these work conditions, empirical quantitative evidence is scarce regarding their direct effects on health among undocumented and newly regularized migrants. Consequently, we have formulated the following research question: Does 'dirty work' have an influence on the self-rated health of undocumented and newly regularized migrants over time? To answer this question, we utilized a dataset collected during an exceptional regularization procedure in the Swiss Canton of Geneva. Through surveys conducted across four waves, we demonstrate the direct and indirect effects of work conditions on migrants' health using both random effects and fixed effects models. Our operationalization of 'dirty work' reveals that exposure to physically demanding positions has a direct, negative impact on migrants' self-rated health. This result holds independently of the development of chronic health conditions over time. Our study confirms the existence of a relationship between occupational risks and health and underscores the significance of residence status in this context.

Ramifications of Precarious Employment for Health and Health Inequity: Emerging Trends from the Americas

Precarious employment (PE), which encompasses the power relations between workers and employers, is a well-established social determinant of health that has strong ramifications for health and health inequity. In this review, we discuss advances in the measurement of this multidimensional construct and provide recommendations for overcoming continued measurement challenges. We then evaluate recent evidence of the negative health impacts of PE, with a focus on the burgeoning studies from North America and South America. We also establish the role of PE in maintaining and perpetuating health inequities and review potential policy solutions to help alleviate its health burden. Last, we discuss future research directions with a call for a better understanding of the heterogeneity within PE and for research that focuses both on upstream drivers that shape PE and its impacts on health, as well as on the mechanisms by which PE causes poor health.

A Groundbreaking Insight Into Primary Care Physiotherapists' Remuneration

Introduction Physiotherapy in Greece, as part of primary health care (PHC), faces sound imbalances: reduced quality, productivity, and efficiency, along with rather inflexible remuneration schemes. This study is aimed at reporting the attitude and perceptions of Greek PHC physiotherapists toward their current remuneration and also at identifying any other preferable remuneration schemes. Methods A stratified proportional sampling study was undertaken, using an anonymous, electronic survey. The participants were 250 self-employed physiotherapists running their business in Central and Eastern Macedonia and Thrace, being also contracted with the National Organisation for Healthcare Provision (EOPYY). The sample size stands for 34% of the population with a circa 5% margin of error. Results Nearly 9/10 physiotherapists (84%) underline that remuneration falls short of their productivity, leading to reduced job satisfaction. Moreover, their remuneration does not motivate them to provide services of higher quality (46%), while 58% of them stated that they are forced to claim informal fees. There is no clear desire regarding the remuneration scheme, but nearly ¼ of physiotherapists revealed their preference for the cost-per-case philosophy combined with co-payments. Conclusion The majority of physiotherapists believe that their current remuneration does not reflect their productivity nor the quality of their services and, therefore, informal payments arise. The preference of physiotherapists lies between cost-per-case fees and patient co-payments, which, however, favors supplier-induced demand and access inequalities, respectively. Hence, policymakers should revise the current remuneration scheme and overcome its deficiencies without creating new ones.

Forced labor and health-related outcomes. The case of beggar children

BACKGROUND

Limited qualitative research indicates that beggar children might be victims of forced labor, and/or modern slavery. However, research quantifying the manifestations and health-related implications of forced child begging is missing in the literature. Because forced child begging might be physically, mentally, socially and morally harmful to children, research on the subject is needed to inform policymaking.

OBJECTIVE

This study addressed the gap in the literature on child begging. The work aimed to examine whether beggar children are victims of forced labor, as well as to identify the manifestations of forced labor in beggar children, and assess whether forced child begging relates to deteriorated health-related quality of life and mental health.

PARTICIPANTS AND SETTING

The study focused on the capital city of Greece, Athens, where beggar children are not a hard-to-reach group. Cross-sectional data were collected in 2011, 2014, 2018 and 2022, with 127 beggar children taking part in the study.

METHODS

The study adopted the Anti-Slavery International research toolkit, which sets methodological guidelines on researching child begging. A scale was developed to quantify forced child begging based on the International Labour Organization's definition of forced labor. Multivariate regressions were performed with a view to answering the research questions.

RESULTS

The study found that most beggar children were forced by others to beg, experienced threats of violence, physical and verbal harassment aimed at forcing them to beg, and difficulty in terms of being allowed by others to stop begging. Moreover, it was found that forced child begging was positively associated with living with unknown people, hunger due to food unavailability the previous week, and negatively associated with native beggar children. In addition, it was discovered that forced child begging was negatively associated with health-related quality of life and mental health for beggar children.

CONCLUSION

Based on the study's findings, child begging encompasses elements of coercion and the deprivation of human freedom. These factors collectively amount to instances of forced labor and/or modern slavery. Policies should ensure that beggar children are removed from harm's way, and that those forcing children to beg are brought to justice, thus preventing forced child begging. Policies to reduce poverty, which constitutes the root of forced child begging, should also be considered. The goal is to create a protective environment where children can thrive, free from forced labor. In line with Sustainable Development Target 8.7, policy makers should take immediate and effective measures to eradicate forced labor, and end modern slavery.

The relationship between employment and health for people from refugee and asylum-seeking backgrounds: A systematic review of quantitative studies

Background

For the general population, the positive effects of paid employment on health and wellbeing are well established. However, less is known for people from refugee and asylum-seeking backgrounds. This review aims to systematically summarise the quantitative literature on the relationship between employment and health and wellbeing for refugees and asylum seekers.

Method

A search strategy was conducted in online databases, including MEDLINE, PsychINFO, EMCARE, SCOPUS, CINHAL, ProQuest and Web of Science. Articles were screened against inclusion and exclusion criteria. Studies published in English between 2000 to October 2021 were included if they used quantitative methods to consider the relationship between employment and health for refugees and asylum seekers in resettlement countries. Study quality was assessed using The Joanna Briggs Institute's Critical Appraisal Tools. Findings were synthesised using a narrative approach.

Results

Seventy-two papers were identified. The majority of papers (N = 58, 81%) examined the association between employment and mental health outcomes. Overall, while there were inconsistencies in the findings, employment had a positive effect on mental health particularly in reducing levels of psychological distress and depression. Though more limited in number, the papers examining physical health suggest that people who are employed tend to have better physical health than unemployed persons. There was some evidence to support the bi-directional relationship between employment and health. Poor mental and physical health negatively impacted the odds of employment and occupational status of refugees.

Conclusion

Good quality employment is an essential component of refugee resettlement and this review found that in general employment is also beneficial for refugee health, particularly aspects of mental health. More research regarding the effects of employment on physical health is required. The effects of refugee-specific factors such as gender roles, torture, and trauma on the relationship between employment and health also require further investigation.

Improving Entrepreneurs’ Digital Skills and Firms’ Digital Competencies through Business Apps Training: A Study of Small Firms

The lack of awareness of digital services and outcomes is a concern in business environments since small firms need to improve their digital competencies. The present exploratory study investigated whether business apps training was associated with entrepreneurs’ and firms’ digital advancements. The business apps training was offered to migrant entrepreneurs running small firms in Athens (Greece) over three months, with data collected before and after the training. The analysis revealed that business apps training was positively associated with entrepreneurs’ attitudes toward technology, willingness to change (relating to technology/skills/operations), and internet/digital skills, as well as an increased use of business apps. Moreover, the training was positively associated with firms’ digital competencies related to communication, networking, social media, customer relationship management, payments, accounting and finance, and project management operations. Furthermore, business apps training was positively associated with migrant entrepreneurs’ integration into Greek society. Given the increased number of migrants in Europe, factors that positively impact their entrepreneurship and integration merit consideration. The study provides researchers with a systematic method for evaluating the association between business app training and entrepreneurs’ and firms’ digital advancements.