The association between non-standard employment, job insecurity and health among British adults with and without intellectual impairments: Cohort study

Factors That Influence the High Number of Elderly People Working in the Informal Sector

Aim

As individuals age, they are expected to experience a natural progression that usually involves a slight and permanent decrease in bodily functions and physical abilities. Despite this, many older people remain active in the workforce.

Purpose

This study seeks to explore the correlation between the health conditions, disabilities, social factors, and demographic circumstances of elderly individuals engaged in both formal and informal employment sectors.

Methods

This study utilizes an observational analytical method with a cross-sectional structure. The participants in the research involved all individuals aged 60 years and above who met the outlined criteria, totaling 15,034,946 respondents. The data analysis was conducted using multivariate logistic regression in Model II.

Results

Overall, most older adults are working in informal jobs. Moreover, most respondents are 60-69 years old, married, have a primary school certificate, own health insurance and a house, and live with family. In addition, the multivariate analysis shows the relationship between each variable and the informal sector working elderly. It is known that older women have a 1.45 times higher limited educational background, not having savings is 1.21 times, rural areas living 1.93 times, not being the head of the family is linked 1.34 times, poor health conditions are 1.01 times, and having a disability has a 1.20 times higher likelihood of informal-sector employment.

Conclusion

Several variables are assigned as the determinants that increase the number of elderly working in informal sectors, including gender, education level, savings ownership, living areas, head of the family role, health status, and disability.

Does persistent precarious employment affect health outcomes among working age adults? A systematic review and meta-analysis

OBJECTIVE

To evaluate the impact of persistent precarious employment (lasting 12+ months) on the health of working age adults, compared with more stable employment. Persistent precarity reflects a shift towards less secure forms of employment and may be particularly important for health.

METHODS

Nine databases were systematically searched to identify quantitative studies that assessed the relationship between persistent precarious employment and health outcomes. Risk of bias (RoB) was assessed using an adaptation of the Effective Public Health Practice Project tool. Narrative synthesis and random effects meta-analysis were conducted. Certainty of evidence was assessed using the Grades of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

RESULTS

Of 12 940 records screened, 50 studies met the inclusion criteria and 29 were included in meta-analyses. RoB was generally high (n=18). The most reported outcome domain was mental health; with evidence also reported relating to general health, physical health,and health behaviours. Of GRADE assessed outcomes, persistent precarious employment was associated with increased risk of poor self-rated health (OR 1.53, 95% CI 1.09 to 2.14, I2=80%) and mental health symptoms (OR 1.44, 95% CI 1.23 to 1.70, I2=65%). The association with all-cause mortality was imprecisely estimated (OR 1.10, 5% CI 0.91 to 1.33, I2=73%). There was very low GRADE certainty across all outcomes.

CONCLUSIONS

Persistent precarious employment is associated with poorer health, particularly for outcomes with short time lags, though associations are small and causality is highly uncertain. Further research using more robust methods is needed but given potential health harms of persistent precarious employment, exploration of precautionary labour regulations and employment policies is warranted.

Employment Consequences of COVID-19 for People with Disabilities and Employers

Purpose The COVID-19 pandemic has disproportionately affected the lives of people with disabilities (PWD). How the pandemic affects the employment of PWD and employers has yet to be determined. We aimed to investigate the employment consequences of the pandemic as experienced by PWD and employers. The research questions were: (1) What employment effects do PWD experience, and what business changes do employers encounter as a result of the COVID-19 pandemic? (2) What challenges have PWD encountered during the pandemic? Methods Cross-sectional online surveys of 733 PWD and 67 employers in the Midwestern United States. Results Compared to non-disabled peers, PWD encountered more challenges in employment during the pandemic. We found high percentages of both employers and PWD experiencing employment changes and business shutdown during the pandemic. For PWD whose employment was not affected, 14.6% of the participants (n = 107) expected a loss of income and worried about the economic uncertainty of the pandemic. Unemployment for PWD is high due to illness or disability, being laid-off or furloughed, business reductions, and not feeling safe to work. However, only about 18.6% of unemployed PWD (n = 16) received pay or benefits for the time they were not working even though more than half filed for unemployment benefits. Conclusions The pandemic adversely affected employment of PWD as reported by workers and employers. Findings parallel the experience of the non-disabled workforce, but reveal vulnerabilities that reflect disability consequences and the need for job accommodations. Results reveal emergent needs for policy supports to reduce the disparities experienced by PWD in the workplace.

The measure of precarious employment and its impact on the mental health of workers: A systematic review 2007–2020

BACKGROUND: Precarious employment conditions can influence the worker’s mental health; however, there is no consensus regarding the definition of precarious employment or the way it is measured. OBJECTIVE: The objective is to identify existing research of the conceptual framework, the ways to measure precarious employment and its impact on the mental health of workers. METHODS: A systematic review with the strategic search for observational-empirical and qualitative studies published between 2007 and 2020 in Embase, Scopus and PubMed, full text, in English and Spanish. Studies were selected and excluded, according to eligibility criteria. Two independent reviewers and one arbitrator evaluated the quality of selected papers with the STROBE guidelines for observational studies and SRQR for qualitative ones. RESULTS: 408 studies were obtained, 21 met inclusion criteria, in 14 studies precarious employment was measured one-dimensionally. Of these, 11 with the dimension of temporality and three with insecurity. Four studies it was measured in a multidimensional way, with the Employment Precariousness Scale (EPRES) and in three qualitative designs, with different categories of analysis. Mental health was measured with SF-36 (n = 4), GHQ-12 (n = 3) and CES-D (n = 3). CONCLUSIONS: The concept of precarious employment requires a multidimensional construct, although the tendency to measure precarious employment is one-dimensional. Regardless of how is measured, this has a negative impact on the mental health of workers. The outcomes related to this social determinant included depression, depressive symptoms, psychological distress, stress, and suicidal thoughts. Youths, women, people with low levels of education and immigrants are the groups that show the major precariousness.

Do Area-Level Environmental Factors Influence Employment for People with Disability? A Scoping Review

Employment is an important social determinant of health and wellbeing. People with disability experience labour market disadvantage and have low labour force participation rates, high unemployment rates, and poor work conditions. Environmental factors are crucial as facilitators of or barriers to participation for people with disability. Understanding how the physical, social, and economic characteristics of local areas influence employment for people with disability can potentially inform interventions to reduce employment inequalities. We conducted a scoping review of research investigating associations between area-level environmental factors and employment for people with disability. Eighteen articles published between 2000 and 2020 met the inclusion criteria, and data were extracted to map the current evidence. Area-level factors were categorised into six domains relating to different aspects of environmental context: socioeconomic environment, services, physical environment, social environment, governance, and urbanicity. The urbanicity and socioeconomic environment domains were the most frequently represented (15 and 8 studies, respectively). The studies were heterogeneous in terms of methods and data sources, scale and type of geographic units used for analysis, disability study population, and examined employment outcomes. We conclude that the current evidence base is insufficient to inform the design of interventions. Priorities for future research are identified, which include further theorising the mechanisms by which area-level factors may influence employment outcomes, quantifying the contribution of specific factors, and interrogating specific factors underlying the association between urbanicity and employment outcomes for people with disability.

Flexible Work: Opportunity and Challenge (FLOC) for individual, social and economic sustainability. Protocol for a prospective cohort study of non-standard employment and flexible work arrangements in Sweden

INTRODUCTION

Flexibility in working life, including non-standard employment (NSE) and flexible work arrangements (FWAs), offers the organisation a better ability to adapt to changing conditions while also posing considerable challenges for organisations as well as workers. The aim of the Flexible Work: Opportunity and Challenge (FLOC) study is to investigate associations between NSE and FWA on the one hand, and individual, social and economic sustainability on the other.

METHODS AND ANALYSIS

This prospective open cohort study targets approximately 8000 workers 18-65 years old in 8-10 public and private organisations in Sweden. We will use a comprehensive battery of measurement methods addressing financial performance, physical and psychosocial exposures, and physical and mental health, both at the organisational and the individual level. Methods include valid survey questionnaires and register data, and, in subpopulations, technical measurements, interviews and diaries. Main exposures are type of employment and type of work arrangement. Main outcomes are indicators of social and economic sustainability and, at the individual level, health and well-being. Data, collected over 54 months at approximately 18-month intervals, will be analysed using multivariate methods considering main effects as well as potential effect modifiers. The analyses will take into account that respondents are nested in organisations, divisions and/or have specific managers.

ETHICS AND DISSEMINATION

FLOC is approved by the Swedish Ethical Review Authority (decision numbers 2019-06220, 2020-06094 and 2021-02725). Data will be published in peer-reviewed journals and presented at international conferences, and researchers will assist the organisations in improving policies and routines for employment and organisation of work.

The role of nonstandard and precarious jobs in the well-being of disabled workers during workforce reintegration

BACKGROUND

Nonstandard employment arrangements are becoming increasingly common and could provide needed flexibility for workers living with disabilities. However, these arrangements may indicate precarious employment, that is, employment characterized by instability, powerlessness, and limited worker rights and benefits. Little is known about the role of nonstandard and precarious jobs in the well-being of disabled persons during workforce reintegration after permanent impairment from work-related injuries or illnesses.

METHODS

We used linked survey and administrative data for a sample of 442 Washington State workers who recently returned to work and received a workers' compensation permanent partial disability award after permanent impairment from a work-related injury. Multivariable logistic regression models were used to examine associations between nonstandard employment and outcomes related to worker well-being and sustained employment. We also examined associations between a multidimensional measure of precarious employment and these outcomes. Secondarily, qualitative content analysis methods were used to code worker suggestions on how workplaces could support sustained return to work (RTW).

RESULTS

Workers in: (1) nonstandard jobs (compared with full-time, permanent jobs), and (2) precarious jobs (compared with less precarious jobs) had higher adjusted odds of low expectations for sustained RTW. Additionally, workers in precarious jobs had higher odds of reporting fair or poor health and unmet need for disability accommodation. Workers in nonstandard and precarious jobs frequently reported wanting safer and adequately staffed workplaces to ensure safety and maintain sustained employment.

CONCLUSIONS

Ensuring safe, secure employment for disabled workers could play an important role in their well-being and sustained RTW.

The Impact of Mandate Contract and Self-Employment on Workers' Health-Evidence from Poland

The purpose of the study is to analyze the correlations between two clearly defined forms of non-standard employment (self-employment and mandate contract) and workers' health. The study also addressed such variables as gender, age, length of service, and the reason for employment (voluntary vs. non-voluntary). The research was carried out in Poland in 2020 using the CATI method (a telephone interviewing technique), and it covered a sample of 200 workers (100 self-employed and 100 working under a mandate contract). Most of the respondents declared that their form of employment did not affect their health. However, the statistical analysis showed significant differences in health status between the self-employed and those working on a mandate contract. Self-employed respondents experienced mental health impacts more often, whereas those working under a mandate contract more frequently declared that their physical health was affected. The length of service was only important for mental health, having a negative impact on it. The respondents' age and gender turned out to be statistically insignificant, which is in contradiction to many previous research findings. The inability to choose one's form of employment resulted in worse physical health. These findings demonstrate the importance of certain variables that were not prioritized in previous studies and emphasize the need to clearly define what non-standard and precarious forms of employment are, as well as revealing new correlations between the studied categories and providing directions for further research.

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work

BACKGROUND

The use of facilities such as disability pension, psychiatric care, health care and services for people with intellectual disabilities and borderline intellectual functioning (BIF) were compared with the general population and two other study groups comprising people with mild intellectual disabilities (MIDs) and learning problems (LPs).

METHODS

The population-based sample (N = 416,973), 'Finland-in-Miniature', was gathered in 1962 and followed until 1998. For the purpose of the present study, three groups were formed: BIF (n = 416), MID (n = 312) and LP (n = 284). The use of services was examined with the help of national registers.

RESULTS

As compared with the general population, people with BIF had been granted disability pension 2.7 times more often and had been patients in psychiatric care 3.4 times more often. They had also systematically used more services than people with LP.

CONCLUSIONS

People with BIF are at risk of inability to work and facing severe mental health problems. They also seem to have more severe psychiatric problems than people with MID and LP. There is, therefore, a crucial need for increasing the awareness in society of BIF. Although this study's follow-up data were collected about 20 years ago, it is still relevant because people with BIF are a neglected group and still face growing demands in school and work life with no marked changes in services.

Association between Area-Level Socioeconomic Deprivation and Prehospital Delay in Acute Ischemic Stroke Patients: An Ecological Study

We analyzed the associations between area-level socioeconomic status (SES) and prehospital delay in acute ischemic stroke (AIS) patients by degree of urbanization with the use of an ecological framework. The participants were 13,637 patients over 18 years of age who experienced AIS from 2007 to 2012 and were admitted to any of the 29 hospitals in South Korea. Area-level SES was determined using 11 variables from the 2010 Korean census. The primary outcome was a prehospital delay (more than three hours from AIS onset time). Multilevel logistic regression was conducted to define the associations of individual- and area-level SES with prehospital delay after adjusting for confounders, which includes the use of emergency medical services (EMS) and individual SES. After adjusting for covariates, it was found that the area-level SES and urbanization were not associated with prehospital delay and EMS use was beneficial in both urban and rural areas. However, after stratification by urbanization, low area-level SES was significantly associated with a prehospital delay in urban areas (adjusted odds ratio (aOR) 1.24, 95% confidence interval (CI) 1.04–1.47) but not in rural areas (aOR 1.04, 95% CI 0.78–1.38). Therefore, we posit that area-level SES in urban areas might be a significant barrier to improving prehospital delay in AIS patients.

Non-Permanent Employment and Employees’ Health in the Context of Sustainable HRM with a Focus on Poland

This study is focused on the assumption that the analyses focused on sustainable human resource management (HRM) should include the problem of unstable forms of employment. Reference was also made to Poland, the country where the share of unstable forms of employment is the highest in the European Union. The authors based their findings on the literature and the data published, i.e., by Eurostat, OECD and Statistics Poland, accompanied by CSR reports. Insecure forms of employment have negative impact on employees’ health, primarily regarding their mental health. Statistically significant correlations were found between the expectation rate of possible job loss and non-standard employment variables, and the rate of reporting exposure to risk factors that affect mental wellbeing and precarious employment rates. However, conducting statistical analyses at the macro level is associated with limitations resulting from leaving out many important factors characteristic of the given countries and affecting the presented data. Current guidelines, relevant to reporting the use of non-standard forms of employment by enterprises, are inconsistent. Companies voluntarily demonstrate the scope of using non-permanent forms of employment and not referring to the issue of employees’ choice of a given type of employment and employees’ health. Future research projects should be focused on developing a comprehensive, coherent and universal tool allowing for an assessment of the implementation level of sustainable HRM ideas in an organization, including standardized reporting of non-permanent employment and employees’ health, and making comparisons not only between organizations, but also between countries.

Association of Borderline Intellectual Functioning and Adverse Childhood Experience with adult psychiatric morbidity. Findings from a British birth cohort

BACKGROUND

To examine whether Borderline Intellectual Functioning (BIF) and Adverse Childhood Experiences independently predict adult psychiatric morbidity.

METHODS

We performed a secondary analysis of longitudinal data derived from the 1970 British Birth Cohort Study to examine whether BIF and Adverse Childhood Experiences independently predict adult mental distress as measured by the Malaise Inventory. Factor analysis was used to derive a proxy measure of IQ from cognitive testing at age 10 or 5. Variables that could be indicators of exposure to Adverse Childhood Experiences were identified and grouped into health related and socio-economic related adversity.

RESULTS

Children with BIF were significantly more likely than their peers to have been exposed to Adverse Childhood Experiences (BIF mean 5.90, non-BIF mean 3.19; Mann-Whitney z = 31.74, p < 0.001). As adults, participants with BIF were significantly more likely to score above the cut-off on the Malaise Inventory. We found statistically significant relationships between the number of socio-economic Adverse Childhood Experiences and poorer adult psychiatric morbidity (r range 0.104-0.141, all p < 001). At all ages the indirect mediating effects of Adverse Childhood Experiences were significantly related to adult psychiatric morbidity.

CONCLUSIONS

The relationship between BIF and adult psychiatric morbidity appears to be partially mediated by exposure to Adverse Childhood Experiences. Where possible, targeting Adverse Childhood Experiences through early detection, prevention and interventions may improve psychiatric morbidity in this population group.