What should we know about precarious employment and health in 2025? Framing the agenda for the next decade of research

Leveraging Key Informant Interviews to Inform Intervention Development: The Greater Lawndale Healthy Work Project

BACKGROUND

The Greater Lawndale Healthy Work project is a sequential mixed methods community based participatory research project that examines work as a structural determinant of health and builds community capacity for healthy work in a predominantly Black and Latinx community in Chicago known as Greater Lawndale (GL).

OBJECTIVES

We interviewed community leaders in GL as key informants to understand the barriers to healthy work and inform intervention development.

METHODS

We conducted a directed content analysis of transcripts from 20 key informants and coded the social ecology and type of intervention.

RESULTS

Every key informant mentioned at least one asset in GL, showing an opportunity to employ a capacity-oriented approach to intervention development. Key informants suggested a variety of interventions to address precarious work across levels of the social ecology, with individual and community level interventions being the most salient.

CONCLUSION

Through this approach, we were able to navigate tensions and challenges in conducting research for community-wide change. Key informant stakeholder interviews can be leveraged to meaningfully inform intervention development and support the development of multi-level, sustainable, and culturally acceptable interventions that advance health equity.

Screening tools for employment in clinical healthcare delivery systems: a content analysis

BACKGROUND

The relationship between work and health is complex and bidirectional, where work can have both health-harming and health-enhancing effects. Though employment is recognized as a social determinant of health, and clinical healthcare delivery systems are increasingly using screening tools to ask patients about social needs, little research has explored the extent to which employment-related social risk is captured in these screening tools. This study aimed to identify and characterize employment- and work-related questions in social risk screening tools that have been implemented in clinical healthcare delivery systems.

METHODS

We conducted a qualitative content analysis of employment-related items in screening tools that have been implemented in clinical healthcare service delivery systems. Three content areas guided data extraction and analysis: Setting, Domain, and Level of Contextualization.

RESULTS

Screening tools that asked employment-related questions were implemented in settings that were diverse in the populations served and the scope of care provided. The intent of employment-related items focused on four domains: Social Risk Factor, Social Need, Employment Exposure, and Legal Need. Most questions were found to have a low Level of Contextualization and were largely focused on identifying an individual's employment status.

CONCLUSIONS

Several existing screening tools include measures of employment-related social risk, but these items do not have a clear purpose and range widely depending on the setting in which they are implemented. In order to maximize the utility of these tools, clinical healthcare delivery systems should carefully consider what domain(s) they aim to capture and how they anticipate using the screening tools to address social determinants of health.

Work-related crashes in rideshare drivers in the United States

INTRODUCTION

Motor vehicle crashes (MVCs) are the leading cause of work-related deaths in the United States. The increasing popularity of the competitive rideshare market and the lack of oversight over workforce health and safety limits understanding of the current occupational hazards and associated risk factors faced by this precarious workforce. The objective of this analysis was to determine what the personal, social and occupational risk factors for work-related crashes in rideshare drivers are in the United States and suggest further research required to understand occupational health risks and opportunities for interventions.

MATERIAL AND METHODS

We conducted a survey of a convenience sample of rideshare and taxi drivers using an online questionnaire. Rideshare respondents (n = 277) were recruited through an email that was distributed to people who subscribe to TheRideshareGuy.com. We examined the general characteristics of rideshare drivers by history of work-related MVCs and logistic regression models were used to determine major predictors of MVCs.

RESULTS

Of 276 rideshare drivers that reported their crash history, one-third (n = 91, 33%) reported being involved in a work-related crash. Results from a multivariable logistic regression model showed rideshare MVCs were more likely in older drivers (aOR for 10 year increases in age, 1.55, p = 0.001), if drivers undertook 10 or more rideshare trips per day (aOR 1.84, p = 0.041), frequently or very frequently were driving on unfamiliar roads (aOR 1.72, p = 0.048) and driving whilst tired (aOR 3.03, p = 0.003).

CONCLUSION

Precarious workers and health and safety is emerging as a major area of research focus. There is a unique opportunity to explore the occupational health risks in rideshare drivers to provide interventions that encourage growth of a healthy and fit rideshare workforce and promote work practices and future regulations aimed at improving safe work practices.

PRACTICAL APPLICATIONS

This analysis paints a complex picture of personal and occupational factors that are associated with MVCs in rideshare drivers suggesting that additional policy development related to occupational health and safety of rideshare drivers could be constructive.

An urgent call to address work-related psychosocial hazards and improve worker well-being

Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards.

Precarious employment in young adulthood and later alcohol-related morbidity: a register-based cohort study

OBJECTIVES

The prevalence of precarious employment is increasing, particularly among young adults where less is known about the long-term health consequences. The present study aims to test if being precariously employed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.

METHODS

A register-based cohort study was conducted in Sweden. The Swedish Work, Illness, and Labor-market Participation (SWIP) cohort was used to identify individuals who were aged 27 years between 2000 and 2003 (n=339 403). Information on labour market position (precarious employment, long-term unemployment, substandard employment and standard employment relations) was collected for young people 3 years after graduation from school using nationwide registers. Details about alcohol-related morbidity during a 28-year follow-up period were collected from the National Hospital Discharge Register. Data on sex, age, country of birth, education and previous poor health were also obtained from the registers.

RESULTS

Young adults in precarious employment had an increased risk of alcohol-related morbidity compared with individuals of the same age in standard employment (HR 1.43, 95% CI 1.32 to 1.55), after adjusting for several important covariates. A stronger association was found among young men who were precariously employed compared with young women.

CONCLUSION

This nationwide register-based study conducted in Sweden with a long-term follow-up suggests that being precariously employed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.

The impact of precarious employment on the commitment of registered nurses

AIM

To investigate the association between precarious employment and commitment among registered nurses.

BACKGROUND

The nursing profession faces numerous challenges, and precarious employment (PE) has emerged as a significant issue affecting nurses' well-being and professional status.

METHODS

In spring 2023, we conducted a cross-sectional survey involving members of a healthcare workers' trade union in Finland. The study encompassed data from 2,370 registered nurses representing various healthcare sectors nationwide. Regression analysis was used to explore the relationship between PE and nurses' commitment. STROBE guidelines were used to report the study.

RESULTS

The modified PE scale demonstrated a good fit. Among the various dimensions of PE, nurses perceived the highest level of precariousness in terms of inadequate training opportunities, followed by unpredictable and nonstandard working hours, low wages, and disempowerment. Vulnerability arising from authoritarian management exhibited the most significant and negative association with nurses' commitment (B = -0.233).

DISCUSSION

The findings of this study underscore that PE is a pressing concern within the nursing profession, and it has a detrimental impact on nurses' commitment. While precariousness in nursing is associated with issues related to empowerment and fair leadership, it appears that conventional challenges related to working hours, typical of the nursing profession, do not significantly affect nurses' commitment.

IMPLICATIONS FOR NURSING AND NURSING POLICY

To enhance nurses' commitment, healthcare institutions and managers must actively promote leadership practices that empower and support employees. Also, employees' legal work-related rights have to be respected in organizations. Addressing these aspects can contribute to a more resilient and dedicated nursing workforce.

Globalization, platform work, and wellbeing-a comparative study of Uber drivers in three cities: London, Helsinki, and St Petersburg

BACKGROUND

Globalization of platform work has become a challenge for wider social and employment relations and wellbeing of workers, yet on-location work remains governed also by local regulatory context. Understanding common challenges across countries and potential for regulatory measures is essential to enhance health and wellbeing of those who work in platform economy. Our comparative study on platform work analyzed concerns of Uber drivers in three cities with a different regulatory and policy context.

METHODS

Drawing from current understanding on employment and precarity as social determinants of health we gathered comparative documentary and contextual data on regulatory environment complemented with key informant views of regulators, trade unions, and platform corporations (N = 26) to provide insight on the wider regulatory and policy environment. We used thematic semi-structured interviews to examine concerns of Uber drivers in Helsinki, St Petersburg, and London (N = 60). We then analysed the driver interviews to identify common and divergent concerns across countries.

RESULTS

Our results indicate that worsening of working conditions is not inevitable and for drivers the terms of employment is a social determinant of health. Drivers compensated declining pay with longer working hours. Algorithmic surveillance as such was of less concern to drivers than power differences in relation to terms of work.

CONCLUSIONS

Our results show scope for regulation of platform work especially for on-location work concerning pay, working hours, social security obligations, and practices of dismissal.

Informal Employment Under the Skin: Informality and Health Inequalities Among Chilean Workers

Informal employment has been identified as an important social determinant of health. This article addresses the processes through which informal employment affects workers' health in Chile. The study's methodological approach was based on qualitative interviews with 34 formal and informal workers. The findings show how workers perceive informal employment as negatively affecting their mental and physical health through different dimensions of their living and working conditions. Incorporating a gender perspective proves to be integral to the analysis of these processes. The article concludes by discussing how neoliberalism underlies such vulnerability processes and negatively impacts on the population's health.

Transitioning into and out of precarious employment and life satisfaction: Evidence from asymmetric fixed effects models

Previous studies have found that those with precarious jobs report lower levels of life satisfaction than those with non-precarious jobs. However, it is unclear whether transitioning into and out of precarious jobs has differential effects on life satisfaction. This study examines the association between employment status transitions and life satisfaction, as well as gender differences in these associations. Data from the Korean Welfare Panel Study (N = 9,792) from 2006 to 2020 were used in this study. A novel asymmetric fixed effects model was employed to separately estimate the association for transitioning into and out of precarious employment. Gender heterogeneity was estimated by including an interaction term of gender and employment transition. Standard fixed effects estimates showed that precarious employment is negatively associated with life satisfaction (b = -0.048). Asymmetric fixed effects models revealed that transitioning out of precarious employment is associated with increased life satisfaction (b = 0.051), while transitioning into a precarious job is not significantly associated with life satisfaction. These asymmetric associations were more pronounced for men than women. This study provides evidence that, especially for men, the association for transitioning out of precarious employment is significantly larger than the association for transitioning into precarious employment. Policies that facilitate the transition into stable employment are likely to enhance the quality of life for employed individuals.

Multidimensional typologies of precarious employment and their relationships with mental well-being in Korean wageworkers: A latent class analysis based on the Korean Working Conditions Survey (2020-2021)

BACKGROUND

Precarious employment (PE) has been conceptualized as having a multidimensional nature, and research addressing this topic in Asian countries is scarce. This study examined the typologies of PE and their relationships with mental health among Korean workers.

METHODS

From October 2020 to April 2021, the Korean Working Conditions Survey was conducted on Korean wageworkers (weighted N = 38,347), representative of the nation. With theory-based operationalization of PE, we identified typologies and classified workers through latent class analysis. Logistic regression was performed to explore the association between PE typologies and mental health among workers, represented as odds ratio (ORs) and confidence intervals (CIs).

RESULTS

Four distinct employment typologies emerged: (i) standard employment relationships (SER, 34.5%), (ii) moderate employment precariousness (MEP, 43.5%), (iii) underemployment (17.9%), and (iv) daily laborers (4.1%). Women were overrepresented in the MEP and underemployment types, while the SER type consisted of those with higher educational attainment and white-collar jobs. The OR (95% CI) of depression was 1.38 (1.27-1.50) for the MEP type, 1.48 (1.32-1.66) for the underemployment type, and 2.15 (1.85-2.51) for the daily laborers, compared to the SER type. For individual elements of PE, temporary employment, low wages, low-income predictability, and low involvement in work process were positively associated with depression, whereas part-time employment was negatively associated with depression.

CONCLUSION

Employment insecurity, low material rewards, and a lack of rights and protection can contribute to the poor mental health of workers. Policy interventions are warranted to mitigate inequalities in employment quality among Korean workers.

The effects of precarious employment and calling on the psychosocial health and work well-being of young and older workers in the care sector: a longitudinal study

OBJECTIVE

Employment conditions in the care sector are changing, and precarious employment (PE) is becoming more widespread, manifesting as undervaluation, adverse leadership, work overload, and inadequate control over work. This study aimed to examine changes in psychosocial health, work well-being, PE, and calling over time and explore the effects of PE and calling on psychosocial health and work well-being.

METHODS

The longitudinal study collected follow-up panel data in the three time points (2020, 2022, and 2023) from care workers (n = 1502), linear mixed effects models.

RESULTS

PE decreased (β =  - 0.02), and perceived work well-being increased (β = 0.04), but there were no change in psychosocial health (β =  - 0.01) and calling (β = 0.01) during the three-year period. Younger (< 39) care workers perceived higher levels of PE and had poorer psychological health. Moreover, PE had a negative effect on psychosocial health (β =  - 0.63) and work well-being (β =  - 0.68) and calling had a positive effect on psychosocial health (β = 0.41) and work well-being (β = 0.49) in multivariate models.

CONCLUSION

PE conditions affect work performance and employee well-being and may threaten patient care; therefore, it should be further investigated in the care sector. It is noteworthy that calling still seems to be central in care work. The results deepen the understanding of the current shortage crisis in health and social care workplaces but can also provide keys to resolving the crisis.

Precarious employment in early adulthood and later mental health problems: a register-linked cohort study

BACKGROUND

Precarious employment is a determinant of self-reported mental health problems among young adults. Less is known about more severe and objectively measured health outcomes, such as mental health problems requiring inpatient care. The current study aims to investigate the effect of precarious employment in early adulthood on later mental health problems requiring inpatient care.

METHOD

A register-based cohort study, based on the Swedish Work, Illness and Labor-market Participation cohort, was conducted, following a cohort of young adults aged 27 years between 2000 and 2003 (born between 1973 and 1976) (n=339 403). Information on labour market position in early adulthood (precarious employment, substandard employment, unemployment and standard employment) was collected from registers 3 years after graduating from school. Information on the outcome of mental health problems (depression, anxiety and stress-related disorders) was collected from the National Patient Register. HRs with 95% CIs were obtained by Cox regression analyses.

RESULTS

After adjusting for important covariates, such as prior mental health problems, compared with individuals in standard employment, individuals who were precariously employed in early adulthood had an increased risk of later mental health problems (HRadjusted: 1.51 95% CI 1.42 to 1.60). The association between precarious employment and mental health was slightly stronger for males.

CONCLUSIONS

In Sweden, entry into the labour market with precarious employment is associated with an increased risk of mental health problems, which is important given that precarious employment is becoming more prevalent among young adults.

Precarious employment and workplace health outcomes in Britain

RATIONALE

The world of work is changing rapidly, and precarious employment is becoming more prevalent in Britain and elsewhere, particularly since the 2008 financial crisis. This is despite the evidence linking employment precarity to adverse health outcomes, and the policy discourses advocating for high-quality jobs.

OBJECTIVE

I seek to establish empirically the extent and nature of the potential link between employment precarity and health outcomes, which is done chiefly at the workplace level. The research can be vital from the perspective of informing policy, given that the workplace represents the level where key policy levers operate.

METHODS

I use nationally representative data from the British Workplace Employment Relations Survey. Four workplace health outcomes (WHOs; viz., injuries, illnesses, job satisfaction, and job anxiety) have been used to examine if organizations with precarious employment arrangements are likely to experience adverse health outcomes. I use alternative econometric approaches to compare organizations that reported to have three types of precarious employment arrangements, viz., shift working, annualised hours, and zero-hours contracts (ZHCs), vis-à-vis their counterparts without such arrangements.

RESULTS

The results obtained reveal that workplaces with precarious employment arrangements are significantly unhealthier, and those with the most insecure form of precarious employment perform particularly worst in this respect.

CONCLUSIONS

Precarious employment may become ever more prevalent as organizations contend with economic fallouts from shocks such as Brexit or Covid-19. This may lead to sub-standard health outcomes. The positive influence of trade unions on working conditions has largely been decimated and the workforce in Britain is ageing. These combinations may pose significant challenges to public health including mental health crises. Public policy ought to help minimise adverse health outcomes linked to employment precarity.

Precarious Employment and Well-Being: Insights from the COVID-19 Pandemic

While precarious employment is not a new concept, it has been brought to the center of scholarly and public discourse worldwide by the unprecedented COVID-19 pandemic. This essay delineates how precarious employment shapes well-being and situates that relationship in the context of the COVID-19 pandemic. The essay also provides an overview of how the nine articles boldly investigate how these two layers of global risk-precarious employment and the pandemic-interact to shape individuals' well-being. In addition to advancing theoretical and empirical knowledge by analyzing timely data from diverse sources and populations, these articles call for more efforts on worker protection reforms and government financial support.

Seeking Good Work in the COVID-19 Recovery: Shifting Priorities and Employment Choices Among Workers

OBJECTIVE

Disruption to working lives spurred by the COVID-19 pandemic may shape people's preferences for future employment. We aimed to identify the components of work prioritized by a UK sample and the employment changes they had considered since the start of the COVID-19 pandemic.

METHODS

A nationally representative longitudinal household survey was conducted in Wales at two time points between 2020 and 2021.

RESULTS

Those in poorer health prioritized flexibility and were more likely to consider retiring. Those with limiting preexisting conditions or low mental well-being were more likely to consider becoming self-employed. Those experiencing financial insecurity (including those with high wage precarity or those furloughed) were more likely to consider retraining, becoming self-employed, or securing permanent employment.

CONCLUSIONS

Ensuring flexible, secure, and autonomous work is accessible for individuals facing greater employment-related insecurity may be key.

The multidimensional construct of precarious work, the future of work, and workers' health

This essay aims to discuss the flexibilization of work, which has been accentuated during the COVID-19 pandemic, leading to an expansion of precarious work. Additionally, the essay seeks to explore theoretical models and methodological challenges for the study of precarious work, its dimensions, and its effects on workers' health. The health and economic crisis has heightened the social vulnerability of workers, introduced by the global flexibilization and the Brazilian Labor Reform. The setbacks materialize in precarious work, a multidimensional construct that encompasses the characteristics of this flexibilization in its three dimensions: (1) unstable work relationships resulting from insecure hiring, temporary contracts, involuntary part-time work, and outsourcing; (2) inadequate and unstable income; and (3) insufficient rights and protection, with reduced collective representation of workers, resulting in low power to react to degrading working conditions, lack of social security, and setbacks in regulatory support for labor safety. Repercussions of precarious work on health - work accidents, musculoskeletal and mental disorders - are evidenced in epidemiological studies, highlighting the theoretical and methodological limitations that still exist. The conclusion is that if the current bases of social protection and work insertion for workers are maintained, the future will see an expansion of precarious work. Thus, highlighting the causal relationships between precarious work and health is a contemporary challenge of the research and public policy agenda that is imposed upon society, with a focus on workers' health services.

Gender Differences in the Indirect Effect of Psychosocial Work Environment in the Association of Precarious Employment and Chronic Stress: A Cross-Sectional Mediation Analysis

Gender differences in the association between precarious employment and chronic stress have been found but the mechanisms underlying this relationship have not been explored. The main objective of this study was to evaluate the mediating effects of psychosocial risk factors at work (i.e., demands, control, and support) and work-life conflicts in the relationship between precarious employment and chronic stress as measured through the production of steroid hormones (both adrenal and gonadal) for men and women separately. Cross-sectional data were derived from a sample of workers from Barcelona (n = 125-255 men; 130 women). A set of 23 markers were determined from hair samples to evaluate the production of both adrenal and gonadal steroids. Decomposition analyses were applied to estimate the indirect effects of psychosocial risk factors and work-life conflict using linear regression models. Gender differences in the association between precarious employment and steroids production were confirmed. Psychosocial risk factors and work-life conflicts had indirect effects only among women (β_Cortisol = 0.18; 95% CI: 0.04-0.32; β_{Cortisol/Cortisone} 0.19; 95% CI: 0.08-0.31; β_%Cortisol 0.12; 95% CI: 0.05-0.20). Gender differences suggest that the physiological response to precarious employment could be determined by the social construction of gender identities, as well as by positions and roles in the labour market and family. Future studies should delve further into these differences to improve employment and working policies, thus mitigating gender inequalities in the labour market to prevent work-related stress.

Early retirement intentions: the impact of employment biographies, work stress and health among a baby-boomer generation

In recent years, early retirement decisions have become more frequent in the European Union despite political efforts to prevent early retirement. This is a growing problem for the social security system. The study focuses on a life course approach using employment biographies and investigates the influence of work stress and health on early retirement intentions. Data of employees who were born in either 1959 or 1965 of the German cohort study on work, age, health and work participation are analysed (n = 3338). By linking survey and register data from 1993 to 2011, a sequence analysis is conducted to identify employment biographies. To analyse the relationship between the employment biographies and intended early retirement, a longitudinal path analysis is computed and includes work stress, measured through effort-reward imbalance, and self-rated health. The statistical analyses identify three adverse employment biographies, i.e. part-time work, episodes of unemployment or marginal employment. In addition, two favourable employment biographies are determined, characterised by full-time work and few episodes of unemployment. The results of the path analysis show that employment biographies with high work-related stress have early retirement intentions. Among adverse employment biographies, indirect effects of poor health on the association between work stress and early retirement intentions are found. Unexpectedly, among full-time workers, work stress is also associated with early retirement intentions with an additional mediation through health. The findings of this study highlight the importance of the life course perspective when analysing retirement decisions. In addition to health-promoting interventions in the labour market, effects of psychosocial factors should be focussed on in order to reduce early exits from the labour market.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00731-0.

Changing Employment and Work Schedule Patterns over the 30 Working Years-A Sequential Cluster Analysis

OBJECTIVE

As labor markets have become increasingly volatile and precarious since 1980s, more workers are susceptible to working conditions such as unpredictable and unstable hours, threatening their economic security. However, our understanding of employment patterns regarding the changes in work schedules over our working lives has yet been established. This study builds our knowledge in this area by paying attention to how social positions may shape the specific work schedule patterns over our working lives.

METHODS

We used the National Longitudinal Survey of Youth-1979 (NLSY79) to examine our research questions. NLSY79 follows a nationally representative sample of United States men and women between the ages of 14 and 22 when first interviewed in 1979. The participants were then interviewed annually until 1994 and then biennially thereafter. We first conducted a sequence analysis to examine work schedule patterns between ages 22 and 53 (n = 7987). We then used a multinomial logit regression to examine the factors contributing to specific work schedule patterns, with attention to social position.

RESULTS

Our sequence analysis results suggest five work schedule patterns during 31 years of adult life: working only standard hours (25%), mainly standard hours with some portions of nonstandard hours (38%), standard hours during early working years but transitioning to either largely variable or mainly evening or night hours (14% and 13%), and mostly not working (10%). Our multinomial logit analysis indicates that being non-Hispanic Black, having a high school degree or below, or having ever experienced poverty or welfare by age 23 were more likely to have a nonstandard work schedule pattern than their counterparts.

CONCLUSIONS

Our analysis underscores the dynamic employment patterns over our working lives, with some groups more likely than others to be engaged in nonstandard or volatile work schedules. Importantly, the groups likely to be subject to nonstandard work schedules also tend to have relatively disadvantaged social positions, thus worsening their vulnerability in securing work characterized by stability and economic security.

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 Precarity, COVID-19 Risk, and Workers' Well-Being During the Pandemic in Europe

The COVID-19 crisis highlights a growing precarity in employment and the importance of employment for workers' well-being. Existing studies primarily examine the consequences of employment precarity through non-standard employment arrangements or the perception of job insecurity as a one-dimensional measure. Recent scholars advocate a multidimensional construct with a wide range of objective and subjective characteristics of precariousness. Using data from Eurofound's Living, Working, and COVID-19 surveys, I define employment precarity as the objective form of employment instability, as well as subjective terms of job insecurity and emotional precariousness. I also investigate whether and how various facets of employment precarity along with COVID-19 risk are associated with workers' mental and subjective well-being across 27 European Union member states during the pandemic. This study sheds light on a comprehensive understanding of objective and subjective dimensions of employment precarity, as well as their effects on workers' well-being during the COVID-19 pandemic.

Investigating Employment Quality for Population Health and Health Equity: A Perspective of Power

Employment quality (EQ) has gained increasing attention as a determinant of health, but the debate among occupational health researchers over the measurement of EQ poses a challenge to advancing the literature. This is especially problematic when the concept is used across social, cultural, and national borders, as EQ is shaped by power dynamics within sociopolitical and economic contexts that are specific to each society. Investigating EQ in context could help develop a clearer understanding as to why EQ is configured in certain ways, how best EQ could be measured, how EQ impacts health, and ultimately how EQ could be improved. In this paper, we propose that attention to social context-and in particular power-may help advance the research on EQ and health. We present an allegory, or a visual description, that articulates the power balance in the employer-worker relation as well as in the sociopolitical context in which the employer-worker relation takes place. We end by proposing specific approaches for occupational health researchers to incorporate a perspective of power in EQ research that may clarify the concept and measurement of EQ. A clearer recognition of EQ as a product of power in social context aligns with the research approach of addressing work as a social structural determinant of health.

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.

Association between Precarious Employment and Chronic Stress: Effect of Gender, Stress Measurement and Precariousness Dimensions-A Cross-Sectional Study

Precarious employment has been highlighted as a social determinant of health, given, among others, to its alleged association with chronic stress. However, few studies have been conducted analyzing such association, using both perceived stress indicators and biological markers. Accordingly, the present study analyzed the association of multidimensional (6 dimensions) precarious employment scale with perceived stress and 23 markers of adrenal and gonadal hormone production, including cortisol. The sample consisted of 255 salaried workers from Barcelona (125 men, 130 women) aged 25-60. OLS regression models stratified by sex were conducted. Results demonstrated that precarious employment increased the probabilities of having perceived stress in both sexes. In addition, the production of adrenal hormones among men is associated with precarious wages and among women with precarious contracts ("Temporariness", "Disempowerment", and "Rights" dimensions). Therefore, precarious employment could be embodied by workers, altering their perceived well-being and physiological characteristics. Differences between men and women in the physiological effect of precarious employment could express not just the biochemical differences inherent to biological sex, but also the social construction of gender identities, positions and roles in society and family, as well as gender inequalities in the labour market.

Work-family trajectories and health: A systematic review

BACKGROUND

Work and family lives interact in complex ways across individuals' life courses. In the past decade, many studies constructed work-family trajectories, some also examined the relation with health. The aims of this systematic review were to summarise the evidence from studies constructing work-family trajectories, and to synthesise the evidence on the association between work-family trajectories and health.

METHODS

We searched MEDLINE, EMBASE, PsycINFO, SocINDEX and Web of Science databases. Key search terms related to work, family and trajectories. Studies that built combined work-family trajectories or examined the relationship between work and family trajectories were included. Risk of bias was assessed independently by two authors. The identified work-family trajectories were summarised and presented for men and women, age cohorts and contexts. The evidence on the association with health as antecedent or consequence was synthesised.

RESULTS

Forty-eight studies, based on 29 unique data sources, were included. Thirty-two studies (67%) were published in 2015 or later, and sequence analysis was the primary analytic technique used to construct the trajectories (n = 43, 90%). Trajectories of women were found to be more diverse and complex in comparison with men. Work-family trajectories differed by age cohorts and contexts. Twenty-three studies (48%) examined the association between work-family trajectories and health and most of these studies found significant associations. The results indicate that work-family trajectories characterised by an early transition to parenthood, single parenthood, and weak ties to employment are associated with worse health outcomes.

CONCLUSIONS

Work-family trajectories differed greatly between men and women, but differences seemed to decrease in the youngest cohorts. Given the current changes in labour markets and family formation processes, it is important to investigate the work and family lives of younger cohorts. Work-family trajectories were associated with health at different life stages. Future research should examine longitudinal associations of work-family trajectories with health and focus on elucidating why and under which circumstances some trajectories are associated with better or worse health compared with other trajectories.

[Job conditions and precarious work among Mexican physicians: an analysis based on a national survey]

The study aimed to describe the socioeconomic characteristics and job conditions of medical personnel in Mexico. This was a cross-sectional study based on the Mexican National Occupational and Employment Survey (ENOE) for all four quarters of 2019 and the first quarter of 2020. We included all physicians who had concluded their university training. The variable "cumulative precarious labor" was constructed as the sum of five binary variables related to minimum wage, workweek, and lack of employment contract, job security, and labor benefits. Using this unweighted sum, we classified their labor conditions as absence of (0) or low (1), medium (2 to 3), or high (4 to 5) precarious labor. In the public sector, 13.4% and 3.3% of physicians were engaged in medium or high precarious labor, respectively; the percentages were higher in the private sector, with 38.5% and 7.7% (p < 0.01), respectively, due mainly to the lack of formal contracts and medical insurance. These conditions were exacerbated in women working in medical offices in private-sector companies, where 75.2% and 6% worked in medium or high precarious conditions, respectively, while the proportions in men were 15.6% and 7.7%, respectively (p < 0.01). Precarious labor exists in the Mexican health sector; labor conditions for physicians are more precious in the private sector than in the public sector, especially in private-sector offices where female physicians are more exposed to precarious employment.

The Path from Survey Development to Knowledge Activism: A Case Study of the Use of a Physical Loads Survey in a Retail Workplace

Workers at a multi-site retailer were concerned that they were experiencing higher than anticipated work-related musculoskeletal disabilities (MSDs). They approached union leadership and academic researchers and a Participatory Action Research (PAR) project was developed which culminated in a targeted online Physical Loads Survey (PLS). The goal was to initiate discussions to design a preventative collaborative ergonomic program. Survey results confirmed that during a shift, workers had significant exposure to standing, carrying loads of more than 25 lbs, pushing and pulling loads greater than 225 lbs, and repetitive arm and hand movements. The successful survey was the first step in the development of a proactive health and safety program. The union proceeded without management participation and was able to move beyond knowledge creation to knowledge activism and change.

Temporal Dimensions of Job Quality and Gender: Exploring Differences in the Associations of Working Time and Health between Women and Men

Research shows strong links between working time organization and workers’ health outcomes. Working time is also known to be highly gendered, with men and women working to different schedules. This article merges these two strands of research and takes a gender-based approach to investigating the relationship between temporal job quality and self-reported health in Europe. First, the sixth European Working Conditions Survey (EWCS) is used to establish the relationship between temporal dimensions of job quality and health and well-being outcomes for employed women and men. This is then corroborated using larger samples and more restricted measures of job quality drawn from micro-data from the 2019–2020 EU Labor Force Survey (LFS). The analyses show that good temporal job quality is positively associated with health and subjective well-being for both women and men, but this effect is significantly stronger for women, who are also at a greater risk of exposure to low control over working time and time under-employment. The findings highlight the importance of studying the impact of working and employment conditions on health from gender perspective, and the need for further exploration of job quality due to changes in the spatio-temporal organization of work during and beyond the COVID-19 pandemic.

Trajectories of precarious employment and the risk of myocardial infarction and stroke among middle-aged workers in Sweden: A register-based cohort study

BACKGROUND

The aim is to identify trajectories of precarious employment (PE) over time in Sweden to examine associations of these with the subsequent risk of myocardial infarction (MI) and stroke.

METHODS

This is a nation-wide register-based cohort study of 1,583,957 individuals aged 40 to 61 years old residing in Sweden between 2003-2007. Trajectories of PE as a multidimensional construct and single PE components (contractual employment relationship, temporariness, income levels, multiple job holding, probability of coverage by collective agreements) were identified for 2003-2007 by means of group-based model trajectories. Risk Ratios (RR) for MI and stroke according to PE trajectories were calculated by means of generalized linear models with binomial family.

FINDINGS

Adjusted estimates showed that constant PE and borderline PE trajectories increased the risk of MI (RR: 1·08, CI95%:1·05-1·11 and RR:1·13, CI95%: 1·07-1·20 respectively) and stroke (RR:1·14, CI95%: 1·10-1·18 and HR:1·24, CI95%: 1·16-1·33 respectively) among men. A higher risk of stroke in men was found for the following unidimensional trajectories: former agency employees (RR:1·32, CI95%:1·04-1·68); moving from high to a low probability of having collective agreements (RR: 1·10, CI95%:1·01-1·20). Having constant low or very low income was associated to an increased risk of MI and Stroke for both men and women.

INTERPRETATION

The study findings provide evidence that PE increases the risk of stroke and possibly MI. It highlights the importance of being covered by collective bargaining agreements, being directly employed and having sufficient income levels over time.

FUNDING

The Swedish Research Council for Health, Working Life and Welfare, no. 2019-01226.

Maintaining High Eudaimonic Wellbeing Despite Ambiguity Intolerance Among Three Employment Status Groups: Examining the Buffering Effects of Positive Psychological Attributes

The unemployed, as well as individuals in self and salaried employment, face several work-related risks and uncertainties which can result in diminished psychological wellbeing especially for individuals with high ambiguity intolerance. However, positive psychology literature suggests that individuals with strong psychological resources can be resilient in difficult circumstances. Using a sample of 922 individuals (including 240 unemployed, 391 salary-employed, and 291 self-employed) from Uganda and Kenya, we investigated the moderating effects of locus of control and psychological capital on the association between ambiguity intolerance and eudaimonic wellbeing, comparing the unemployed with individuals in salaried and self-employment. Our findings indicated that ambiguity intolerance and external locus of control are negatively associated with eudaimonic wellbeing. Conversely, internal locus of control and psychological capital were positively associated with eudaimonic wellbeing. The moderation analysis revealed that whereas an external locus of control boosts the negative effects of ambiguity intolerance on eudaimonic wellbeing, internal locus of control and psychological capital buffer against the negative effects of ambiguity intolerance on eudaimonic wellbeing. Differences between employment status groups and implications are discussed.

The Concepts of Social Space and Social Value: An Interpretation of Clinical Nursing Practice in Vietnam Các khái niệm về không gian xã hội và giá trị xã hội: diễn giải về thực hành điều dưỡng lâm sàng ở Việt Nam

This research draws on broader inquiry that explores the construction of the spatial positioning of nurses in Vietnam and how power structures sustained that positioning. Observations and individual interviews were undertaken with 32 registered nurses. Analysis of participant data and relevant policy documents moved beyond coding to theorising and thus to the abstraction of key concepts. Social space and social value were significant concepts developed in the research. The concept of space reflected the ways in which nurses constantly engaged in processes of negotiation to embed a sense of control over their practice. The related concept of social value brought focus to a power structure whereby the fiscal priorities of health care managers reinforced a disconnect between the use and exchange values of nurses. An interpretation of power relations that underpinned the material and symbolic spaces in which nurses worked was framed within the historical context of Vietnam.

Tóm lưược

Bài báo này dựa trên nghiên cứu với qui mô lớn hơn nhằm tìm hiểu vị thế của nghành điều dưỡng tại Việt Nam. Phương pháp quan sát và phỏng vấn cá nhân được thực hiện với 32 nhân viên điều dưỡng làm việc tại tám khoa của một bệnh viện ở Việt Nam. Việc phân tích dữ liệu của người tham gia và các tài liệu về chính sách liên quan đã vượt ra khỏi phạm vi mã hóa dữ liệu đơn thuần, mở rộng sang học thuyết và chuyển sang trừu tượng hóa các khái niệm chính. Không gian xã hội và giá trị xã hội là những khái niệm quan trọng được phát triển trong nghiên cứu này. Khái niệm về không gian phản ánh cách thức mà các nhân viên điều dưỡng liên tục tham gia vào các quá trình thương lượng để kiểm soát được việc thực hành của họ. Khái niệm liên quan về giá trị xã hội tập trung vào cơ cấu quyền lực, theo đó ưu tiên tài chính của các nhà quản lý chăm sóc sức khỏe góp phần làm gián đoạn mối liên kết giữa giá trị sử dụng và giá trị trao đổi mà ngành điều dưỡng mang lại. Lý giải về các mối quan hệ quyền lực đã được củng cố trong không gian thực và không gian mang tính biểu tượng nơi các điều dưỡng làm việc, được định hình trong bối cảnh lịch sử của Việt Nam.

Precarious Work in Midlife: Long-Term Implications for the Health and Mortality of Women and Men

Although prior research documents adverse health consequences of precarious work, we know less about how chronic exposure to precarious work in midlife shapes health trajectories among aging adults. The present study uses longitudinal data from the Health and Retirement Study to consider how histories of precarious work in later midlife (ages 50-65) shape trajectories of health and mortality risk after age 65. Results show that greater exposure to unemployment, job insecurity, and insufficient work hours in midlife predicts more chronic conditions and functional limitations after age 65. Characteristics of precarious work also predict increased mortality risk in later life. Findings indicate few gender differences in linkages between precarious work and health; however, women are more likely than men to experience job insecurity throughout midlife. Because precarious work is unlikely to abate, results suggest the need to reduce the health consequences of working in precarious jobs.

The Influence of Flexible Employment on Workers’ Wellbeing: Evidence From Chinese General Social Survey

Based on the 2017 China General Social Survey data, with 5,439 observations as research objects, this paper empirically tests the impact of flexible employment on workers’ wellbeing and introduces labor income as mediator and social security as moderator to explore the mechanism of action. The empirical results show that: flexible employment has an inverted U-shaped relationship with workers’ wellbeing, which indicates that increasing employments’ flexibility will first rise and then reduce their perceived subjective wellbeing after reaching the peak; labor income plays a mediating role in the relationship of flexible employment and wellbeing of workers; social security moderates the mediating effect of labor income whereas the moderating role in the relationship between flexible employment and workers’ wellbeing is not observed. Implications and future development of flexible employment are discussed.

Initiatives Addressing Precarious Employment and Its Effects on Workers' Health and Well-Being: A Systematic Review

The prevalence of precarious employment has increased in recent decades and aspects such as employment insecurity and income inadequacy have intensified during the COVID-19 pandemic. The purpose of this systematic review was to identify, appraise, and synthesise existing evidence pertaining to implemented initiatives addressing precarious employment that have evaluated and reported health and well-being outcomes. We used the PRISMA framework to guide this review and identified 11 relevant initiatives through searches in PubMed, Scopus, Web of Science, and three sources of grey literature. We found very few evaluated interventions addressing precarious employment and its impact on the health and well-being of workers globally. Ten out of 11 initiatives were not purposefully designed to address precarious employment in general, nor specific dimensions of it. Seven out of 11 initiatives evaluated outcomes related to the occupational health and safety of precariously employed workers and six out of 11 evaluated worker health and well-being outcomes. Most initiatives showed the potential to improve the health of workers, although the evaluation component was often described with less detail than the initiative itself. Given the heterogeneity of the 11 initiatives regarding study design, sample size, implementation, evaluation, economic and political contexts, and target population, we found insufficient evidence to compare outcomes across types of initiatives, generalize findings, or make specific recommendations for the adoption of initiatives.

Precarious employment and mental health across European welfare states: a gender perspective

OBJECTIVE

The aim of this article was to examine the relationship between precarious employment (PE), welfare states (WS) and mental health in Europe from a gender perspective.

METHODS

Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, and categorized into quartiles. Countries were classified into Continental, Anglo-Saxon, Scandinavian, Southern and Central-Eastern WS. Mental health was assessed through the WHO-5 Well-Being Index and dichotomized into poor and good mental health. In a sample of 22,555 formal employees, we performed gender-stratified multi-level logistic regression models.

RESULTS

Results showed greater prevalences of PE and poor mental health among women. However, the association between them was stronger among men. Cross-country differences were observed in multi-level regressions, but the interaction effect of WS was only significant among women. More precisely, Central-Eastern WS enhanced the likelihood of poor mental health among women in high precarious employment situations (quartiles 3 and 4).

CONCLUSIONS

These findings suggest the interaction between contextual and individual factors in the production of mental health inequalities, both within and across countries. They also call for the incorporation of gender-sensitive welfare policies if equitable and healthy labor markets are to be achieved in Europe.

Precarious Employment and Chronic Stress: Do Social Support Networks Matter?

Precarious employment has been identified as a potentially damaging stressor. Conversely, social support networks have a well-known protective effect on health and well-being. The ways in which precariousness and social support may interact have scarcely been studied with respect to either perceived stress or objective stress biomarkers. This research aims to fill this gap by means of a cross-sectional study based on a non-probability quota sample of 250 workers aged 25–60 in Barcelona, Spain. Fieldwork was carried out between May 2019 and January 2020. Employment precariousness, perceived social support and stress levels were measured by means of scales, while individual steroid profiles capturing the chronic stress suffered over a period of a month were obtained from hair samples using a liquid chromatography-tandem mass spectrometry methodology. As for perceived stress, analysis indicates that a reverse buffering effect exists (interaction B = 0.22, p = 0.014). Steroid biomarkers are unrelated to social support, while association with precariousness is weak and only reaches significance at p < 0.05 in the case of women and 20ß dihydrocortisone metabolites. These results suggest that social support can have negative effects on the relationship between perceived health and an emerging stressful condition like precariousness, while its association with physiological measures of stress remains uncertain.

An international scoping review of rangers’ precarious employment conditions

Protecting wildlife and other natural resources requires engaging and empowering local communities, ensuring compliance with rules, and ongoing monitoring and research. At the frontline of these efforts are rangers. Despite their critical role in maintaining the integrity of parks and protected areas, rangers across the world are exposed to precarious employment conditions and hazardous work environments. We conducted an international scoping review to understand which employment and working conditions are examined in the context of the ranger occupation and to assess whether the concept of precarious employment is used in the conservation, criminological, and environmental sustainability literature on rangers. We reviewed publications from Web of Knowledge, Scopus, ProQuest, and Medline, and grey literature for relevant English language articles published between 2000 and 2021. Our findings are based on the analysis of 98 included studies. We found that the most commonly discussed aspect of rangers’ employment and working conditions was the hazardous social and physical work environment, although this was often accompanied by severe income inadequacy, employment insecurity, and a lack of social security, regulatory support, and workplace rights. Such employment and working conditions can cause adverse impacts on rangers’ mental and physical health, well-being, and safety, and are also detrimental to their ability to adequately protect biodiversity. We conclude by outlining the need for sustainable solutions and additional research based on established conceptualizations of the precarious employment concept and other related concepts. Lastly, we suggest that governments should acknowledge the importance of rangers through their recognition as essential workers and provide greater support to improve their employment conditions.

Informal employment and poor self-perceived health in Latin America and the Caribbean: a gender-based comparison between countries and welfare states in a pooled analysis of 176,786 workers

BACKGROUND

More than half of the working population in Latin American and Caribbean (LAC) countries is engaged in informal employment. The few previous studies indicate that this employment condition could have negative consequences for workers' health. The aim of the present study was to estimate the association between self-perceived health and informality in LAC countries according to gender and welfare state type.

METHODS

The cross-sectional study based on different working conditions and health national surveys was carried out in 13 LAC countries between 2012 and 2018. A sample of 176,786 workers was selected from these surveys. The association between health and informality was estimated using Poisson regression. Finally, a random effects meta-analysis was carried out by country. All results were stratified by sex and type of welfare state (statalist or familialist).

RESULTS

Informal workers reported significantly worse health than formal workers, for both women (1.28 [95% CI 1.14-1.43]) and men (1.30 [1.12-1.50]). This difference was broader and more significant in countries with statalist welfare state regimes, among both women (1.40 [1.22-1.60]) and men (1.51 [1.30-1.74]), than in familialist regime countries (1.19 [1.03-1.38] and 1.24 [1.03-1.49], respectively).

CONCLUSIONS

This study provides strong evidence of the association between informal employment and worker health. Welfare states appear to have a modifying effect on this association. The transition from the informal to the formal labour market in LAC is essential to improving the health of the population.

Precarious work and heath: Do occupation- and state-specific unemployment rates matter for women and for men?

Precarious work has the potential to undermine workers' health and well-being, and linkages between precarious work and health may depend on contextual measures of unemployment. The present study uses data from the Current Population Survey (CPS; 2001-2019) to examine whether several characteristics of precarious work are associated with self-rated health, with attention to differences in these associations by occupation- and state-specific unemployment rates. Findings indicate that experiences of unemployment, part-time work, and poor work quality (limited social benefits and low wages) are associated with worse self-rated health for working women and men. Moreover, associations between some measures of precarious work and health are weaker at higher levels of occupation- and state-specific unemployment for men, but not for women. The present study points to precarious work as a chronic stressor for many workers that must be considered within broader economic contexts.

The Relation Between Precarious Employment Arrangements and Social Precarity: Findings from the PREMIS Study in Stockholm, Sweden

Precarious employment (PE) is a well-known social determinant of health and health inequalities. However, as most previous studies have focused on physical and mental well-being, less is known about the social-related outcomes (ie, social precarity) associated with precarious arrangements. This cross-sectional study aims to investigate whether PE is associated with social precarity in a working population of 401 nonstandard employed workers in Stockholm, Sweden (2016-2017). PE was assessed with the Swedish version of the Employment Precarious Scale (EPRES-Se) and analyzed in relation to social precarity related to working life (eg, task quality and job security) and living conditions (eg, restraint in social activities and financial constraints). We found positive adjusted associations between quartiles of EPRES-Se and social precarity related to working life (eg, being locked in an occupation [aPR_q4:1.33 [1.10-1.61]]) and living conditions (eg, inability to participate in social activities because of work [aPR_q4:1.27 [1.10-1.46]]). Our findings suggest that individuals in PE experience social precarity, stressing that PE may have negative effects on well-being. Further studies using multidimensional constructs of PE and larger samples should analyze these findings according to social and policy contexts in order to be able to inform policymakers.

Job precarity and economic prospects during the COVID-19 public health crisis

OBJECTIVE

As labor markets in recent decades have become increasingly volatile and precarious, more workers are susceptible to working conditions threatening their economic security. COVID-19 has further laid bare such economic insecurity from holding a precarious job. We examined the association between precarious employment and the probability of losing income or a job during COVID-19 pandemic.

METHODS

A multivariate regression analysis was conducted using a cross-sectional data set collected in May 2020 in the United States.

RESULTS

Our results confirm a strong positive association between precarious employment and losing work or income. Specifically, holding part-time work in the service sector, and feeling disempowered in the workplace, receiving low material rewards, having few benefits, and experiencing obstacles in exercising rights all significantly doubled the probability of losing income or jobs.

CONCLUSION

Our analysis underscores the increasing vulnerability faced by our workforce and how a public health crisis magnifies the dire consequences of a precarious job.

Part-time work and health in the United States: The role of state policies

Part-time work is a common work arrangement in the United States that can be precarious, insecure, and lacking opportunities for advancement. In turn, part-time work, especially involuntary part-time work, tends to be associated with worse health outcomes. Although prior research documents heterogeneity in the health consequences of precarious work across countries, we do not know whether state-level institutional contexts shape the association between part-time work and self-rated health in the United States. Using data from the Current Population Survey (2009-2019; n = 813,077), the present study examined whether linkages between part-time work and self-rated health are moderated by state-level social policies and contexts. At the population level, we document differences in the prevalence of fair/poor health among part-time workers across states. For instance, 21% of involuntary part-time workers reported fair/poor health in West Virginia compared to 7% of involuntary part-time workers in Massachusetts. Findings also provide evidence that voluntary (β =.51) and involuntary (β=.57) part-time work is associated with greater odds of fair/poor health among individuals. Moreover, the association between voluntary part-time work and self-rated health is weaker for individuals living in states with higher amounts for maximum unemployment insurance, higher minimum wage, and lower income inequality. State-level policies did not moderate the association between involuntary part-time work and health. The present study points to the need to mitigate the health consequences of part-time work with social policies that enhance the health of workers.

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.

Risk and protective factors for depressive symptoms and suicidal behavior in the general population

OBJECTIVE

To analyze the participants' perception of risk and protective factors for depressive symptoms and their relationship with suicidal behavior in a general adult population.

METHOD

Exploratory-descriptive, qualitative research, using Content Analysis. Interviews with 200 participants over 18 years old, domiciled in Poços de Caldas/MG, between January 2017 and October 2018.

RESULTS

Risk factors were sadness, loneliness, problematic family relationships, losses/difficulties in emotional relationships, unemployment/financial difficulties, depressive symptoms, worsening of the feeling of depression, inability to frustration, problems in experiencing spirituality. Protective factors were family, emotional relationships, and spirituality. Suicidal behavior was related to the severity of depression, feelings of hopelessness, psychiatric comorbidities, and unemployment.

FINAL CONSIDERATIONS

Perception of risk factors was linked to family problems, sadness, loss of emotional relationships, unemployment, loneliness, and inability to experience frustrations; and the protective ones perceived were family and spirituality. There was a relationship between depressive symptoms and suicidal behavior.

Initiatives addressing precarious employment and its effects on workers' health and well-being: a protocol for a systematic review

BACKGROUND

Precarious employment is a significant determinant of population health and health inequities and has complex public health consequences both for a given nation and internationally. Precarious employment is conceptualized as a multi-dimensional construct including but not limited to employment insecurity, income inadequacy, and lack of rights and protection in the employment relation, which could affect both informal and formal workers. The purpose of this review is to identify, appraise, and synthesize existing research on the effectiveness of initiatives aiming to or having the potential to eliminate, reduce, or mitigate workers' exposure to precarious employment conditions and its effects on the health and well-being of workers and their families.

METHODS

The electronic databases searched (from January 2000 onwards) are Scopus, Web of Science Core Collection, and PubMed, along with three institutional databases as sources of grey literature. We will include any study (e.g. quantitative, qualitative, or mixed-methods design) evaluating the effects of initiatives that aim to or have the potential to address workers' exposure to precarious employment or its effects on the health and well-being of workers and their families, whether or not such initiatives were designed specifically to address precarious employment. The primary outcomes will be changes in (i) the prevalence of precarious employment and workers' exposure to precarious employment and (ii) the health and well-being of precariously employed workers and their families. No secondary outcomes will be included. Given the large body of evidence screened, the initial screening of each study will be done by one reviewer, after implementing several strategies to ensure decision-making consistency across reviewers. The screening of full-text articles, data extraction, and critical appraisal will be done independently by two reviewers. Potential conflicts will be resolved through discussion. Established checklists will be used to assess a study's methodological quality or bias. A narrative synthesis will be employed to describe and summarize the included studies' characteristics and findings and to explore relationships both within and between the included studies.

DISCUSSION

We expect that this review's findings will provide stakeholders interested in tackling precarious employment and its harmful health effects with evidence on effectiveness of solutions that have been implemented to inform considerations for adaptation of these to their unique contexts. In addition, the review will increase our understanding of existing research gaps and enable us to make recommendations to address them. Our work aligns with the sustainable development agenda to protect workers, promote decent work and economic growth, eliminate poverty, and reduce inequalities.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42020187544 .

Precarious Employment and Increased Incidence of Musculoskeletal Pain among Wage Workers in Korea: A Cross-Sectional Study

The number of precarious workers is increasing globally, and precarious employment is becoming a public concern in terms of workers' health. However, sufficient research on precarious employment and its impact on musculoskeletal pain (MSP) is lacking. This study aimed to investigate the relationship between precarious employment and the risk of MSP among Korean wage workers. After merging the data from the 4th and 5th Korean Working Conditions Surveys, 59,644 wage workers were analyzed. The control group comprised full-time permanent workers, and precarious employment was defined as workers involved in temporary or daily employment, or part-time workers. The outcome variable was the summed number of MSP in three anatomical sites (back, neck and upper limb, lower limb). Zero-inflated negative binomial analyses were selected to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) between precarious employment and MSP. In adjusted models with age, sex, educational level, income level, weekly working hours, and occupation, precarious employment was significantly associated with an increased risk of both MSP (OR 1.66 95% CI 1.56-1.77) and work-related MSP (OR 1.18 95% CI 1.11-1.25). Given the job insecurity and health inequity associated with precarious employment, special attention on precarious workers' health is needed.

Precarious Work, Health, and African-American Men: A Qualitative Study on Perceptions and Experiences

Precarious work has steadily grown in the United States since the rise of neoliberal policies. The continued expansion of this type of work has led to precarious employment as a recognized category within social determinants of health work and to a growing literature within public health research. African-American men are disproportionately vulnerable to precarious work, which in turn contributes to adverse health effects. Nevertheless, African-American men's experiences of employment and the perceived impact on their well-being remain underexplored. This study was part of the formative exploratory phase of a 5-year community-based participatory research project to examine the biopsychosocial determinants of stress among low/no-income, African-American men. Through thematic analysis of 42 semi-structured interviews, 3 themes emerged: (a) occupational hazards and health, (b) internalization of neoliberal ideology, and (c) constraints of structural factors. Neoliberal economic policies cause material deprivation and exacerbate systemic injustices that disproportionately affect communities of color. The accompanying neoliberal ideology of personal responsibility shapes men's perceptions of success and failure. Public health research must continue to push against health promotion practices that predominantly focus on individual behavior. Rather than exploring only the granularities of individual behaviors, health problems must be examined through prolonged historical, political, economic, and social disenfranchisement.