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Piekarz-Porter E, Oddo VM, Stiehl E, Kim SJ. Beyond minimum wage: Broader employment policies can significantly affect food insecurity. Transl Behav Med 2024; 14:333-337. [PMID: 38734881 DOI: 10.1093/tbm/ibae022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2024] Open
Abstract
Although many have investigated the impacts of minimum wage on a broad array of health outcomes, innovative policies surrounding broader employment policies have largely not been studied. To that end, this paper contributes in three ways. First, it discusses the rise in precarious employment. Then, it turns to the current federal framework of employment policies, namely minimum wage. Finally, it explores what a broader definition of employment policies could include and how future studies could use state, county, and municipal policymaking in this space to investigate ways in which they might contribute to reducing food insecurity and in turn, improve health outcomes.
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Affiliation(s)
- Elizabeth Piekarz-Porter
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
- University of Illinois Chicago School of Law, Chicago, Illinois, USA
| | - Vanessa M Oddo
- Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Emily Stiehl
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Sage J Kim
- Health Policy and Administration, School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
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2
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Hajat A, Andrea SB, Oddo VM, Winkler MR, Ahonen EQ. Ramifications of Precarious Employment for Health and Health Inequity: Emerging Trends from the Americas. Annu Rev Public Health 2024; 45:235-251. [PMID: 38012123 PMCID: PMC11128534 DOI: 10.1146/annurev-publhealth-071321-042437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Precarious employment (PE), which encompasses the power relations between workers and employers, is a well-established social determinant of health that has strong ramifications for health and health inequity. In this review, we discuss advances in the measurement of this multidimensional construct and provide recommendations for overcoming continued measurement challenges. We then evaluate recent evidence of the negative health impacts of PE, with a focus on the burgeoning studies from North America and South America. We also establish the role of PE in maintaining and perpetuating health inequities and review potential policy solutions to help alleviate its health burden. Last, we discuss future research directions with a call for a better understanding of the heterogeneity within PE and for research that focuses both on upstream drivers that shape PE and its impacts on health, as well as on the mechanisms by which PE causes poor health.
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Affiliation(s)
- Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, USA;
| | - Sarah B Andrea
- School of Public Health, Oregon Health and Sciences University-Portland State University, Portland, Oregon, USA
| | - Vanessa M Oddo
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Megan R Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Emily Q Ahonen
- Division of Occupational and Environmental Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USA
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3
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McDonnall MC, Cmar JL. Employment and retirement among workers who develop vision loss in midlife. Work 2024:WOR230669. [PMID: 38640188 DOI: 10.3233/wor-230669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Vision loss increases with age and is thus more likely to happen later in one's career. With more individuals working beyond typical retirement age, the possibility of experiencing vision loss while working has increased. OBJECTIVE The purpose of this study was to investigate how developing vision loss during midlife affects employment and retirement. METHOD Using longitudinal Health and Retirement Study data, we identified a sample of 167 workers, 44 to 64 years old, who developed vision loss and a matched comparison sample of 800 workers who did not. We explored job retention and retirement differences between the groups and differences between people with vision loss who retained jobs versus those who did not. RESULTS Vision loss was associated with leaving the labor force, although there was a clear trend over time of increasing likelihood of job retention. Occupational category was associated with job retention and people who continued working had more favorable financial situations. Retirees with vision loss were more likely to report involuntary retirement and dissatisfaction with retirement. CONCLUSIONS The decreasing likelihood of leaving the labor market after vision loss is an encouraging finding of this study. Workers who left the labor force after vision loss were more likely to be in precarious financial positions, and retirees did not have positive experiences with retirement. Assisting workers with vision loss to remain in the labor force is of vital importance, and increasing awareness and usage of free services for this population may reduce involuntary retirement and its negative consequences.
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Affiliation(s)
- Michele C McDonnall
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
| | - Jennifer L Cmar
- The National Research & Training Center on Blindness & Low Vision, Mississippi State University, USA
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4
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Wang M, Huang Z. A contemporary review of employee retirement. Curr Opin Psychol 2024; 55:101749. [PMID: 38043149 DOI: 10.1016/j.copsyc.2023.101749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 10/23/2023] [Accepted: 11/13/2023] [Indexed: 12/05/2023]
Abstract
As societies in many developed countries grapple with the rapid aging trend of the population, the research field of retirement has gained increasing attention. Considering the extensive scope of psychological research on retirement, in this article we focus on providing a review of recent advancements, especially those that have not been covered in existing reviews. We structure our review around four primary empirical themes in alignment with the temporal process model of retirement: retirement planning, retirement decision-making, bridge employment, as well as retirement transition and adjustment. We conclude this review with a discussion on potential future research directions.
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Affiliation(s)
- Mo Wang
- Warrington College of Business, University of Florida, United States.
| | - Zhefan Huang
- Warrington College of Business, University of Florida, United States
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5
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Kinitz DJ, Shahidi FV, Ross LE. Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study. SSM Popul Health 2023; 24:101535. [PMID: 38021458 PMCID: PMC10661442 DOI: 10.1016/j.ssmph.2023.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/23/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Background Employment outcomes among sexual minority (i.e., lesbian, gay, bisexual) workers are poorly understood, and previous research on this topic has focused almost exclusively on inequities in earnings, neglecting other important dimensions of job quality. We address this gap by describing and comparing the job quality of straight and sexual minority workers in Canada. Methods Data are from the 2016 General Social Survey: Canadians at Work and Home, the only national survey providing both a measure of sexual orientation and a multidimensional view of job quality in Canada. We identified 25 unique job quality indicators (e.g., temporary employment; job insecurity; health benefits; low income; job satisfaction; job control; discrimination). Latent class cluster analysis was used to establish a typology of job quality describing standard, flexible, and precarious employment types. We used multivariable regression methods to examine the association between sexual orientation and job quality. Results Sexual minorities reported lower job quality than their straight counterparts along many dimensions, with bisexual people reporting the lowest job quality. While inequities were generally observed among both sexual minority men and women, they sometimes differed in magnitude by gender. The prevalence of precarious employment was nearly three times higher among lesbian, gay, and bisexual workers (PR: 2.94, CI: 1.89-4.58 among all sexual minorities; PR: 3.04, CI: 1.71-5.43 among gay/lesbian workers; and PR: 2.81, CI: 1.45-5.47 among bisexual workers) compared to their straight counterparts. Conclusion Inequities in job quality among sexual minorities persist despite comprehensive human rights protections in Canada. These inequities are pervasive, extending well beyond conventional indicators such as dollars earned and hours worked. Multi-pronged interventions are needed that move beyond simply ensuring that sexual minority workers are employed. Sexual minority workers deserve access to secure, well-paid work with benefits where they can foster connection and be free from discrimination.
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Affiliation(s)
- David J Kinitz
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
| | - Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
- Institute for Work & Health, 400 University Avenue, Suite 1800, Toronto, Ontario, M5G 1S5, Canada
| | - Lori E Ross
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Room 500, Toronto, Ontario, M5T 3M7, Canada
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Melton-Fant C. Corporate influenced state preemption and health: A legal mapping analysis of workers' rights preemption bills in the US south. Soc Sci Med 2023; 336:116255. [PMID: 37742540 DOI: 10.1016/j.socscimed.2023.116255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 09/13/2023] [Accepted: 09/15/2023] [Indexed: 09/26/2023]
Abstract
Work is a structural determinant of health. As local governments have taken the lead on implementing workers' rights policies, state governments have increasingly been using preemption to block local them. These policies would improve work and employment conditions, particularly for Black, Brown, immigrant, and low-wage workers. Thus, preemption of workers' right policies is an important health equity issue. Legal epidemiology methods were used to analyze and quantify worker's rights preemption bills introduced in southern state legislatures between 2009 and 2019. Between 2009 and 2019, over 100 workers' rights preemption bills were introduced in southern state legislatures, and there was significant variation between states. Preemption of local paid leave and minimum wage ordinances were the most common. Textual analysis of the bills revealed that states prioritize the perspectives of employers instead of workers. State labor policies are prioritizing the perspectives of businesses over workers resulting in a labor environment that creates structural advantages for employers and is hostile to the well-being of workers. Preemption is part of the political and social context that is shaping the association between work and health in and is likely re (creating) racial and economic inequities.
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Affiliation(s)
- Courtnee Melton-Fant
- University of Memphis, School of Public Health, 130 Robison Hall, Memphis, TN, 38152, USA.
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7
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Eisenberg-Guyot J, Blaikie K, Andrea SB, Oddo V, Peckham T, Minh A, Owens S, Hajat A. A tutorial on a marginal structural modeling approach to mediation analysis in occupational health research: Investigating education, employment quality, and mortality. Am J Ind Med 2023; 66:472-483. [PMID: 36938776 PMCID: PMC10164112 DOI: 10.1002/ajim.23471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 01/30/2023] [Accepted: 02/20/2023] [Indexed: 03/21/2023]
Abstract
Life expectancy inequities between more- and less-educated groups have grown by 1 to 2 years over the last several decades in the United States. Simultaneously, employment conditions for many workers have deteriorated. Researchers hypothesize that these adverse conditions mediate educational inequities in mortality. However, methodological barriers have impeded research on the role of employment conditions and other hazards as mediating factors in health inequities. Indeed, traditional mediation analysis methods are often biased in occupational health settings, including in those with exposure-mediator interactions and mediator-outcome confounders that are caused by exposure. In this paper, we outline-and provide code for-a marginal structural modeling (MSM) approach for estimating total effects and controlled direct effects originally proposed elsewhere, which can be applied to common mediation analysis settings in occupational health research. As an example, we apply our approach to assess the extent to which disparities in employment quality (EQ)-a multidimensional construct characterizing the terms and conditions of the worker-employer relationship-explained educational inequities in mortality in a 1999-2015 US Panel Study of Income Dynamics sample of workers with mortality follow-up through 2017. Under certain strong assumptions described in the text, our estimates suggest that over 70% of the educational inequity in mortality would have been eliminated if EQ had been at the 80th percentile (100th = best) across exposure groups.
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Affiliation(s)
- Jerzy Eisenberg-Guyot
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Kieran Blaikie
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
| | - Sarah B. Andrea
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, OR, USA
| | - Vanessa Oddo
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Trevor Peckham
- Department of Environmental and Occupational Health Services, School of Public Health, University of Washington, Seattle, WA, USA
| | - Anita Minh
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
- School of Population and Public Health, University of British Columbia, Vancouver, BC, CA
| | - Shanise Owens
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA
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Lu P, Kezios K, Milazzo F, Jawadekar N, Shelley M, Zeki Al Hazzouri A. Racial Differences in Employment and Poverty Histories and Health in Older Age. Am J Prev Med 2023; 64:543-551. [PMID: 36642644 DOI: 10.1016/j.amepre.2022.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 10/19/2022] [Accepted: 10/27/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Black Americans encounter more barriers in the job market and earn less than White Americans. However, the extent to which racial disparities in employment and poverty histories impact health is not fully understood. This study characterized employment‒poverty histories for Black and White middle-aged adults and examined their association with health. METHODS Respondents born in 1948-1953 and enrolled in the 2004 Health and Retirement Study (NBlack=555, NWhite=2,209) were included. Sequence analysis grouped respondents with similar employment‒poverty trajectories from 2004 to 2016, and confounder-adjusted regression analyses estimated the associations between these trajectories and health in 2018. Analyses were conducted in 2021-2022. RESULTS More than 23% of Black respondents experienced both employment and poverty fluctuations, including bouts of extreme poverty (<50% of the federal poverty threshold), whereas no trajectory for White respondents included extreme poverty. Adversities in employment‒poverty were associated with worse health. For example, among Black respondents, those who experienced both employment and poverty fluctuations had worse cognition than those employed and not poor (β= -0.55 standardized units, 95% CI= -0.81, -0.30). Similarly, among White respondents, those who experienced employment fluctuations had worse cognition than those employed (β= -0.35, 95% CI= -0.46, -0.24). Notably, the employed and not poor trajectory was associated with worse survival among Black respondents than among White respondents. CONCLUSIONS Employment fluctuations were associated with worse health, especially cognitive function, where the association was stronger among Black Americans who experienced both employment fluctuations and poverty. Findings highlight the importance of enhancing employment stability and of antipoverty programs, especially for Black Americans.
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Affiliation(s)
- Peiyi Lu
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York.
| | - Katrina Kezios
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Floriana Milazzo
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Neal Jawadekar
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Mack Shelley
- Department of Political Science, Iowa State University, Ames, Iowa; Department of Statistics, Iowa State University, Ames, Iowa
| | - Adina Zeki Al Hazzouri
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
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9
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Zhuang CC, Jones-Smith JC, Andrea SB, Hajat A, Oddo VM. Maternal precarious employment and child overweight/obesity in the United States. Prev Med 2023; 169:107471. [PMID: 36870570 PMCID: PMC10041450 DOI: 10.1016/j.ypmed.2023.107471] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/09/2023] [Accepted: 02/23/2023] [Indexed: 03/06/2023]
Abstract
Precarious employment has increased in the United States and is now recognized as an important social determinant of health. Women are disproportionately employed in precarious jobs and are largely responsible for caretaking, which could deleteriously affect child weight. We utilized data from the National Longitudinal Survey of Youth adult and child cohorts (1996-2016; N = 4453) and identified 13 survey indicators to operationalize 7 dimensions of precarious employment (score range: 0-7, 7 indicating the most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relations, and training. We estimated the association between maternal precarious employment and incident child overweight/obesity (BMI ≥85th percentile) using adjusted Poisson models. Between 1996 and 2016, the average age-adjusted precarious employment score among mothers was 3.7 (Standard Error [SE] = 0.02) and the average prevalence of children with overweight/obesity was 26.2% (SE = 0.5%). Higher maternal precarious employment was associated with a 10% higher incidence of children having overweight/obesity (Confidence Interval: 1.05, 1.14). A higher incidence of childhood overweight/obesity may have important implications at the population-level, due to the long-term health consequences of child obesity into adulthood. Policies to reduce employment precariousness should be considered and monitored for impacts on childhood obesity.
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Affiliation(s)
- Castiel Chen Zhuang
- Peking University School of Economics, Beijing, China; University of Washington, Department of Economics, WA, USA
| | - Jessica C Jones-Smith
- University of Washington School of Public Health, Department of Health Systems and Population Health, Seattle, WA, USA; University of Washington School of Public Health, Department of Epidemiology, Seattle, WA, USA
| | - Sarah B Andrea
- Oregon Health & Science University-Portland State University, School of Public Health, Portland, OR, USA
| | - Anjum Hajat
- University of Washington School of Public Health, Department of Epidemiology, Seattle, WA, USA
| | - Vanessa M Oddo
- University of Illinois Chicago, College of Applied Health Sciences, Department of Kinesiology and Nutrition, Chicago, IL, USA.
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Rauvola RS, Rudolph CW. Worker aging, control, and well-being: A specification curve analysis. Acta Psychol (Amst) 2023; 233:103833. [PMID: 36623471 DOI: 10.1016/j.actpsy.2023.103833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 12/14/2022] [Accepted: 01/05/2023] [Indexed: 01/09/2023] Open
Abstract
Among the many work (and life) characteristics of relevance to adult development and aging, various forms of control are some of the most extensively and diversely studied. Indeed, "control," whether objectively held (i.e., "actual" control), perceived, or enacted through self-regulation, is a concept central to our understanding of person-environment interactions, development, and well-being within and across life domains. However, variability in conceptualization and analysis in the literature on control presents challenges to integration. To partially address these gaps, the present study sought to explore the effects of conceptual and analytical specification decisions (e.g., construct types, time, covariates) on observed control-well-being relationships in a large, age-diverse, longitudinal sample (Midlife in the United States I, II, and III datasets), providing a specification curve analysis (SCA) tutorial and guidance in the process. Results suggest that construct types and operationalizations, particularly predictor variables, have bearing on observed results, with certain types of control serving as better predictors of various forms of well-being than others. These findings and identified gaps are summarized to provide direction for theoretical clarification and reconciliation in the control and lifespan development literatures, construct selection and operationalization in future aging and work research, and inclusive, well-specified interventions to improve employee well-being.
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Affiliation(s)
| | - Cort W Rudolph
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA
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11
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Changes in Precarious Employment and Health in the United States Amidst the COVID-19 Pandemic. Prev Med Rep 2023; 31:102113. [PMID: 36688136 PMCID: PMC9841738 DOI: 10.1016/j.pmedr.2023.102113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/07/2023] [Accepted: 01/14/2023] [Indexed: 01/17/2023] Open
Abstract
This study aimed to investigate the association between changes in employment precarity and changes in health amidst the COVID-19 pandemic. We conducted an online survey of 623 U.S. adults at-risk for cardiovascular disease, which queried respondents on employment, food insecurity, and blood pressure measurements in the Fall of 2020 and retrospectively, in February 2020. Respondents were also queried on perceived stress in the Fall of 2020. We created a multidimensional precarious employment score (PES) using 13 survey indicators, that operationalized the following dimensions of employment precarity (PES range: 0-13): material rewards, working time arrangements, employment stability, workers' rights, collective organization, interpersonal relations, and training opportunities. Using adjusted linear regression models, we investigated the association between a change in the PES and 1) change in systolic blood pressure, 2) change in pulse pressure, 3) change in food insecurity, and 4) perceived stress. Models controlled for race/ethnicity, age, gender, and education. Results indicated that employment precarity was 13 % higher between February and Fall 2020, particularly among women and non-Hispanic Black respondents. A change in the PES was associated with a change in food insecurity ( β : 0.02; 95 % CI:0.01, 0.03) and higher perceived stress ( β : 0.39; 95 % CI:0.25, 0.53). The PES was not associated with a change in systolic blood pressure ( β : -0.22; 95 % CI:-0.76, 0.32) nor in pulse pressure ( β : -0.33; 95 % CI: -0.73, 0.07). Policy approaches to mitigate the growth in employment precarity, and in turn food insecurity and stress, warrant consideration to prevent widening of health inequities.
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12
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Oddo VM, Zhuang CC, Dugan JA, Andrea SB, Hajat A, Peckham T, Jones-Smith JC. Association between precarious employment and BMI in the United States. Obesity (Silver Spring) 2023; 31:234-242. [PMID: 36541156 PMCID: PMC9782712 DOI: 10.1002/oby.23591] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/01/2022] [Accepted: 08/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE There is growing recognition that precarious employment is an important determinant of health, which may increase BMI through multiple mechanisms, including stress. It was investigated whether increases in precarious employment were associated with changes in BMI in the United States. METHODS Data were from the National Longitudinal Survey of Youth adult cohort (1996-2016) (N = 7280). Thirteen indicators were identified to operationalize seven dimensions of precarious employment (range: 0-7, 7 indicating most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relationships, and training. The precarious employment-BMI association was estimated using linear regression models and an instrumental variables approach; state- and individual-level firm sizes were the instruments for precarious employment. Models also included individual and year fixed effects and controlled for age, marital status, education, region, and industry. RESULTS The average precarious employment score (PES) was 3.49 (95% CI: 3.46-3.52). The PES was the highest among Hispanic (4.04; 95% CI: 3.92-4.15) and non-Hispanic Black (4.02; 95% CI: 3.92-4.12) women with lower education. A 1-point increase in the PES was associated with a 2.18-point increase in BMI (95% CI: 0.30-4.01). CONCLUSIONS Given that even small changes in weight affect chronic disease risk, policies to improve employment quality warrant consideration.
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Affiliation(s)
- Vanessa M Oddo
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois Chicago, Chicago, Illinois, USA
| | - Castiel Chen Zhuang
- Department of Economics, University of Washington, Seattle, Washington, USA
- School of Economics, Peking University, Beijing, China
| | - Jerome A Dugan
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
| | - Sarah B Andrea
- Oregon Health & Science University-Portland State University School of Public Health, Portland, Oregon, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
| | - Trevor Peckham
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
| | - Jessica C Jones-Smith
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, Washington, USA
- Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
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13
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Baron S, Cuervo I, Winkel G, Flores D, Gonzalez A, Harari H. Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15973. [PMID: 36498045 PMCID: PMC9741237 DOI: 10.3390/ijerph192315973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners' EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners' exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers' rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners' employment quality.
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Affiliation(s)
- Sherry Baron
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Isabel Cuervo
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, NY 11367, USA
| | - Gary Winkel
- Population Health Science and Policy Department, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | | | | | - Homero Harari
- Selikoff Centers for Occupational Health, Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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14
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Peckham T, Seixas N, de Castro AB, Hajat A. Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811237. [PMID: 36141509 PMCID: PMC9517248 DOI: 10.3390/ijerph191811237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/16/2022] [Accepted: 09/02/2022] [Indexed: 06/12/2023]
Abstract
Compared to recent generations, workers today generally experience poorer quality employment across both contractual (e.g., wages, hours) and relational (e.g., participation in decision-making, power dynamics) dimensions within the worker-employer relationship. Recent research shows that women are more likely to experience poor-quality employment and that these conditions are associated with adverse health effects, suggesting employment relations may contribute to gender inequities in health. We analyzed data from the General Social Survey (2002-2018) to explore whether the multidimensional construct of employment quality (EQ) mediates the relationship between gender and health among a representative, cross-sectional sample of U.S. wage earners. Using a counterfactually-based causal mediation framework, we found that EQ plays a meaningful role in a gender-health relationship, and that if the distribution of EQ among women was equal to that observed in men, the probability of reporting poor self-reported health and frequent mental distress among women would be lower by 1.5% (95% Confidence Interval: 0.5-2.8%) and 2.6% (95% CI: 0.6-4.6%), respectively. Our use of a multidimensional, typological measure of EQ allowed our analysis to better account for substantial heterogeneity in the configuration of contemporary employment arrangements. Additionally, this study is one of the first mediation analyses with a nominal mediator within the epidemiologic literature. Our results highlight EQ as a potential target for intervention to reduce gender inequities in health.
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Affiliation(s)
- Trevor Peckham
- Hazardous Waste Management Program in King County, Seattle, WA 98104, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - Noah Seixas
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA 98195, USA
| | - A. B. de Castro
- School of Nursing, University of Washington, Seattle, WA 98195, USA
| | - Anjum Hajat
- Department of Epidemiology, University of Washington, Seattle, WA 98195, USA
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Fujishiro K, Ahonen EQ, Winkler M. Investigating Employment Quality for Population Health and Health Equity: A Perspective of Power. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169991. [PMID: 36011625 PMCID: PMC9408001 DOI: 10.3390/ijerph19169991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 05/31/2023]
Abstract
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.
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Affiliation(s)
- Kaori Fujishiro
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH 45226, USA
| | - Emily Q. Ahonen
- Division of Occupational and Environmental Health, Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA
| | - Megan Winkler
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
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Andrea SB, Eisenberg-Guyot J, Blaikie KJ, Owens S, Oddo VM, Peckham T, Minh A, Hajat A. The inequitable burden of the COVID-19 pandemic among marginalized older workers in the United States: an intersectional approach. J Gerontol B Psychol Sci Soc Sci 2022; 77:1928-1937. [PMID: 35863041 PMCID: PMC9384534 DOI: 10.1093/geronb/gbac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives The COVID-19 pandemic has profoundly affected the lives of people globally, widening long-standing inequities. We examined the COVID-19 pandemic’s impact on employment conditions by race/ethnicity, gender, and educational attainment and the association between such conditions and well-being in older adults in the United States. Methods Using data from the Health and Retirement Study respondents interviewed between May 2020 and May 2021 when they were ≥55 years of age, we examined intersectional patterns in COVID-19-related changes in employment conditions among 4,107 participants working for pay at the start of the pandemic. We also examined the compounding nature of changes in employment conditions and their association with financial hardship, food insecurity, and poor self-rated health. Results Relative to non-Hispanic White men with greater than high school education (>HS), Black and Latinx men and women were more likely to experience job loss irrespective of education; among those who did not experience job loss, men with ≤HS reporting Black, Latinx, or “other” race were >90% less likely to transition to remote work. Participants who experienced job loss with decreased income or continued in-person employment with decreased income/shift changes had greater prevalence of financial hardship, food insecurity, and poor/fair self-rated health than others. Discussion The impact of COVID-19 on employment conditions is inequitably patterned and is associated with financial hardship, food insecurity, and adverse health in older adults. Policies to improve employment quality and expand social insurance programs among this group are needed to reduce growing inequities in well-being later in life.
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Affiliation(s)
| | | | - Kieran J Blaikie
- University of Washington School of Public Health, Department of Epidemiology, Seattle, WA
| | - Shanise Owens
- University of Washington School of Public Health, Department of Epidemiology, Seattle, WA
| | - Vanessa M Oddo
- University of Illinois Chicago, Department of Kinesiology and Nutrition, Chicago, IL, USA
| | - Trevor Peckham
- University of Washington School of Public Health, Department of Environmental and Occupational Health Sciences, Seattle, WA, USA
| | - Anita Minh
- University of Washington School of Public Health, Department of Epidemiology, Seattle, WA.,University of British Columbia, Department of Sociology, Vancouver, BC, Canada
| | - Anjum Hajat
- University of Washington School of Public Health, Department of Epidemiology, Seattle, WA
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