Diversity patterns in non-standard employment and their relationship with self-rated health in urban China from 2010 to 2021

In recent decades, the rise of non-standard employment in China is thought to profoundly influence workers' health. Using data from the China General Social Survey 2010-2021, this study compares the self-rated health of workers engaged in various non-standard employment types with those in unemployment or standard employment in urban China. The research also investigates how these patterns have evolved over time among urban residents with different hukou types amid the expansion of China's welfare system and labor market shifts. We find that while unemployment is significantly related to worse self-rated health, the effects vary across different types of non-standard employment. Precarious employment has a more substantial adverse effect on health than part-time and self-employment, although the effect is less severe than that of unemployment. Between 2010 and 2018, the health impact of precarious employment declined, aligning with China's enhanced welfare system. However, its negative effect re-emerged in 2021. These patterns are particularly pronounced for urban residents holding agricultural hukou, highlighting the intersection of non-standard employment with the household registration system in shaping health outcomes within evolving labor markets.

Precarious employment and mental health in the Belgian service voucher system: the role of working conditions and perceived financial strain

INTRODUCTION

Jobs in domestic cleaning are often conceived as 'precarious employment' (PE)-i.e. a multidimensional concept referring to accumulated adverse characteristics of employment due to workers' weak bargaining position. Against this background, the Belgian service voucher system (SVS) was implemented aimed at creating formal and stable, subsidized domestic services jobs.

PURPOSE

The current study assesses the relationship between PE and mental health (WHO5) in the Belgian SVS, accounting for the potential mediating role of working conditions and perceived financial strain at the household level.

METHODS

We analysed a cross-sectional sample of 1,115 Belgian SVS domestic cleaners, collected in 2019 through an online survey. A mediation model was estimated.

RESULTS

The crude effect of PE on adverse mental health was strong (ß 0.545-S.E. 0.063). However, 50% of the association between PE and mental well-being was mediated by work task characteristics (quantitative demands, physical demands, task variation and autonomy) and 25% by household-level perceived financial strain. The remaining direct effect of PE on adverse mental well-being is ß 0.066 (S.E. 0.032-25% of the total effect).

CONCLUSION

These findings are the first based on the Belgian Employment Precariousness Scale (EPRES-BE) and are consistent with earlier-made-but seldom simultaneously tested-assumptions on the mechanisms relating PE to adverse mental health-i.e. involving direct associations and indirect associations via adverse working conditions and material deprivation. Based on the results, we recommend more democratic and higher-quality management practices in the SVS, in addition to higher wages and working time reduction.

What is the impact of job precariousness on depression? Risk assessment and attributable fraction in Spain

OBJECTIVES

The prevalence of depression related to precarious employment (PE) has become a significant public health concern, given the declining trend of the standard employment relationship. Research has focused on the mental health detrimental effects of employment conditions, whereas there is scarce evidence concerning the burden of depression that could be prevented by targeting precariousness. This paper estimates the impact of PE on the risk of depression and the attributable fraction within the active and working salaried population in Spain.

STUDY DESIGN

Observational cross-sectional on data drawn from the Spanish portion of European Health Survey 2020.

METHODS

After applying selection criteria and descriptives, binary logistic regression models stratified by sex are used to examine the associations between a 9-categories combination of employment precariousness and occupational social class, and depressive symptoms.

RESULTS

There is a higher risk of depression among individuals in PE and among those who are unemployed, with a notable gradient based on occupational social class for women. Adjusting by sex, age and foreign-born origin, we estimate that approximately 15.0% (95% confidence interval [CI]: 1.0%-26.2%) of depression cases among the working population and 33.3% (95% CI: 23.2%-43.2) among the active population can be attributed to PE.

CONCLUSIONS

These findings highlight the public health impact of PE on mental health, provide evidence to estimate the economic burden linked to employment-related mental health, and underscore the need for policy changes and interventions at the level of labour markets and workplaces to mitigate the detrimental effects of PE.

The gendered associations between precarious employment and mental health in working-age Australians: A longitudinal analysis using 16 waves of the HILDA survey

Unemployment and precarious employment (PE) are routinely found to be associated with poorer mental health. Importantly, women are over-represented in PE (due to disproportionate unpaid care demands), yet a gender lens has been lacking in much of the extant literature. This study addresses several gaps by reconsidering how PE can be conceptualised from a gender perspective and examining the impact of differing levels of multidimensional PE on the mental health of working-age Australians. Utilising sixteen annual waves (2005-2020) of the HILDA survey, this longitudinal study employed mixed-effects analysis and Mundlak modelling to examine the association between PE and mental health in working-age (25-64yrs) adults. Mental health was assessed using the MHI-5 scale. A multidimensional PE scale (based on objective and subjective indicators) was developed and three levels of precarity were modelled. 19,442 participants were included in the analyses and all models were stratified by gender. We found women experience greater exposure to PE in Australia, and our results showed a ubiquitously strong and negative association between PE and mental health in both women and men, across all levels of PE, with a dose dependent association observed with increasing PE. Additional adjustment for prior mental health slightly attenuated effect sizes, but the strength and direction of all associations were unchanged. This study provides longitudinal evidence of the detrimental impact of PE on the mental health of working age Australians, highlighting the importance of labour regulations and employment policies to minimize PE for all adults. However, given women's differential exposure to PE, this study also reinforces the urgent need for gender-sensitive social policies to address continued inequity in the division of unpaid household labour to promote a more equitable paid labour market into the future.

The Employment Quality of Persons with Disabilities: Findings from a National Survey

PURPOSE

Labour market integration is a widely accepted strategy for promoting the social and economic inclusion of persons with disabilities. But what kinds of jobs do persons with disabilities obtain following their integration into the labour market? In this study, we use a novel survey of workers to describe and compare the employment quality of persons with and without disabilities in Canada.

METHODS

We administered an online, cross-sectional survey to a heterogeneous sample of workers in Canada (n = 2,794). We collected data on sixteen different employment conditions (e.g., temporary contract, job security, flexible work schedule, job lock, skill match, training opportunities, and union membership). We used latent class cluster analysis to construct a novel typology of employment quality describing four distinct 'types' of employment: standard, portfolio, instrumental, and precarious. We examined associations between disability status, disability type, and employment quality.

RESULTS

Persons with disabilities reported consistently lower employment quality than their counterparts without disabilities. Persons with disabilities were nearly twice as likely to report low-quality employment in the form of either instrumental (i.e., secure but trapped) or precarious (i.e., insecure and unrewarding) employment. This gap in employment quality was particularly pronounced for those who reported living with both a physical and mental/cognitive condition.

CONCLUSION

There are widespread inequalities in the employment quality of persons with and without disabilities in Canada. Policies and programs aiming to improve the labour market situation of persons with disabilities should emphasize the importance of high-quality employment as a key facet of social and economic inclusion.

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.

Job quality and precarious employment among lesbian, gay, and bisexual workers: A national study

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.

To what extent do job insecurity, income satisfaction, and self-rated health mediate the association between low income and presenteeism in Germany? A gendered analysis

PURPOSE

Low income is considered a possible determinant of presenteeism, explained by poor working and living conditions, increased levels of uncertainties and anxiety, and poor health status. We aimed to examine the association between low income and presenteeism by gender and to explain their association using different mediators.

METHODS

A total of 14,299 employees aged 18-65 from the 6th BIBB/BAuA Employment Survey 2012 were used, and mediation analyses with inverse odds weighting stratified by gender were conducted.

RESULTS

Low income was significantly associated with presenteeism for men at a significant level of α < .05 (β: 0.376; 95%-CI 0.148-0.604) and for women at a significant level of α < .10 (β: 0.120; 95%-CI - 0.015-0.255). The total effect (TE) was fully and significantly mediated for women when all mediator-weights were considered, whereas for men the consideration of single mediator-weights led to a full and significant mediation of the association between low income and presenteeism. Self-rated health status and income satisfaction contributed the most to the differences in presenteeism by low income with a proportion mediated of 96.3% (men) and 169.2% (women) for self-rated health and 101.6% (men) and 162.5% (women) for income satisfaction.

DISCUSSION

The results indicated a strong association between low income and presenteeism, in particular for men. Self-rated health and income satisfaction were the most important mediators of this association. The results underline not only the relevance of occupational health management and preventive measures, but also the need of a public debate about employment traditions, possibly resulting in role conflicts among men, and wage equality to prevent presenteeism of low-income earners.

"When there is no money, that is when I vomit blood": the domino effect and the unfettered lethal exploitation of Black labor on Dominican sugar plantations

BACKGROUND

In this article, I utilize the concept of the Plantationocene as an analytical framework to generate a holistic and historical understanding of the present-day struggles of a mostly Haitian migrant workforce on sugar plantations in the Dominican Republic.

METHODS

Inspired by Paul Farmer's methodology, I combine political economy, history, and ethnography approaches to interpret the experiences of sugarcane cutters across historical and contemporary iterations of colonial, post-colonial, and neo-colonial practices over the course of five centuries.

RESULTS

My findings elucidate the enduring power of capitalism, implicating corporate and state elites, as the structural scaffolding for acts of racialized violence that condition the life-and-death circumstances of Black laborers on Caribbean plantations to this day. Although today's sugarcane cutters may suffer differently than their enslaved or wage labor ancestors on the plantation, I argue that an unfettered racialized pattern of lethal exploitation is sustained through the structural violence of neoliberalism that links present conditions with the colonial past.

CONCLUSIONS

Ultimately, this paper contributes understandings of the plantationocene's enduring effects in the global south by demonstrating how imperialist arrangements of capitalism are not a distant memory from the colonial past but instead are present yet hidden and obscured while relocated and reanimated overseas to countries like the Dominican Republic, where American capitalists still exploit Black bodies for profit and power.

[Working poverty and self-rated health during the COVID-19 pandemic: a comparative study over time using 1995-2021 Socioeconomic Panel data]

BACKGROUND

The working poor are considered a vulnerable group. This study examines whether health disparities between working-poor and non-working-poor workers have worsened in the wake of the COVID-19 pandemic by comparing them over time with earlier periods of economic crisis and social and labor market policy reform.

METHODS

The analyses are based on the Socioeconomic Panel (SOEP, 1995-2020) and the Special Survey on Socioeconomic Factors and Consequences of the Spread of Coronavirus in Germany (SOEP-CoV, 2020-2021). All employed persons aged 18-67 years were considered for the analyses to calculate the risks of poor subjective health due to working poverty using pooled logistic regression by sex.

RESULTS

Subjective health improved during the COVID-19 pandemic. Differences in health between the working poor and those who were not working poor remained relatively constant between 1995 and 2021. Individuals who were more likely to be in working poverty over time had the highest risk of inadequate health. The health disparities associated with the frequency of working poverty increased over time and peaked for both sexes in the pandemic. Significant sex differences were not identified.

DISCUSSION

This study illustrates the social embeddedness of working poverty as a determinant of poor health. In particular, those who were more likely to experience working poverty during their working lives are considered to be particularly vulnerable to inadequate health. Tendentially, the COVID-19 pandemic appears to reinforce this gradient in health.

Effect of trajectory of employment status on all-cause mortality in the late middle-aged and older population: results of the Korea Longitudinal Study of Aging (2006-2020)

OBJECTIVES

This study conducted a longitudinal analysis of the effect of trajectory of employment status (TES) on all-cause mortality in late middle-aged and older Koreans based on the Korean Longitudinal Study of Aging (KLoSA).

METHODS

After excluding missing values, data on 2,774 participants were analyzed using the chi-square test and the group-based trajectory model (GBTM) for data from the first to fifth KLoSA and the chi-square test, log-rank test, and Cox proportional hazard regression for data from the fifth to eighth KLoSA.

RESULTS

The GBTM analysis identified 5 TES groups: sustained white collar (WC; 18.1%), sustained standard blue collar (BC; 10.8%), sustained self-employed BC (41.1%), WC to job loss (9.9%), and BC to job loss (20.1%). Compared to the sustained WC group, the WC to job loss group had higher mortality at 3 years (hazard ratio [HR], 4.04, p=0.044), 5 years (HR, 3.21, p=0.005), and 8 years (HR, 3.18, p<0.001). The BC to job loss group had higher mortality at 5 years (HR, 2.57, p=0.016) and 8 years (HR, 2.20, p=0.012). Those aged 65 years and older and males in the WC to job loss and BC to job loss groups had an increased risk of death at 5 years and 8 years.

CONCLUSIONS

There was a close association between TES and all-cause mortality. This finding highlights the need for policies and institutional measures to reduce mortality within vulnerable groups with an increased risk of death due to a change in employment status.

A cross-sectional analysis of work schedule notice and depressive symptoms in the United States

The implementation of last-minute work scheduling practices, including fluctuations in work hours, shift cancellations, and short notice, reflects a new norm in employment in the United States. This study aimed to investigate whether work schedule notice of ≤2 weeks was associated with high depressive symptoms. We used data from the 2019 cycle of the National Longitudinal Survey of Youth 1997 (N = 4963 adults aged 37-42 years). Using adjusted gender-stratified modified Poisson models, we tested the association between schedule notice (≤2 weeks, >2 weeks, consistent scheduling) and high depressive symptoms. Presence of high depressive symptoms was assessed using the 7-item Center for Epidemiologic Studies Depression (CES-D) Short-Form scale and defined as CES-D-SF ≥8. Respondents reporting >2 weeks schedule notice (versus ≤2 weeks) were disproportionately non-Hispanic Black or Hispanic and resided in the South and/or in a rural area. High depressive symptoms were 39% more prevalent among women with schedule notice of ≤2 weeks compared to those with >2 weeks notice (Prevalence Ratio [PR]: 1.39, 95% Confidence Interval (CI): 1.07, 1.80). We did not observe an association among men (PR: 1.06, 95% CI: 0.75, 1.50). Schedule notice of ≤2 weeks was associated with a greater burden of high depressive symptoms among US women. Policies to reduce precarious work scheduling practices should be further evaluated for their impacts on mental health.

Health effects of informal precarious workers in occupational environments with high exposure to pollutants

The aim is to investigate and describe the health conditions of workers who are employed in precarious work settings in Mexico. Specifically, the study aims to provide insight on the health status of workers who are vulnerable due to the informal nature of their employment. Through the evaluation of three different scenarios of precarious employment (n = 110), including workers in mercury miner (workers A), brick-kilns (workers B), and quarries workers (workers C). The study analyzes clinical parameters to determine the workers' renal health condition and assesses their pulmonary function using spirometry. Multivariate analyses and Spearman correlation are performed to determine the contribution of length of service to workers' health parameters. Workers B have the highest incidence of clinical health alterations, with the highest BMI and prediabetes/diabetes index, albumin creatinine ratio, and eGFR. Moreover, pulmonary function parameters show a decrease in %FEV1/FVC in workers B and C compared to workers A, while workers A demonstrate a more significant decrease in %FEV1. Additionally, a negative correlation is observed between the length of service in precarious work settings and lung parameters (r = -0.538, p < 0.001). In conclusion, this study highlights the need to address the issue of precarious employment in Mexico by improving working conditions, access to healthcare and promoting social protection for workers, which can reduce the number of work-related illnesses and deaths and ensure the safety and health of workers.

Employment Insecurity and Material Deprivation in Families with Children in the Post-Great Recession Period: An Analysis for Spain and Portugal

The aim of this paper is to analyse the relationship between household employment insecurity and the risk of children's exposure to household material deprivation in Spain and Portugal. Specifically, using EU-SILC microdata for 2012, 2016 and 2020, it examines how this relationship evolved during the Post-Great Recession period. Although in both countries there was an improvement in the employment situation of individuals and families after the Great Recession, the main findings reflect an increase in the risk of children's exposure to material deprivation in households where no adults have a secure job. However, there are some differences between the two countries. In the case of Spain, the results seem to indicate that the incidence of household employment insecurity on material deprivation was higher in 2016 and 2020 than in 2012. In Portugal, the increase in the effect of employment insecurity on deprivation seems to have occurred only in 2020, the year the Covid-19 pandemic began.

"I grabbed my stuff and walked out": Precarious workers' responses and next steps when faced with procedural unfairness during work injury and claims processes

PURPOSE

Injured workers can experience adverse effects from work injury and claims processes.Workers may be treated unfairly by employers, compensation boards, and return-to-work coordinators; however,how workers respond to these challenges is unknown. This article describes how injured precarious workersresponded behaviourally and emotionally to procedural unfairness in work injury and claims processes, and whatworkers did next.

METHODS

Interviews were conducted with thirty-six precariously employedinjured workers recruited in Ontario through social media, email, cold calling, word-of-mouth, and the "snowball"method. Thematic code summaries were analyzed to identify how precarious workers responded to procedural unfairness.

RESULTS

Workers went through all or most of these five stages (not always linearly)when faced with procedural unfairness: (1) passive, (2) fought back, (3) quit pursuit of claim, (4) quit job, and (5)won or got further in fight. Feeling confused, angry, frustrated, unsupported, disappointed, determined, optimistic,and wary were common emotions.

CONCLUSIONS

Identifying unfairness and its emotional,behavioral, and material effects on workers is important to understand implications for compensation systems.Understanding and recognizing unfairness can equip employers, legal representatives, compensation boards, andphysicians, to address and prevent it, and provide worker resources. Policy changes can ensure accountability andconsequences to unfairness initiators.

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.

Employment trajectories and mental health-related disability in Belgium

OBJECTIVES

An individual's quality of employment over time has been highlighted as a potential determinant of mental health. With mental ill-health greatly contributing to work incapacities and disabilities in Belgium, the present study aims to explore whether mental health, as indicated by registered mental health-related disability, is structured along the lines of employment quality, whereby employment quality is assessed over time as part of individuals' labour market trajectories.

METHODS

Using administrative data from the Belgian Crossroads Bank for Social Security over 16 quarters between 2006 and 2009, transitions between waged jobs of varying quality (based on dimensions of income, working time, employment stability and multiple jobholding), self-employment, and unemployment are considered among individuals in the labour force aged 30-40 at baseline (n = 41,065 women and 45,667 men). With Multichannel Sequence Analysis and clustering, we constructed ideal types of employment trajectories. Fitting Cox regressions, we then evaluated individuals' hazard of experiencing a disability from a mental disorder between 2010 and 2016.

RESULTS

Our analysis highlights various gender-specific trajectories. Among both genders, individuals exposed to near-constant unemployment over the initial 4 years showed the highest hazard of subsequent mental health-related disability compared to a group characterised by stable full-time employment, single jobholding, and above-median income. Trajectories involving a higher probability of subsidised and non-standard employment and (potential) spells of unemployment and lower relative income were also strong predictors of cause-specific disabilities. Health selection and confounding might, however, be contributing factors.

CONCLUSIONS

Our study shows a gradient of mental disorders resulting in a disability along trajectory types. Our findings highlight the predictive power of labour market trajectories and their employment quality for subsequent mental disorder-related disability. Future research should examine the mechanisms, including selection effects in this association.

Fear of Job Loss and Hypertension Prevalence Among Working Latino Adults

Evidence indicates that stress increases cardiovascular disease risk. Latinos are disproportionately employed in precarious work conditions that can trigger hypertension risk. We examined if fear of job loss, a work stressor, was associated with hypertension among U.S. Latinos. We utilized 2015 National Health Interview Survey data from working Latino adults (n = 2683). In multivariate logistic regression models, we examined if fear of job loss was associated with hypertension, adjusting for age, sex, education, household income, and health insurance, and whether nativity status modified this relationship. Fear of job loss was significantly associated with increased probability of reporting hypertension among Latino workers in fully adjusted models (PR 1.55, 95% CI 1.18-2.03), compared with no fear of job loss. This relationship varied by nativity. These findings suggest that work-related conditions may contribute to cardiovascular disease risk among Latinos and public health initiatives should promote behavioral interventions in work settings.

Employment conditions as barriers to the adoption of COVID-19 mitigation measures: how the COVID-19 pandemic may be deepening health disparities among low-income earners and essential workers in the United States

Background

The COVID-19 pandemic has disproportionately impacted economically-disadvantaged populations in the United States (US). Precarious employment conditions may contribute to these disparities by impeding workers in such conditions from adopting COVID-19 mitigation measures to reduce infection risk. This study investigated the relationship between employment and economic conditions and the adoption of COVID-19 protective behaviors among US workers during the initial phase of the COVID-19 pandemic.

Methods

Employing a social media advertisement campaign, an online, self-administered survey was used to collect data from 2,845 working adults in April 2020. Hierarchical generalized linear models were performed to assess the differences in engagement with recommended protective behaviors based on employment and economic conditions, while controlling for knowledge and perceived threat of COVID-19, as would be predicted by the Health Belief Model (HBM).

Results

Essential workers had more precarious employment and economic conditions than non-essential workers: 67% had variable income; 30% did not have paid sick leave; 42% had lost income due to COVID-19, and 15% were food insecure. The adoption of protective behaviors was high in the sample: 77% of participants avoided leaving home, and 93% increased hand hygiene. Consistent with the HBM, COVID-19 knowledge scores and perceived threat were positively associated with engaging in all protective behaviors. However, after controlling for these, essential workers were 60% and 70% less likely than non-essential workers, who by the nature of their jobs cannot stay at home, to stay at home and increase hand hygiene, respectively. Similarly, participants who could not afford to quarantine were 50% less likely to avoid leaving home (AOR: 0.5; 95% CI: 0.4, 0.6) than those who could, whereas there were no significant differences concerning hand hygiene.

Conclusions

Our findings are consistent with the accumulating evidence that the employment conditions of essential workers and other low-income earners are precarious, that they have experienced disproportionately higher rates of income loss during the initial phase of the COVID-19 pandemic and face significant barriers to adopting protective measures. Our findings underscore the importance and need of policy responses focusing on expanding social protection and benefits to prevent the further deepening of existing health disparities in the US.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13259-w.

A preliminary study on health impacts of Mexican mercury mining workers in a context of precarious employment

Mercury mining is one of the main sources of mercury (Hg) release into the environment, causing serious impacts on human health and the environment. Workers in these mines are employed informally and precariously and therefore lack labor rights such as social security. The objective of the study is to make visible the exposure to environmental contaminants and the health of workers in mercury mines. An environmental assessment was conducted to determine workers' exposure to contaminants; urine samples were obtained to measure exposure to mercury and arsenic, and blood samples were obtained for lead and cadmium. Clinical parameters were also evaluated. Concentrations of Hg, As and Pb were determined in soil, 279.4 mg/kg (24.4-788.5), 14.7 mg/kg (9.5-20.3) and 1.4 mg/kg (1-2.8), respectively. The exposure results for mercury were 551 μg/g creatinine, for arsenic 50 μg/L and for lead 4.7 μg/dL. Cd-B was not found. In addition, 17.6 % of the workers had diabetes and 17.6 % had renal disorders. Principal Component Regression was performed obtaining an r2 of 0.86 for glomerular filtration rate and 0.54 for albumin creatinine ratio using clinical, occupational, and metal exposure variables. Exposure to Hg in this type of mine is not exclusive, so there is a cumulative risk of chronic exposure to different environmental pollutants directly impacting the health of workers. It is necessary to implement health strategies and different work opportunities for these workers.

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.

Long Working Hours, Precarious Employment and Anxiety Symptoms Among Working Chinese Population in Hong Kong

This study aimed to examine the association between working hours and anxiety of a working population in Hong Kong. We used a cross sectional data from a population-based household survey of Hong Kong Chinese adults. Key measures included employment status, skill level, working hours, length of stay at current job and anxiety level. Symptoms of anxiety were assessed using the Depression Anxiety Stress Scale (DASS-21). The data were analysed using logistic regression. Chinese adults who had long working hours (≥ 72 h per week) had higher odds of developing symptoms of anxiety than those who worked for ≤ 36 h per week (odds ratio [OR] 5.94, 95% confidence interval [CI]: 1.82‒19.41). Compared with short period (< 1 year), long period of stay at current job (≥ 5 years) was found as a protective factor from anxiety (OR 0.38, 95% CI: 0.20‒0.73). We found that a working period of 72 h per week was a significant threshold to cause anxiety to workers. Stable job arrangement was a protective factor to workers from anxiety. Implementation of labour market regulations, such as standard working hour policy and stable job arrangement, was also significant to mitigate risk of anxiety for working people in Hong Kong.

Self-employment, work and health: A critical narrative review

BACKGROUND

Self-employment (SE) is a growing precarious and non-standard work arrangement internationally. Economically advanced countries that favor digital labor markets may be promoting the growth of a demographic of self-employed (SE'd) workers who are exposed to particular occupational diseases, sickness, and injury. However, little is known about how SE'd workers are supported when they are unable to work due to illness, injury, and disability.

OBJECTIVE

Our objective was to critically review peer-reviewed literature focusing on advanced economies to understand how SE'd workers navigate, experience, or manage their injuries and illness when unable to work.

METHODS

Using a critical interpretive lens, a systematic search was conducted of five databases. The search yielded 18 relevant articles, which were critically examined and synthesized.

RESULTS

Five major themes emerged from the review: (i) conceptualizing SE; (ii) double-edged sword; (iii) dynamics of illness, injury, and disability; (iv) formal and informal health management support systems; and (v) occupational health services and rehabilitation.

CONCLUSION

We find a lack of research distinguishing the work and health needs of different kinds of SE'd workers, taking into consideration class, gender, sector, and gig workers. Many articles noted poor social security system supports. Drawing on a social justice lens, we argue that SE'd workers make significant contributions to economies and are deserving of support from social security systems when ill or injured.

Spatial Mismatch, Different Labor Markets and Precarious Employment: The Case of Hong Kong

Spatial mismatch theory argues that geographic barriers have significant adverse effects on (un)employment, especially with respect to disadvantaged workers. Existing debates on spatial mismatch have focused on its influence on unemployment, but few studies have paid attention to the impact of spatial factors on increasingly precarious employment in today's labor market. Using data from four waves of the Hong Kong Panel Study of Social Dynamics (HKPSSD), the 2011 Population Census and the 2016 Population By-census, this study aims to investigate the effects of spatial mismatch on precarious employment in the low- and high-skilled labor markets in Hong Kong with multi-leveled modeling. The results suggest that with higher levels of spatial mismatch, workers in the low-skilled labor market are more likely to be in precarious employment. In the high-skilled labor market, sub-degree holders are also more likely to engage in precarious employment. Even worse, spatial mismatch in Hong Kong has deteriorated over time. Based on these results, we offer policy recommendations and show how the study of spatial mismatch can inform policymaking. Overall, we contribute to the literature by demonstrating that spatial mismatch can lead to precarious employment among employed workers and has differentiated effects on low- and high-skilled labor markets.

Intersectional trends in employment quality in older adults in the United States

Americans' working lives have become more precarious over the past several decades. Worsening employment quality has been linked to poorer physical and mental health and may disproportionately impact marginalized working populations. We examined differences in the quality and character of worker-employer relationships among older workers in the United States (US) across intersecting gender-racial/ethnic-educational subgroups. Using longitudinal data on employment stability, material rewards, workers' rights, working-time arrangements, unionization, and interpersonal power relations from the Health and Retirement Study (1992-2016), we used principal components analysis to construct an employment quality (EQ) score. We estimated intersectional differences in EQ, overall and over time, using generalized estimating equations. Overall, EQ was greatest for white men with college degrees and poorest for Latinx women with < high school degrees. Over time, EQ tended to remain unchanged or slightly worsen across intersectional strata; the greatest EQ reduction was for Latinx women with college degrees, while the greatest improvement was for white women with high school degrees. There are enduring and growing inequities in EQ for older marginalized adults in the US, which may contribute to growing health inequities.

Precarious employment and health: A qualitative study in Venezuelan immigrant population in Colombia

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Precarious employment constitutes an axis of analysis of health inequalities in vulnerable populations, such as immigrants.

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Most studies have focused on migratory movements between countries with different levels of wealth (SouthNorth contexts).

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The Venezuelan immigrant population is in a situation of precarious employment and high vulnerability.

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Precarious employment impacts immigrants’ health conditions and increases their exposure to occupational risks.

Background

Employment and working conditions are considered as an element that impacts on health inequalities, especially among vulnerable groups such as the immigrant population. This study aims to describe the characteristics of precarious employment in the Venezuelan immigrant population in Medellín (Colombia) according to its theoretical model and its relationship with the perception of their physical, mental, and psychosocial health.

Methods

A qualitative study was conducted with a focused ethnography perspective. 31 people with Venezuelan origin and work experience were interviewed in the city of Medellin and its metropolitan area and 12 key informants from different formal and informal social organizations that work with the immigrant population. A narrative content analysis was carried manually and by using the Atlas.Ti 8.0 software. The principles of analytical induction were applied to carry out a thematic analysis of the main categories defined in the precarious employment framework.

Results

The following characteristics of precarious employment were found: instability in employment conditions, work in the informal or submerged economy, limited empowerment, absence of social benefits, high vulnerability, low income, and a limited capacity for exercising labor rights. This situation affects mental health conditions, access to health services, and the presence of risks due to the work they perform.

Conclusions

The Venezuelan working population in Medellín is found in a precarious employment situation. Inclusive social strategies and policies that take into account the reality of this population are required.

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 .

Paid sick leave benefits among essential frontline workers serving people experiencing homelessness in Canada during the COVID-19 pandemic

Objectives

This study examined the prevalence and factors associated with paid sick leave benefits among direct service providers who work with people experiencing homelessness.

Study design

Cross-sectional study using an online survey disseminated during the second wave of the COVID-19 pandemic in Canada.

Methods

Survey data from 572 direct service providers working in the homeless, supportive housing, and harm reduction service sectors were analyzed for this study. Univariate and multivariate logistic regression models were used to examine predictors of paid sick leave benefits.

Results

One hundred one (17.7%) participants did not have any paid sick leave benefits. In the univariate models, paid sick leave was associated with older age, greater family income, full-time work, specific employment settings (supportive housing and not emergency shelters or harm reduction programs), having a regular medical doctor, and fewer occupational impacts of the COVID-19 pandemic. Older age, full-time work, and non-receipt of emergency financial benefits remained statistically significant predictors in the multivariate model.

Conclusions

Although the majority of service providers working with people experiencing homelessness have some amount of paid sick leave benefits, there is a precariously employed subset of individuals who are younger and working part-time in the sector. Temporary expansion of paid sick leave and removal of waiting periods for new employees to qualify for benefits are recommended.

Health care workers and migrant health: Pre- and post-COVID-19 considerations for reviewing and expanding the research agenda

The main purpose of this article is to review several ways in which health care workers could either impact migrant health or be directly impacted by migration and, based on this, suggest the expansion of the current research agenda on migration and health to address a range of topics that are currently either neglected, insufficiently researched, or researched from different perspectives. To ground this suggestion and emphasize the complexity and significance of migrant health research, we start by briefly reviewing several migration-related notions including the process of migration and its key facilitators and benefits; existing barriers to the provision of migrant health care; and the intricate links between health systems, health professionals, and migrant health. The three areas of research examined in this article address (i) the specific role of health workers in providing care to migrants and refugees and their capacity to do so, (ii) the health problems experienced by health workers who become migrants or refugees, and (iii) the precarious employment conditions experienced by both migrant and non-migrant health care workers. After summarizing the current available evidence on these topics, we discuss key information gaps and strategies to address them, while also incorporating several relevant COVID-19 pandemic considerations and research implications. Expanding the focus of research studies on migration and health could not only enhance the results of current strategies by supplying additional information to support their implementation but also spearhead the development of new solutions to the migrant health problem.

The impact of economic uncertainty, precarious employment, and risk attitudes on the transition to parenthood

This study investigates how precarious employment throughout the life course affects the fertility behavior of men and women in Germany, and how risk attitudes moderate exposure to objectively given uncertainty. Analyzing data from the German Socio-Economic Panel (SOEP) study from 1990 to 2015, I find that men and women have become quite similar in their fertility behavior: Stable employment accelerates family formation, whereas discontinuous and precarious employment delays it. With regard to risk attitudes, risk-averse women show the highest likelihood of family formation. They appear to choose a family- and parenthood-centered path in their life course that provides them with stability and social approval when unstable career prospects and uncertain employment are unable to provide these resources.

Essential work, precarious labour: The need for safer and equitable harm reduction work in the era of COVID-19

This commentary highlights labour concerns and inequities within the harm reduction sector that hinder programs' ability to respond to converging public health emergencies (the overdose crisis and COVID-19), and potentially contribute to spread of the novel coronavirus. Many harm reduction programs continue to support people who use illicit drugs (PWUD) during the pandemic, yet PWUD working in harm reduction programs (sometimes termed 'peers') experience precarious labour conditions characterized by low wages, minimal employee benefits (such as paid sick leave) and high employment insecurity. Along with precarious labour conditions, PWUD face heightened vulnerabilities to COVID-19 and yet have been largely overlooked in global response to the pandemic. Operating under conditions of economic and legal precarity, harm reduction programs' reliance on precarious labour (e.g. on-call, temporary and unpaid work) renders some services vulnerable to staffing shortages and service disruptions during the pandemic, while also heightening the risk of virus transmission among workers, service users and their communities. We call for immediate policy and programmatic actions to strengthen working conditions within these settings with a priority on enhancing protections and supports for workers in peer roles.

The impact of precarious jobs on mental health: a gender-sensitive literature review

PURPOSE

The aim of this study is to analyse the extent to which research and knowledge production on a key occupational health issue-the impact of precarious employment on health-incorporates, and is sensitive to, a gender perspective.

METHODS

A systematic literature review was carried out to identify studies that analysed the relationship between precarious employment and mental health in the period January 2010-May 2018 through. A minimum of two independent reviewers assessed each article for quality and eligibility. A checklist was used to determine whether the articles included in the review incorporated a gender perspective.

RESULTS

The search retrieved 1522 papers, of which 54 (corresponding to 53 studies) met the inclusion criteria. Of these 54 papers, 22 (40.7%) stratified the analyses by sex. Only 5.4% of the total of articles both stratified by sex and considered variables of household composition and marital status, while only 33.3% incorporated an intersectional perspective. None considered the distribution of domestic work and only a quarter (25.9%) approached the study and interpreted the results in terms of gender.

CONCLUSION

Too few studies researching paid work and health include a gender perspective. This omission necessarily implies a biased interpretation of the reality of precarious employment and its impact on health.

Precarious employment and general, mental and physical health in Stockholm, Sweden: a cross-sectional study

Objectives: To investigate the association between precarious employment and health in a sample of non-standard employees in Stockholm County, Sweden, by addressing three specific research questions: is the degree of precarious employment (low, moderate, high) associated with self-rated. . . (a) general health, (b) mental health, (c) musculoskeletal pain? Methods: Web-based respondent-driven sampling was used to recruit a sample of 415 employees in Stockholm, Sweden, during 2016-2017. Questionnaire data were collected on employment conditions (the Swedish version of the employment precariousness scale (EPRES-Se)), general health, mental health and musculoskeletal pain. EPRES-Se scores were categorised as low, moderate or high. Generalised linear models with Poisson distribution, log link functions and robust variances were applied for calculating crude and adjusted prevalence ratios (PR; aPR) with 95% confidence intervals (CIs) for all outcomes. Results: The prevalence ratios of poor self-rated general and mental health increased with increased degree of precariousness, as indicated by estimates of moderate precarious employment (a₂PR_Moderate 1.44 (CI 0.98-2.11); a₂PR_Moderate 1.13 (CI 0.82-1.62)), and high precarious employment (a₂PR_High 1.78 (CI 1.21-2.62); a₂PR_High 1.69 (CI 1.25-2.28)), albeit only significantly so for high precarious employment. Conclusions: This is the first study in Sweden reporting on the association between precarious employment, as measured with a multidimensional scale, and multiple health outcomes. The results add to the evidence of an association between precarious employment and self-rated poor general and mental health. Larger, representative studies with longitudinal designs using the EPRES-Se are called for in order to strengthen these results and the already existing evidence of the harm of precarious employment.

Life-course trajectories of employment quality and health in the U.S.: A multichannel sequence analysis

The organization of employment in the U.S. has changed dramatically since the 1970s, causing decreased power and security for workers across many dimensions of the employment relationship. Multidimensional employment-quality (EQ) measures can be used to capture these changes and test their association with health. However, most public-health EQ studies have used cross-sectional, unidimensional data. We addressed these limitations using a longitudinal, multidimensional EQ measure and data on 2779 1985-2017 Panel Study of Income Dynamics respondents. First, using a multichannel sequence-analysis approach, we identified gender-specific clusters of mid-career (ages 29-50) EQ trajectories based on respondents' employment stability, material rewards, working-time arrangements, collective organization, and power relations. Next, we examined cross-cluster variation in respondent characteristics. Finally, we estimated the gender-specific associations between cluster-membership and post-sequence-analysis-period prevalence of poor/fair self-rated health (SRH) and moderate mental illness (Kessler-K6≥5). We identified five clusters among women and seven among men. Respondents in poor-EQ clusters were disproportionately people of color and less-educated; they also tended to report worse health. For example, among women, the prevalence of poor/fair SRH and moderate mental illness was lowest among standard-employment-relationship-like-non-union workers and the becoming self-employed, and greatest among minimally-attached, returning-to-the-labor-force, and precariously-employed workers. Meanwhile, among men, the prevalence of the outcomes was lowest among stably-high-wage workers and the wealthy self-employed, and greatest among exiting-the-labor-force and precariously-employed workers. Given the potential role of EQ in health inequities, researchers and practitioners should consider EQ in their work.

The relationship between precarious employment and subjective well-being in Korean wage workers through the Cantril ladder Scale

Background

The global labor market is moving towards increasing job instability. Relatively few studies have examined the relationship between precarious employment and subjective well-being using quantitative scales. We evaluated the association between wage workers' employment status and their subjective well-being through the Cantril ladder scale using Korean Welfare Panel Survey data (KOWEPS).

Methods

This study used KOWEPS data. A total of 4,423 wage workers were divided into permanently employed workers, temporarily employed workers and daily employed workers. The relationship between precarious employment and subjective well-being was analyzed by multiple linear regression adjusted for potential confounding factors.

Results

The more unstable the employment status, the lower the subjective well-being, which can be expressed by the Cantril ladder scale. The mean score of both temporarily employed and daily employed workers were statistically significantly lower (B = −0.454, p < 0.001; B = −0.994, p < 0.001, respectively) than permanently employed workers. This appeared to be the same when occupational and sociodemographic factors were adjusted (B = −0.153, p = 0.002 for temporarily employed, B = −0.610, p < 0.001 for daily employed).

Conclusions

The more unstable the employment status, the lower the subjective well-being score according to the Cantril ladder scale.

Diverting blame to stay sane - young people's strategies for dealing with the mental health effects of precarious employment: a grounded theory study

BACKGROUND

Precarious employment is a risk factor for poor mental health, particularly among young adults. Knowledge about how young people maintain their mental health while in a precarious employment situation is scarce. The aim of the study was to explore the meaning of precarious employment for young adults in Sweden and their strategies for maintaining good mental health.

METHODS

In-depth interviews were conducted with 15 individuals (9 men and 6 women) aged 20-39 years in a precarious employment situation. Contact persons at union offices and at specific job-coaching organizations collaborating with the Swedish public employment agency in the city of Malmö were gate openers to reach informants. Analysis was based on constructivist grounded theory, implying an emergent design where data collection and analysis go hand in hand.

RESULTS

All informants had completed secondary school in Sweden, and one third had studied at the university level. A majority currently had jobs; however, they were mostly employed on an hourly basis and only a few had temporary full-time jobs. The analysis resulted in a core category "Diverting blame to stay sane," which summarized an emergent coping process involving individual resources and resources represented by the individuals' social capital. The developed theoretical model contained four main categories, "Facing reality," "Losing control," "Adapting," and "Fighting back," related to the core category.

CONCLUSIONS

The results implied a process where the challenges created by loss of employment-based rights required a coping process where the individual's social capital plays an important role. However, social capital is to a large extent determined by contextual factors, underlining the strong health equity aspect of precarious employment.

Return to Work and Ripple Effects on Family of Precariously Employed Injured Workers

Purpose Work injury and return to work processes can have adverse effects on injured workers and their families. Family members may experience increased workloads, role reversals, dissolution of marriages or changes in relationships with children, as well as financial strain from loss of income. How these associations interact when the injured worker is precariously employed, however, is unknown. The aim of this study was to explore the impacts of work-related injury or illness as well as subsequent compensation and return to work processes on families and relationships of precariously employed workers. Methods Interviews were conducted with fifteen precariously employed injured workers recruited through on-line advertising, injured worker groups, and social media platforms in Ontario. Situational analysis was used to identify how family members were affected and their role throughout the injury process. Results Precariously employed injured workers felt caught between self-interested employers and disinterested workers' compensation. In some cases, this led to deteriorated mental health and well-being. The worker's difficulties with RTW challenged financial security of families and affected their day-to-day normal routines. While some workers received emotional and instrumental support from their family members, others had their families fall apart when chronic disability and unemployment proved to be too much. Conclusions This study addressed the complex ways that work injury and illness among precariously employed workers interact with family life and relationships. Findings illustrate how the income and employment insecurity associated with precarious employment has ripple effects on workers and their families when they become injured.

Job Quality and the Educational Gradient in Entry Into Marriage and Cohabitation

Men's and women's economic resources are important determinants of marriage timing. Prior demographic and sociological literature has often measured resources in narrow terms, considering employment and earnings and not more fine-grained measures of job quality. Yet, scholarship on work and inequality focuses squarely on declining job quality and rising precarity in employment and suggests that this transformation may matter for the life course. Addressing the disconnect between these two important areas of research, this study analyzes data on the 1980-1984 U.S. birth cohort from the National Longitudinal Survey of Youth 1997 to examine the relationships between men's and women's job quality and their entry into marital or cohabiting unions. We advance existing literature by moving beyond basic measures of employment and earnings and investigating how detailed measures of job quality matter for union formation. We find that men and women in less precarious jobs-both jobs with standard work schedules and those that provide fringe benefits-are more likely to marry. Further, differences in job quality explain a significant portion of the educational gradient in entry into first marriage. However, these dimensions of job quality are not predictive of cohabitation.

Employment conditions and use of gastric cancer screening services in Korea: a nationwide survey

BACKGROUND

Although it is well known that employment conditions exert considerable effects on health and health equity, the association between employment conditions and the use of preventative health services has rarely been studied. We explored whether inequities in the use of preventative services were associated with employment conditions. We used gastric cancer screening as a surrogate for the use of preventative health services.

METHODS

The study population was derived from the Korea National Health and Nutrition Survey IV (2007-2009), which included data on 5626 individuals over 40 years of age. Employment conditions were grouped by employment status, work hours, employment contract term, and salary source. Participants who had undergone gastroscopy or an upper gastrointestinal series within the past 2 years were considered to have used cancer screening services according to the National Cancer Screening Program guidelines. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multiple logistic regression analysis. As the survey procedure incorporated sample weights, we adjusted our calculations to consider the complex sample design.

RESULTS

Self-employed workers were less likely to participate in regular cancer screening than were wage workers (OR = 0.79, 95% CI = 0.68-0.92), and part-time workers were less likely to participate than were full-time workers (OR = 0.81, 95% CI = 0.67-0.99). Among wage workers, temporary workers and daily workers exhibited lower participation rates than did regular workers (OR = 0.81, 95% CI = 0.63-1.05 and OR = 0.58, 95% CI = 0.44-0.76, respectively). Dispatched workers also exhibited lower participation rates (OR = 0.45, 95% CI = 0.25-0.80).

CONCLUSIONS

We found obvious inequities in the use of preventative health services associated with various employment conditions. Self-employed, irregular, and dispatched workers were significantly less likely to participate in cancer screening than were other workers. Political efforts should be made to reduce employment insecurity and to improve participation in preventative screening services by vulnerable employees so as to resolve the evident health inequities.

[Factors involved in job insecurity and their relationship with the health of salaried workers and contract workers in BoliviaRelação entre condições precárias de trabalho e a saúde dos trabalhadores assalariados e contratados na Bolívia]

OBJECTIVE

To examine the association between factors involved in job insecurity and: health service use, tobacco use, and alcohol use among salaried workers and contract workers in Bolivia.

METHODS

A cross-sectional study was performed with a sample of workers composed of 1203 women and 1780 men between the ages of 14 and 65 years using data from Bolivia's 2015 Household Survey. The dependent variables were health service use, tobacco use, and alcohol use; the independent variables were wages, type of contract, work hours, and exercise of workers' rights. Prevalence rates were calculated and the association between factors involved in job insecurity and the dependent variables was assessed using multivariate binomial regression models with adjustment for sociodemographic variables. The analyses were stratified by sex.

RESULTS

The adjusted models showed a significant association between working under a temporary contract and lower use of health services among men (odds ratio [OR]: 0.70; 95% confidence interval [95% CI]: 0.56-0.87) and women (OR: 0.62; 95% CI: 0.46-0.82). Poor exercise of workers' rights was also associated with lower use of health services (OR: 0.61; IC 95%: 0.45-0.83) among men. Long work hours showed an association with greater use of alcohol among women (OR: 1.75; 95% CI: 1.34-2.29). Low wages were associated with lower tobacco use among men (OR: 0.75; 95% CI: 0.57-0.99) and women (OR; 0.57; 95% CI: 0.33-0.99). However, being a manual worker was associated with tobacco use (OR: 1.36; 95% CI: 1.09-1.70) among men.

CONCLUSIONS

Having a temporary contract and belonging to income quintile I (the poorest) are both associated with lower use of health services and lower probability of smoking in individuals of either sex. Long work hours are associated with greater alcohol use among women. Poor exercise of workers' rights is associated with lower use of health services among men.

Influence of changes in the Spanish labor market during the economic crisis (2007-2011) on perceived health

PURPOSE

We analyze the influence of the dramatic changes in the Spanish labor market during the crisis on the perceived health of the Spanish population.

METHODS

We use the longitudinal Living Conditions Survey database and multilevel longitudinal logistic models between 2007 and 2011, before and during the economic crisis in one of the European countries most affected by its consequences.

RESULTS

Unemployment (OR 1.75; p < 0.001), job insecurity (OR 1.38; p < 0.001), and being part of a household with severe material deprivation (OR 1.87; p = 0.004) increase the risk of having worsened perceived health. Available income, on the other hand, is a protective factor (OR 0.72; p < 0.001). Public expenditure policies have little impact on the perceived health. Labor market reforms reducing the degree of job insecurity and unemployment, together with income transfers to those at greater risk of social deprivation, can be more effective in improving the health of the population than the increase of aggregated social or health care expenditure.

CONCLUSIONS

This study provides evidence of the influence that unemployment, job insecurity, and poverty exert on the perceived health of individuals, with data collected in Spain after the onset of the financial crisis. In addition, after analyzing public social expenditure, only expenditure on FPS seems to influence self-reported health, although to a very limited degree.

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

We sought to investigate the association between employment conditions and health among working age British adults with and without intellectual impairments. Using data from the 1970 British Cohort Study, we undertook a series of cross sectional analyses of the association between employment conditions and health (self-reported general health, mental health) among British adults with and without intellectual impairments at ages 30, 34 and 42. Our results indicated that: (1) British adults with intellectual impairments were more likely than their peers to be exposed to non-standard employment conditions and experience job insecurity; (2) in both groups exposure was typically associated with poorer health; (3) British adults with intellectual impairments in non-standard employment conditions were more likely than their peers to transition to economic inactivity; (4) among both groups, transitioning into employment was associated with positive health status and transitioning out of employment was associated with poorer health status. British adults with intellectual impairments are significantly more likely than their peers to be exposed to non-standard and more precarious working conditions. The association between employment conditions and health was similar for British adults with and without intellectual impairments. As such, the study found no evidence to suggest that research on causal pathways between employment and health derived from studies of the general population should not generalize to the population of people with intellectual impairments.

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Little is known about the association between employment conditions and health among adults with intellectual impairments.

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Adults with intellectual impairments were more likely than their peers to be exposed to non-standard employment conditions and experience job insecurity.

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Exposure was associated with poorer health.

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Adults with intellectual impairments in non-standard employment were more likely than their peers to transition to economic inactivity.

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Transitioning into employment was associated with positive health status and transitioning out of employment was associated with poorer health status.

Precarious employment associated with depressive symptoms and suicidal ideation in adult wage workers

BACKGROUND

Precarious employment is one of the most important indicators of social disadvantage and is associated with poor mental health. This study aimed to investigate the association of precarious employment with depressive mood and suicidal ideation in adult wage workers, and the possible mediating or moderating effect of socioeconomic factors in the association between precarious work and mental health status.

METHOD

Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V) conducted between 2010 and 2012 were analyzed. Among the 24,173 participants, 6266 adult wage workers (3206 precarious and 3060 non-precarious workers) aged ≥19 years were included. Socioeconomic and health-related characteristics as well as depressive mood and suicidal ideation were investigated.

RESULTS

Precarious employment was significantly associated with depressive mood in the logistic regression analyses adjusting for all potential confounding factors as covariates. The socioeconomic variables including age, gender, education level, marital status, household income, and occupation type were significantly related with depressive mood and suicidal ideation in adult wage workers. We also found that gender and household income had possible moderating effects on the association between precarious employment and suicidal ideation. Precarious work was associated with suicidal ideation only for male workers and worker with low or middle-lower income levels.

LIMITATIONS

Our study is based on a cross-sectional design, thus, we could not elucidate the causal relationship between the variables.

CONCLUSIONS

Our study suggested that precarious employment plays a pivotal role in the mental health status of adult wage workers.

The impact of precarious employment on mental health: The case of Italy

Although there has been a sizeable empirical literature measuring the effect of job precariousness on the mental health of workers the debate is still open, and understanding the true nature of such relationship has important policy implications. In this paper, we investigate the impact of precarious employment on mental health using a unique, very large data set that matches information on job contracts for over 2.7 million employees in Italy followed over the years 2007-2011, with their psychotropic medication prescription. We examine the causal effects of temporary contracts, their duration and the number of contract changes during the year on the probability of having one or more prescriptions for medication to treat mental health problems. To this end, we estimate a dynamic Probit model, and deal with the potential endogeneity of regressors by adopting an instrumental variables approach. As instruments, we use firm-level probabilities of being a temporary worker as well as other firm-level variables that do not depend on the mental illness status of the workers. Our results show that the probability of psychotropic medication prescription is higher for workers under temporary job contracts. More days of work under temporary contract as well as frequent changes in temporary contract significantly increase the probability of developing mental health problems that need to be medically treated. We also find that moving from permanent to temporary employment increases mental illness; symmetrically, although with a smaller effect in absolute value, moving from temporary to permanent employment tends to reduce it. Policy interventions aimed at increasing the flexibility of the labour market through an increase of temporary contracts should also take into account the social and economic cost of these reforms, in terms of psychological wellbeing of employees.