Employment trajectories and mental health-related disability in Belgium

Employment Quality and Self-Rated General Health in the United States: A 3-Year Observational Follow-Up Study

BACKGROUND

The typological approach of the employment quality (EQ) framework offers a comprehensive lens for assessing the heterogeneity of employment experiences while concurrently acknowledging associated health risk factors. EQ incorporates multiple employment characteristics-such as working hours, wages and benefits, and union representation, among others-where standard employment relationship (SER)-like (or high EQ) features are distinguished from nonstandard features (low EQ). Low EQ features are known to relate negatively to health outcomes. Addressing limitations from previous cross-sectional studies, we contribute to longitudinal research on the link between EQ and self-rated general health in the United States. Our objectives are: (1) to investigate the association between baseline EQ and poor self-rated general health 3 years later; and (2) to examine the relation between poor self-rated health and: (a) transitioning from low EQ to SER-like employment (the scarring hypothesis); (b) transitioning from SER-like employment to low EQ (the initial-impact hypothesis); and (c) consistent low EQ status (for example, the dose-response hypothesis).

METHODS

Using the American Working Conditions Survey (AWCS), baseline and follow-up data on employees' self-rated health was collected (N = 1109). An EQ typology with five categories was created via latent class cluster analysis: SER-like, Instrumental, Precarious Unsustainable, Portfolio; and Precarious Intensive employment. Each EQ segment represents a unique combination of EQ features, with SER-like and Portfolio employment reflecting overall high EQ, while Instrumental, Precarious Unsustainable, and Precarious Intensive reflect varieties of low EQ constellations. We used lagged Poisson regression to link baseline EQ to follow-up self-rated health and Poisson regression to analyze multiple EQ paths between baseline and follow-up and their association with health.

RESULTS

Precarious Unsustainable and Instrumental employment at baseline associated significantly with poor self-rated general health at follow-up. Transitioning from SER-like employment to a low-EQ segment was linked to an increased risk of poor self-rated general health, confirming the initial-impact hypothesis. No evidence was found for the scarring hypothesis. Consistent Instrumental and Precarious Unsustainable employment were both associated with poorer health, underlining the importance of the dose-response effect.

CONCLUSIONS

Enhancing EQ is crucial for public health, particularly in the context of limited welfare provisions in the United States. Policy and legislative measures to improve EQ can promote better health outcomes and reduce health disparities within the working population.

Multidimensional employment trajectories and dynamic links with mental health: Evidence from the UK Household Longitudinal Study

OBJECTIVES

Low-quality and precarious employment have been associated with adverse mental health and wellbeing. More evidence is needed on how the quality of employment trajectories - including transitions in and out of unemployment, inactivity, and employment of varying quality - are associated with individuals' mental health over time. This paper aimed to derive a typology of multidimensional employment trajectories and assess associations with mental health in the UK.

METHODS

Data from waves 1-9 of the UK Household Longitudinal Study were used (2009-2019). Individuals aged 30-40 at baseline were included (N=1603). Using multichannel sequence and clustering analyses, we derived a typology of employment trajectories across employment statuses and four employment quality indicators. We assessed associations with subsequent psychological distress, accounting for baseline mental health. Changes in average General Health Questionnaire scores are described.

RESULTS

A typology of five trajectory clusters highlighted stable and secure and precarious/low-quality trajectories for both men and women. Women who reported being economically inactive at most waves had higher odds of experiencing psychological distress than did women in 'standard' trajectories, regardless of baseline mental health. Women's scores of psychological distress in the 'precarious' group on average increased along their trajectories characterized by instability and transitions in/out of unemployment, before a move into employment. Men who likely moved in and out of unemployment and economic inactivity, with low probability of paid employment, reported increased psychological distress at the end of follow-up. This may partly be due to pre-existing mental ill-health.

CONCLUSION

This paper shows the importance of high-quality employment for individuals' mental health over time. Researchers need to consider dynamic associations between employment quality and mental health across the life-course.

Is it the Past or the Present? Employment Quality, Unemployment History, Psychological Distress and Mental Wellbeing in the United Kingdom

Low employment quality and precarious employment have been associated with adverse mental health outcomes, yet the extent to which this association may be explained by the experience of unemployment "scarring" has not yet been explored. From a life course perspective, understanding this possible confounding is necessary. Drawing on the United Kingdom's Understanding Society dataset and using latent class analysis, we derived a typology of employment quality across six dimensions and assessed the links between individuals' employment quality, unemployment history, and mental well-being and psychological distress. Our results show that precarious types of employment as well as a higher quality "protected part-time" were linked to low mental well-being, though important gender differences were noted. Accounting for past unemployment did not fully explain these associations. No such adverse associations were observed for increased psychological distress. Our results help further the understanding of employment quality as a social determinant of health and highlight the need for both life course and gender-sensitive research in this area.

Impact of informal employment on individuals' psychological well-being: microevidence from China

OBJECTIVE

The number of workers engaged in informal employment in China has reached 200 million individuals, constituting a substantial contribution to the pursuit of high-quality development and the attainment of stable employment objectives. Nevertheless, the psychological well-being of informal workers cannot be overlooked. Therefore, this study aims to investigate the impact of informal employment on individuals' psychological well-being.

METHODS

Drawing on data from the 2020 China Family Panel Studies (CFPS) survey, this work employs ordinary least squares (OLS) models and instrumental variable analysis to empirically examine the impact of informal employment on the psychological well-being. Furthermore, different tests were utilised to analyse the mediating pathway through which informal employment affects the psychological well-being.

RESULTS

Informal employment exhibits a significant negative impact on the psychological well-being, particularly among samples characterised by low educational levels, limited financial resources, and non-agricultural household registration. The exploration of the underlying mechanisms indicates that informal employment negatively affects the psychological well-being of workers through pathways that include reduced access to health entitlements, increased working hours, and decreased job satisfaction, particularly with the work environment.

CONCLUSION

A recommendation is proposed; namely, to further establish a social security system that caters to the needs of the informal employment population and supports and regulates the development of flexible employment forms, with the aim of protecting and enhancing the psychological well-being of the informal employment population.

Vulnerability profiles of workers and the relation with burnout symptoms: results from the Netherlands working conditions survey

INTRODUCTION

Unfavorable working conditions may place workers in a vulnerable position in the labour market, but studies on the clustering of these factors and their relation to burnout symptoms are lacking. This study aims to identify subgroups of workers in potentially vulnerable positions in the labour market and examine whether burnout symptoms differ across the established subgroups.

METHODS

This study utilizes cross-sectional data from 2019 of the Netherlands Working Conditions Survey (n = 55,283). Working conditions included employment contracts, working hours, multiple jobs, tenure, physical strain, autonomy, and workload. Burnout symptoms were measured with five items on a 7-point Likert scale. Latent Class Analysis was used to identify vulnerability subgroups based on working conditions and educational level. Wilcoxon rank-sum tests were used to examine whether burnout symptoms differed between the identified subgroups.

RESULTS

Three out of nine subgroups (i.e., classes 4, 6, and 7) presented combinations of multiple unfavourable working conditions. The vulnerability of class 4, characterized by low educational level, physically demanding work, low autonomy, and a high workload, was underscored by a significantly higher burnout symptom score (M = 2.91;SD = 0.97) compared to all other subgroups. Subgroups 3 (M = 2.69;SD = 1.43) and 8 (M = 2.41;SD = 1.41), without striking unfavourable conditions, had the second and third highest scores on burnout symptoms.

CONCLUSIONS

Determining vulnerability in the labour market is not straightforward as not all profiles that presented clusters of unfavourable working conditions scored high on burnout symptoms, and vice versa. Future research should investigate whether findings are similar to other mental health outcomes.

Downgraded dreams: Labor market outcomes and mental health in undocumented migration

Undocumented immigrant workers are particularly exposed to mental health risk factors, including occupational downgrading - i.e. the loss in occupational status upon arrival. This study breaks new ground by examining the relationship between occupational downgrading and mental health among this hard-to-reach population, offering the first-ever investigation of its kind. Leveraging a unique dataset collected by a primary care outpatient clinic in Milan, Italy, which combines medical evaluations with detailed occupational information, we construct a direct measure of occupational downgrading, which adds to the literature. We employ logistic regression models to estimate odds ratios (ORs) for mental and behavioral disorders. The study also offers fresh evidence on the socioeconomic and health status of a sizable sample of undocumented migrants. The study sample consists of 1738 individuals that had their first medical examination in 2017-18. Prevalence of mental health conditions is 5.58%. Data also highlight poor labor market integration: one third of individuals in the sample is employed, mostly in elementary occupations; 66.63% of immigrant workers experienced occupational downgrading. Regression results show that undocumented immigrants who undergo occupational downgrading are at considerably higher risk of mental disorders. ORs range from 1.729 (95% CI 1.071-2.793), when the model only includes individual characteristics determined prior to migration, to 2.659 (CI 1.342-5.271), when it accounts for all the available controls. From a policy perspective, our study underscores the need to consider the broader impact of policies, including restrictive entry and integration policies, on migrant health. Additionally, ensuring access to primary care for all immigrants is crucial for early detection and treatment of mental health conditions.