The relationship between nonstandard working and mental health in a representative sample of the South Korean population

Association of precarious employment with depressive symptoms and suicidal ideation among female workers: Findings from a nationwide longitudinal study in Korea

BACKGROUND

In this study, we examined the relationship of precarious employment (PE) with depressive symptoms and suicidal ideation among Korean women.

METHODS

We included a nationwide sample of 4162 women drawn from the Korean Longitudinal Study of Women and Families, comprising 7566 observations. PE was assessed using three dimensions: employment insecurity, income inadequacy, and lack of rights and protection. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiological Studies Depression Scale. Generalized estimating equations were used to estimate the association between each element of PE and the depressive symptoms and suicidal ideation over a two-year follow-up period, represented as odds ratios (ORs) and confidence intervals (CIs).

RESULTS

The overall prevalence rates of depressive symptoms and suicidal ideation were 11.8 % and 1.9 %, respectively. Compared with permanent employment, fixed-term employment (OR [95 % CI]:1.29 [1.00-1.67]) or daily employment (OR [95 % CI]:1.53 [1.26-1.99]) was associated with the depressive symptoms at the follow-up. Additionally, lack of social benefits (OR [95 % CI]:1.40 [1.09-1.79]) and high perceived vulnerability (OR [95 % CI]:1.27 [1.08-1.49]) were associated with the depressive symptoms at the follow-up. Additionally, daily employment was associated with the suicidal ideation at the follow-up (OR [95 % CI]:1.94 [1.02-3.68]) and high perceived vulnerability was marginally associated with an increased suicidal ideation risk (OR [95 % CI]:1.49 [0.98-2.29]).

LIMITATION

Causal effect of PE could not be asserted due to the observational nature of this study.

CONCLUSIONS

PE is a social determinant of women's mental health and policy interventions are required to improve their employment conditions.

How our longitudinal employment patterns might shape our health as we approach middle adulthood-US NLSY79 cohort

Recent labor market transformations brought on by digital and technological advances, together with the rise of the service economy since the 1980s, have subjected more workers to precarious conditions, such as irregular work hours and low or unpredictable wages, threatening their economic well-being and health. This study advances our understanding of the critical role employment plays in our health by examining how employment patterns throughout our working lives, based on work schedules, may shape our health at age 50, paying particular attention to the moderating role of social position. The National Longitudinal Survey of Youth-1979 (NLSY79), which has collected 30+ years of longitudinal information, was used to examine how employment patterns starting at ages 22 (n ≈ 7,336) might be associated with sleep hours and quality, physical and mental functions, and the likelihood of reporting poor health and depressive symptoms at age 50. Sequence analysis found five dominant employment patterns between ages 22 and 49: "mostly not working" (10%), "early standard hours before transitioning into mostly variable hours" (12%), "early standard hours before transitioning into volatile schedules" (early ST-volatile, 17%), "mostly standard hours with some variable hours" (35%), and "stable standard hours" (26%). The multiple regression analyses indicate that having the "early ST-volatile" schedule pattern between ages 22 and 49 was consistently, significantly associated with the poorest health, including the fewest hours of sleep per day, the lowest sleep quality, the lowest physical and mental functions, and the highest likelihood of reporting poor health and depressive symptoms at age 50. In addition, social position plays a significant role in these adverse health consequences. For example, whereas non-Hispanic White women reported the most hours of sleep and non-Hispanic Black men reported the fewest, the opposite was true for sleep quality. In addition, non-Hispanic Black men with less than a high school education had the highest likelihood of reporting poor health at age 50 if they engaged in an employment pattern of "early ST-volatile" between ages 22 and 49. In comparison, non-Hispanic White men with a college degree or above education had the lowest likelihood of reporting poor health if they engaged in an employment pattern of stable standard hours. This analysis underscores the critical role of employment patterns in shaping our daily routines, which matter to sleep and physical and mental health as we approach middle adulthood. Notably, the groups with relatively disadvantaged social positions are also likely to be subject to nonstandard work schedules, including non-Hispanic Blacks and people with low education; hence, they were more likely than others to shoulder the harmful links between nonstandard work schedules and sleep and health, worsening their probability of maintaining and nurturing their health as they approach middle adulthood.

Cumulative Disadvantage or Strained Advantage? Remote Schooling, Paid Work Status, and Parental Mental Health during the COVID-19 Pandemic

During the COVID-19 pandemic, parents experienced difficulties around employment and children's schooling, likely with detrimental mental health implications. We analyze National Longitudinal Survey of Youth 1997 data (N = 2,829) to estimate depressive symptom changes from 2019 to 2021 by paid work status and children's schooling modality, considering partnership status, gender, and race-ethnicity differences. We draw on cumulative disadvantage theory alongside strained advantage theory to test whether mental health declines were steeper for parents with more disadvantaged statuses or for parents with more advantaged statuses. Parents with work disruptions, without paid work, or with children in remote school experienced the greatest increases in depressive symptoms, with steepest increases among single parents without paid work and single parents with children in remote school (cumulative disadvantage), fathers without paid work (strained advantage), and White parents with remote school (strained advantage). We discuss the uneven impacts of the pandemic on mental health and implications for long-term health disparities.

The Dual Labor Market and Workers' Health Inequality in South Korea

OBJECTIVE

We investigated how worker health inequality is potentially linked to the dual labor market in South Korea.

METHODS

Using the data from the fifth Korean Working Conditions Survey, we analyzed the data from 21,088 paid workers. We used logistic regression analyses to assess whether employment type or company size had a significant effect on workers' physical and mental health and work-related injuries.

RESULTS

Workers' health status was significantly associated with employment type and company size. Nonstandard workers had higher rates of musculoskeletal diseases or injuries, and their self-rated health and psychological well-being were lower than standard workers. Company size showed a significant correlation only for work-related injuries.

CONCLUSIONS

The structure of inequality in Korea's labor market according to employment type and company size seems to be affecting the health and safety of workers.

Investigating the potential association of temporary employment and job dissatisfaction with alcohol use disorder and depressive symptoms: a 13-wave longitudinal analysis

BACKGROUND

There has been growing interest in protecting workers' mental health. Identifying social determinants that affect workers' mental health could play an important role in preventing psychiatric diseases.

AIMS

We investigated the effects of temporary employment and job dissatisfaction on alcohol use disorder and depressive symptoms.

METHOD

The Korea Welfare Panel Study data-set (2009-2021) was used, and 9611 participants with 52 639 observations were included. Generalised linear mixed models were employed to estimate odds ratios and 95% confidence intervals. The relative excess risk due to interaction (RERI) was calculated to assess supra-additive interactions between temporary employment and job dissatisfaction.

RESULTS

Increased risks for depressive symptoms were observed among fixed-term workers (odds ratio 1.12, 95% CI 1.00-1.26) and daily labourers (odds ratio 1.68, 95% CI 1.44-1.95). Daily labourers were associated with an increased risk of alcohol use disorder (odds ratio 1.54, 95% CI 1.22-1.95). Job dissatisfaction was associated with alcohol use disorder (odds ratio 1.78, 95% CI 1.52-2.08) and depressive symptoms (odds ratio 4.88, 95% CI 4.36-5.46). This effect became stronger when workers were concurrently exposed to temporary employment and job dissatisfaction. Daily labourers with job dissatisfaction showed the highest risks for alcohol use disorder (odds ratio 2.99, 95% CI 2.21-4.03) and depressive symptoms (odds ratio 9.00, 95% CI 7.36-11.02). RERIs between daily employment and job dissatisfaction were >0 for alcohol use disorder (0.91, 95% CI 0.06-1.76) and depressive symptoms (3.47, 95% CI 1.80-5.14), indicating a supra-additive interaction.

CONCLUSIONS

We revealed that temporary employment and job dissatisfaction had detrimental effects on alcohol use disorder and depressive symptoms.

Macro-level gender equality and women's depressive symptoms in South Korea: a longitudinal study

PURPOSE

In 2014, the Korean Government passed the Gender Equality Act, which was accompanied by policies to increase women's participation in the labour force and representation in positions of power in the public and private sectors. While Korea has witnessed modest progress in macro-level gender equality, little is known about the effects of these changes on mental health outcomes. Our study investigated the relationship between regional-level gender equality (as measured by women's economic and political power) and women's depressive symptoms from 2013-18, and whether the effects differed across women from different socioeconomic positions.

METHODS

To examine how change over time in political and economic power influences the severity of depressive symptoms, we applied a fixed-effect regression, using a nationally representative sample for women aged 19-64 (n = 9,589) from the Korean Longitudinal Survey of Women and Families (2013-2018, wave 4 to 6) residing across the 16 regions of South Korea.

RESULTS

Our study found that increases in women's political and economic power led to moderate reductions in depressive symptoms (-0.25 and -0.23 points in CESD respectively). Sensitivity analyses indicate that economic power is more consistently associated with subsequent reductions in CESD. The effect of economic and political power on depressive symptoms did not differ by women's socioeconomic positions.

CONCLUSIONS

Our findings suggest that even modest improvements in gender equality were associated with increases in women's mental health. Further progress to ensure gender equality, such as the anti-discrimination legislation, may lead to greater improvements in public mental health.

Do Different Patterns of Employment Quality Contribute to Gender Health Inequities in the U.S.? A Cross-Sectional Mediation Analysis

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.

Temporary employment and suicidal ideation in COVID-19 pandemic in Japan: A cross-sectional nationwide survey

Objectives

Association between employment contract (temporary vs. permanent) and suicidal ideation (persistent suicidal ideation [i.e., with onset before COVID‐19] or newly developed under COVID‐19 pandemic) was examined using a nationally representative cross‐sectional study in Japan.

Methods

An Internet survey was conducted from August to September 2020. The participants’ inclusion criteria for this study were as follows: (i) 20–65 years old, (ii) employees (excluding self‐employed, students, retired, housewives, and unemployed). The associations of suicidal ideation with the employees’ factors were analyzed using the multinomial logistic regression model, adjusting for covariates (sex, age, marital status, education, company size, industries, and a history of psychiatric disease).

Results

Of total 12 249 participants, 72.4% were permanent and 27.6% were temporary employees. The prevalence was 8.5% for persistent suicidal ideation and 3.2% for newly developed suicidal ideation in the COVID‐19 pandemic. Temporary employment was significantly associated with persistent suicidal ideation (adjusted odds ratio [aOR] = 1.36 [95% confidence interval, CI: 1.16–1.59]; P < .001), but not associated with newly developed suicidal ideation (aOR = 1.10 [0.85–1.42]; P = .457) after adjusting the covariates. Sensitivity analysis showed temporary employment was significantly associated with persistent suicidal ideation only in women. Newly developed suicidal ideation was significantly higher among participants of a young age, employees in drinking/eating/hotel business industry, and those having a history of psychiatric disease than among the counterparts.

Conclusions

Working on a temporary employment contract was associated with persistent suicidal ideation under conditions of COVID‐19 outbreaks in Japan. However, the result showed no significant difference in newly developed suicidal ideation. Further longitudinal study will be needed to examine the risk of being employed on an unstable occupational contract in the prolonged pandemic.

Association between employment stability and depression as moderated by gender among South Korean employees

BACKGROUND

Research in Asian cultures regarding the association between employment status and health has been limited. The current study investigated the association between depression and employment status in Korea, moderated by gender.

METHODS

Data from the 2014, 2016, and 2018 Korea National Health and Nutrition Examination Survey (KNHANES) were analysed. In total, 11,157 participants aged ≥ 19 years responded to the survey. The Korean version of the PHQ-9 was utilised in addition to questions assessing employment status.

RESULTS

Precarious employment indicated a greater prevalence of depression in comparison to permanent employment (14.9% vs 10.8%, p < 0.001; 22.6% vs 20.2%, p < 0.001). Precariously employed men were 1.40 times more likely to have depression (adjusted Odds Ratio (OR): 1.40; 95% Confidence Interval (CI): 1.15-1.70; p= 0.001) while no such association existed among women (adjusted OR: 1.06; 95% CI: 0.89-1.27; p= 0.493). The subgroup analyses revealed that men working day shifts in a precarious employment were 1.48 times more likely to be depressed than those with permanent employment. In contrast, precarious employed women working night shifts were 2.13 times more likely to be depressed than those permanently employed counterparts.

LIMITATIONS

Current research did not investigate the causality of the variables hence was unable to identify whether employment instability from precarious engagements preceded the onset of depression.

CONCLUSIONS

These findings suggest gender can independently modify the relationship between employment stability and depression, as well as in association with additional variables - including work shift type and income.

Mental health symptoms among dependent contractors in Korea: a cross-sectional study based on the Fifth Korean Working Condition Survey

Background

Recently, there has been a call to improve the holistic welfare of dependent contractors (DCs). Thus, our study examined the relationship between DCs and mental health symptoms and how this relationship was modified by age, sex, and income status of workers.

Methods

A total of 27,980 workers from the Fifth Korean Working Conditions Survey are included in our study. The participants who reported having depression or anxiety over the last 12 months are defined those who had mental health symptoms. We performed exact matching for age group and sex, followed by conditional logistic regression with survey weights. Finally, stratified analyses by age, sex and income level were conducted.

Results

DCs were found to be at increased risk of depression/anxiety compared to other workers. The odds ratio (OR) is 1.52 (95% confidence interval [CI]: 1.06–2.17). In the stratified analyses, vulnerable groups were middle-aged (OR [95% CI]: 1.68 [1.10–2.54]), female (OR [95% CI]: 1.85 [1.20–2.84]), and low-income (OR [95% CI]: 3.18 [1.77–5.73]) workers.

Conclusions

Our study's results reinforce those of other studies that show that DCs are at greater risk of experiencing mental health issues than other workers and that and this risk is greater for middle-aged, female, and low-income workers. These results suggest that appropriate policy efforts should be made to improve the psychological well-being of DCs.

Analysis of the 2012 Canadian Community Health Survey-Mental Health demonstrates employment insecurity to be associated with mental illness

A growing number of people depend on flexible employment, characterized by outsider employment and lower levels of job security. This study investigated whether there was a synergistic effect of employment status and job insecurity on mental disorders.This study used data from the 2012 Canadian Community Health Survey-Mental Health (CCHS) of 13,722 Canada's labor force population aged 20 to 70. Data were collected from January to December, 2012, using computer-assisted personal interviewing. As combining employment status with perceived job insecurity, we formed five job categories: secure full-time, full-time insecure, part-time secure, part-time insecure employment, and unemployment.Results showed that, regardless of employment status (full-time vs part-time), insecure employment was significantly associated with high risk of mental disorders. Furthermore, the odds ratios for insecure employment were similar to those for unemployment. Male workers who are full-time, but with insecure jobs, were more likely to experience mental disorders than female workers.This study's findings imply that while perceived job insecurity may be a critical factor for developing mental health problems among workers, providing effective health care services can mitigate an excessive health risk for the most vulnerable employment, especially for insecure part-time employment and unemployment.

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

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

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 .

Factors Related to Physical and Mental Health in Workers With Different Categories of Employment

INTRODUCTION

We examined a large representative sample of workers in South Korea to compare the subjective well-being and musculoskeletal symptoms of those with standard employment and those with non-standard employment (temporary, daily, and part-time work).

METHODS

This was a secondary analysis of data from the fifth Korean Working Condition Survey, conducted in 2017.

RESULTS

Female part-time workers who had temporary and daily jobs were more likely to have poor subjective well-being, whereas female regular workers with part-time jobs were less likely to have poor subjective well-being than regular workers with full-time jobs. Daily workers of both sex with full-time jobs were more likely to have musculoskeletal pain than regular workers.

CONCLUSION

Our characterization of workers with precarious employment indicated that several modifiable factors affected the subjective well-being and musculoskeletal symptoms of these workers.

Effects of precarious work on symptomatology of anxiety and depression in Chilean workers, a cross sectional study

Background

Precarious work is a broad definition for non-standard employment, often including unstable and insecure positions where workers permanently experience uncertainty; these types of jobs are growing steadily around the planet. Since the coup d’état in 1973, Chile has experienced a series of structural economic changes framed by neoliberal ideas cemented in the “Constitution of Pinochet.” Precarious work in Chile is a direct consequence of these ideas. This multidimensional phenomenon has progressively been entering employment areas where it was not previously present. As a result, there has been a rise in work precarization and its full impact on health is not well known. The goal of this study was to estimate the association of work precariousness with mental health outcomes in Chilean workers.

Methods

Data were obtained from the Chilean Survey of Work and Health 2009–2010 (ENETS). Only valid records of salaried workers (excluding hourly-only or commission-only workers) in the private sector without missing values were included (n = 1900). After applying appropriate sampling weights, 1,461,727 workers were represented. Mental health was estimated as anxiety/depression levels using the 12-item General Health Questionnaire (GHQ-12). A multilevel multivariate generalized linear mixed model (GLMM) with negative binomial and log link distribution was used to study the association between precariousness and depression/anxiety.

Results

Looking at the overall precariousness scale (range from zero to four), we observed an increase of approximately 34% in the depression/anxiety score (scale range from 0 to 36) for every unit on the precarious work overall scale (Relative Risk = 1.34, 95% CI = 1.28, 1.42) controlling for age, sex, and occupational group.

Conclusion

Precarious work was associated with anxiety and depression as measured with the 12-item General Health Questionnaire. Controlling for demographic variables changed neither the direction nor the magnitude of the association.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10952-0.

The association between non-regular work patterns and insomnia among Korean wage workers: the fifth Korean working condition survey

BACKGROUND

Non-regular workers are steadily increasing on account of improving corporate productivity. They are classified as non-permanent, part-time, or non-typical workers. Non-regular work has a negative impact on workers' physical and mental health. This study analyzed the relationship between non-permanent, part-time and non-typical work and insomnia among Korean wage workers, and investigated the differences and interactions between different work patterns.

METHODS

The Fifth Korean Working Conditions Survey was used in this study. Non-regular work patterns were classified into 7 types: type 1, sole non-permanent; type 2, sole part-time; type 3, sole non-typical; type 4, part-time-non-typical; type 5, non-permanent-non-typical; type 6, non-permanent-part-time; type 7, all inclusive. Insomnia was measured on a scale from "normal sleep" to "insomnia" based on the 3-item Minimal Insomnia Symptom Scale. Multiple logistic regression was used to analyze the association between non-regular work patterns and insomnia among wage workers.

RESULTS

After multivariate adjustment, a significantly increased odds ratio (OR) for insomnia was found in types 1, 2, 3, 4, 5, 6, and 7 of non-regular work patterns compared to regular work patterns. After stratification for shift and night work, the OR of the group with shift and night work was higher than that of the group without shift and night work.

CONCLUSIONS

Insomnia was significantly associated with non-regular work patterns. This association was prominent in workers with shifts and night work. This finding suggests that proper work patterns may be needed to reduce the risk of insomnia among Korean wage workers and workers who initially had insomnia should consider these results before placement.

Is Job Insecurity Worse for Mental Health Than Having a Part-time Job in Canada?

OBJECTIVES

A growing number of people depend on flexible employment, characterized by outsider employment status and perceived job insecurity. This study investigated whether there was a synergistic effect of employment status (full-time vs. part-time) and perceived job insecurity on major depressive disorder.

METHODS

Data were derived from the 2012 Canadian Community Health Survey-Mental Health of 12 640 of Canada's labor force population, aged 20 to 74. By combining employment status with perceived job insecurity, we formed four employment categories: full-time secure, full-time insecure, part-time secure, and part-time insecure.

RESULTS

Results showed no synergistic health effect between employment status and perceived job insecurity. Regardless of employment status (full-time vs. part-time), insecure employment was significantly associated with a high risk of major depressive disorder. Analysis of the interaction between gender and four flexible employment status showed a gender-contingent effect on this link in only full-time insecure category. Men workers with full-time insecure jobs were more likely to experience major depressive disorders than their women counterparts.

CONCLUSIONS

This study's findings imply that perceived job insecurity may be a critical factor for developing major depressive disorder, in both men and women workers.

Non-Standard Workers Have Poorer Physical and Mental Health Than Standard Workers

OBJECTIVES

To compare the health status of workers who had non-standard and standard employment in Korea.

METHODS

Data from the Korean National Health and Nutrition Examination Survey (KNHANES, 2007 to 2017) were used to compare the health of workers with standard and non-standard employment.

RESULTS

Workers with non-standard employment (rather than standard employment) were more likely to be women, older, have less education, have lower monthly income, perform manual work, and work fewer hours per week. Men with non-standard employment were more likely to have physician-diagnosed cardiovascular disease, arthritis, and to report depressive and suicidal ideation. Women with non-standard employment were more likely to have physician-diagnosed cardiovascular disease and to report depressive feelings.

CONCLUSION

Workers with daily employment were most vulnerable to physical and mental health problems. Health problems differed among individuals who had different types of non-standard employment.

Psychological well-being of South Korean employees in different occupational classes

We compared the mental health of waged Korean workers in different occupational classes. This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017. Men who were "Unskilled manual workers" were more likely to report poor psychological well-being; however, analysis that adjusted for multiple factors (including work stressors and stress relievers) indicated that status as an "Unskilled manual worker" was not associated with poor psychological well-being. Male and female "Service and Sales workers" were less likely to report poor psychological well-being (aOR = 0.794 and 0.797, respectively). In addition, poor psychological well-being increased as the number of work stressors increased and decreased as the number of stress relievers increased. Work stressors and stress relievers are more deterministic than occupational categories on psychological well-being.

Workers With Different Employment Status Have Different Exposures to Work Stressors and Different Responses to Identical Work Stressors

INTRODUCTION

This study evaluated the relationship between exposure to diverse work-related stressors and psychological well-being in workers with precarious employment.

METHODS

This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017.

RESULTS

Daily workers were more likely to report poor psychological well-being than regular or temporary workers. Furthermore, higher proportions of daily workers reported exposure to the nine analyzed work stressors. However, only three of nine workplace stressors (lack of decision latitude, lack of reward, and lack of support from workplace managers) affected male and female daily workers.

CONCLUSION

A strategy designed to improve the psychological well-being of workers with precarious employment that is based on typical job stressor evaluation tools, may have limited effects.

Factors Related to Subjective Well-being in Workers Who Interact with Angry Clients

BACKGROUND

Among workers who interact with angry clients, there is limited information about the characteristics of workers who are most vulnerable to mental health problems. Thus, we determined the association of multiple demographic, socioeconomic, and modifiable work-related psychosocial factors with the subjective well-being of workers who interact with angry clients.

METHODS

This was a secondary analysis of data from the fifth Korean Working Conditions Survey, conducted in 2017. The study focused on workers who interacted with angry clients during 25% or more of their work time. Multiple logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals for the association of multiple factors with self-reported subjective well-being after adjustment for demographic, socioeconomic, and modifiable psychosocial factors.

RESULTS

Overall, 9.6% of men and 7.4% of women who interacted with angry clients reported poor subjective well-being. Poor well-being was significantly more likely to be reported by men who worked 40 hours or more per week (aOR, 3.97-5.37) and by men who were daily workers (aOR, 2.21). Poor subjective well-being had a significantly positive association with exposure to adverse social behaviors by clients (men: aOR, 1.54, women: aOR, 1.58), and significantly negative associations with unskilled manual work (women only: aOR, 0.30), job satisfaction (men: aOR, 0.70, women: aOR, 0.52), and good social climate (men: aOR, 0.70, women: aOR, 0.44).

CONCLUSION

Workers who interact with angry clients were widely distributed over non-manual labor and manual labor, but not limited to service and sales job. We identified modifiable factors that affect the subjective well-being of workers who interact with angry clients. We suggest that employers provide protection to prevent adverse social behaviors by clients, and also make an effort to establish a good social climate at the workplace.

Informal workplaces and their comparative effects on the health of street vendors and home-based garment workers in Yangon, Myanmar: a qualitative study

Background

Globally, two billion workers are employed informally but there is limited research on the relationship between informal work and health. Existing studies have focused on informality as an employment condition, with little emphasis on the diversity of physical and social contexts in which informal work takes place. The study considers the diversity of informal workplaces and explores the ways in which this diversity might influence health and well-being of two informal occupational groups in Yangon, the former capital of Myanmar.

Methods

We conducted 21 field observations and 47 semi-structured interviews with street vendors and home-based garment workers based in Yangon, Myanmar. A constant comparative method was used to identify and compare how the physical characteristics of their informal workplaces affect their health for these two informal subgroups.

Results

Although both street vendors and home-based garment workers work informally, their exposure to occupational health and income risks are specific to the physical features of their informal workplaces. Street vendors, who work in public spaces with minimal coverage, are more likely to experience the direct effects of outdoor pollution, inclement weather and ergonomic risks from lifting, carrying and transporting heavy merchandise while home-based garment workers, many of whom live and work in unsanitary housing and deprived neighborhoods, are more likely to experience pollution in or near their homes, and ergonomic risks from poor posture. Similarly, although both groups face safety challenges, street vendors face urban violence and abuse during their commute and at vending points whereas home-based garment workers felt unsafe in their home-based workplaces due to the presence of crime and violence in their neighborhoods.

Conclusion

While informal employment is universally characterized by lack of social protection, exposure to occupational health and income risks for subpopulations of informal workers is determined by the specific physical and social environments of their workplaces. Efforts to improve the health of informal workers should consider the contexts in which informal work takes place to develop tailored interventions for subpopulations of informal workers.

Multidimensional sleep quality of dependent self-employment workers

Background

The number of workers in non-standard employment (NSE) is increasing due to industrial change and technological development. Dependent self-employment (DSE), a type of NSE, was created decades ago. Despite the problems associated with this new type of employment, few studies have been conducted on the effects by DSE on health, especially sleep quality. This study aims to determine the relationship between DSE and sleep quality.

Methods

This study analyzed data of 50,250 wage workers from the fifth Korean Working Conditions Survey. Workers that did not respond or refused to answer any questions related to variables were excluded, and finally 36,709 participants were included in this study. A total of 2,287 workers (6.2%) were compared with non-DSE (34,422; 93.8%) workers, and multiple logistic regression analyses were applied.

Results

DSE status had a significant association with difficulty falling asleep (odds ratio [OR]: 1.331, 95% confidence interval [CI]: 1.178–1.504), difficulty maintaining sleep (OR: 1.279; 95% CI: 1.125–1.455), and extreme fatigue after waking up (OR: 1.331; 95% CI: 1.184–1.496). A multiple logistic regression of the variables for sleep quality in DSE showed a significant association with exposure to physical factors for all types of poor sleep quality as well as shift work for difficulty maintaining sleep with extreme fatigue after waking up. Long working hours and emotional labor were also associated with extreme fatigue after waking up.

Conclusions

This study shows a significant association between DSE and poor sleep quality, especially when workers were exposed to physical risk factors (noise, vibration, abnormal temperature, etc.) and shift work.

Physical Exposures, Work Tasks, and OSHA-10 Training Among Temporary and Payroll Construction Workers

OBJECTIVE

We characterize and compare the self-reported physical exposures, work tasks, and OSHA-10 training in a non-probabilistic sample of temporary and payroll construction workers.

METHODS

In June 2016, a total of 250 payroll and temporary general laborers employed at Florida construction sites completed a survey at the job site as part of the falls reported among minority employees (FRAME) study.

RESULTS

Workers employed through temp agencies (57.1%) were significantly more likely to report moving or lifting materials more than 100 pounds than payroll workers (38.5%; P < 0.01). Temporary construction workers with 10-hour OSHA training (22.2%) spent significantly less time with intense hand use/awkward hand posture than temporary workers without 10-hour OSHA training (46.9%; P = 0.048).

CONCLUSIONS

Temp construction workers with OSHA 10-hour training reported less hazardous physical postures than workers without the same training.

Nonstandard workers and differential occupational safety and health vulnerabilities

BACKGROUND

Permanent jobs are in decline world-wide, and are being replaced with temporary, casual, part-time, and contract jobs. We investigated the characteristics and occupational safety and health (OSH) vulnerabilities of workers with nonstandard and standard employment.

METHODS

We used the Korean Working Conditions Survey of 2017 to compare working conditions and OSH vulnerabilities of workers with standard and nonstandard employment in five major job categories.

RESULTS

Workers with nonstandard employment were older, less educated, had lower monthly incomes, were employed in smaller businesses, worked fewer hours per week, had shorter work durations, and were more likely to report exposure to physical/chemical and ergonomic hazards, and musculoskeletal and mental symptoms. Among nonstandard workers, the rates of occupational hazards and work-related health problems depended on the type of work performed. In particular, nonstandard male workers who were unskilled manual workers, older, had less education, and earned low wages had a greater risk of working in unstable occupations, greater exposures to occupational hazards, and more musculoskeletal pain (back pain: odds ratio [OR], 2.4; upper extremity pain: OR, 2.1; and lower extremity pain: OR, 1.7) than those performing other types of work.

CONCLUSION

Male unskilled manual workers with nonstandard employment were most vulnerable to OSH problems. Our findings suggest the need for OSH programs that specifically target nonstandard workers especially those in manual unskilled occupations.

The impact of employment protection on health: Evidence from fixed-term contract workers in South Korea

In this paper, we examine the impact of increased employment protection on the self-rated health of workers. We utilize the recent labor reform in South Korea which sharply increased the employment protection level of fixed-term contract workers meeting certain criteria. By applying a difference-in-differences framework to longitudinal data, we explore the causal impact of employment protection. We find that subjective health and perceived job security improved with increased statutory employment protection. Further analysis suggests that the improvement in subjective health is less likely to be driven by improvement in working conditions or health related behaviors.

Health behaviors and health status of Korean middleaged men by marital status: Korea Community Health Study, 2015

OBJECTIVES

Previous studies have shown that marital status is associated with household composition and living arrangements, which partially explain observed differences in health status according to marital status. However, due to the rapid socioeconomic and demographic transformations of the last few decades, the distribution of marital status among middle-aged adults has become more diverse. Therefore, this study aimed to obtain up-to-date information on the associations between marital status and health and to investigate the implications of these findings for conventional explanations of the health effects of marriage.

METHODS

The data for this study were obtained from the 2015 Korean Community Health Study. We compared 4 modifiable lifestyle behaviors—smoking, alcohol consumption, physical activity, and self-rated health status—as outcome variables in association with marital status in Korean middle-aged men (age 40-44) living in Seoul and other regions.

RESULTS

Married men showed the lowest cigarette smoking prevalence and the highest subjective health status both before and after adjusting for education and income. The odds of engaging in vigorous physical activity did not show a major difference before and after adjustment for income and education.

CONCLUSIONS

In married men, the prevalence of cigarette smoking was lowest and subjective health status was highest, similar to previous studies. However, the prevalence of engaging in physical activity was highest in divorced/widowed/separated men. The health behaviors and health status of Korean middle-aged adults should be more closely followed, since they are representative of demographic changes in the Korean population.

Effects of work conditions on suicidal ideation among middle-aged adults in South Korea

BACKGROUND

Korea has the highest rate of suicide in the world and has held this rank for the last decade. Suicide has risen especially sharply among 45- to 54-year-old Koreans; there were about 32.1 suicides per 100,000 individuals in 2015, and this contributed significantly to the rising suicide rate in Korea. Recently, adverse work conditions, including insecure employment and shift work, have been suggested as a suicide risk factor. However, little is known about the influence of insecure employment on suicidal ideation among middle-aged adults. Furthermore, prior research has examined the association between shift work and suicidal ideation only among individuals engaged in specific jobs, such as police work or firefighting, and those investigations have not focused on middle-aged adults.

AIM

This study investigated the influence of employment status and shift work on suicidal ideation among middle-aged adults.

METHODS

The sample comprised waged, middle-aged adult employees ( n = 2,364) aged 45-64 years who had participated in the cross-sectional Korea National Health and Nutrition Examination Survey 2015. Using multivariate logistic regression analyses, this study evaluated the associations of employment status and shift work with suicidal ideation among middle-aged adults.

RESULTS

The major finding was that insecure employment status was independently associated with suicidal ideation in middle-aged adults (odds ratio (OR) = 2.50, 95% confidence interval (CI) = [1.27, 4.94]) and that shift work was significantly associated with suicidal ideation among middle-aged adults (OR = 2.30, 95% CI = [1.14, 4.66]).

CONCLUSIONS

The findings of this study highlight the need for multidimensional interventions regarding suicide, especially for middle-aged adults engaged in insecure jobs and shift work. Multidimensional interventions, including early screening for suicidal thoughts during routine medical check-ups, readily available work-based counselling programmes and regular monitoring, are likely to be useful.

Exploring the public-private and company size differences in employees' work characteristics and burnout: data analysis of a nationwide survey in Taiwan

Distinct differences exist between public-private sector organizations with respect to the market environment and operational objectives; furthermore, among private sector businesses, organizational structures and work conditions often vary between large- and small-sized companies. Despite these obvious structural distinctions, however, sectoral differences in employees' psychosocial risks and burnout status in national level have rarely been systematically investigated. Based on 2013 national employee survey data, 15,000 full-time employees were studied. Sector types were classified into "public," "private enterprise-large (LE)," and "private enterprise-small and medium (SME);" based on the definition of SMEs by Taiwan Ministry of Economic Affairs, and the associations of sector types with self-reported burnout status (measured by the Chinese version of Copenhagen Burnout Inventory) were examined, taking into account other work characteristics and job instability indicators. Significantly longer working hours and higher perceived job insecurity were found among private sector employees than their public sector counterparts. With further consideration of company size, greater dissatisfaction of job control and career prospect were found among SME employees than the other two sector type workers. This study explores the pattern of public-private differences in work conditions and employees' stress-related problems to have policy implications for supporting mechanism for disadvantaged workers in private sectors.

Differences in Metabolic Syndrome Prevalence by Employment Type and Sex

Workers may sometimes do the same work, but differ in their risk of health-related problems depending on whether the employment type is standard or non-standard. Furthermore, even with similar job and employment types, there may be differences in risk factors for health-related problems depending on sex. This study aimed to determine the prevalence of metabolic syndrome (MetS) by employment type and sex using data from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES Ⅴ) (2010–2012) and KNHANES Ⅵ (2013–2015) conducted by the Korea Centers for Disease Control and Prevention. Overall, 9523 adult wage workers (5523 standard workers and 4000 non-standard workers) aged ≥ 19 years were analyzed. To determine MetS prevalence odds ratios according to employment type, logistic regression analysis was performed disaggregated by sex. The prevalence of MetS significantly increased with age (p < 0.001), being married (p < 0.05), current smoking status (p < 0.05), and high-risk drinking (p < 0.001) among male subjects. The prevalence of MetS significantly increased among female manual workers (p < 0.001), those with lower educational level and household income (p < 0.001). Non-standard workers of either sex showed higher MetS prevalence than standard workers; only females showed significant difference (p < 0.001). Female non-standard workers showed 1.44, 1.33, and 1.34 (all p < 0.001) times higher odds of MetS prevalence in Models 1, 2, and 3, respectively, compared to standard workers, suggesting a difference in risk factors of MetS according to sex. Also, that employment type affects MetS prevalence suggests that employment pattern is an important risk factor especially in females. Therefore, to manage MetS in female non-standard workers, individual health care as well as social effort may be necessary.

Body weight misperception and psychological distress among young South Korean adults: the role of physical activity

Background

Emerging evidence suggests that body weight misperception may be associated with psychological distress among people in developed countries. Participating in physical activity (PA) may negate the association between weight misperception and psychological distress given the well-known benefits of PA on psychological health. This study examined the role of PA in associations between body weight misperception and psychological distress among young South Korean adults.

Methods

Data from individuals aged 20 to 39 years who participated in the Fifth Korean National Health and Nutrition Examination Surveys 2010–2012 (N = 6055) was included in the logistic regressions.

Results

The proportions of the respondents under- and over-perceiving their body weight were 66.9% and 0.8% among men and 16.3% and 15.6% among women respectively. A moderating effect of PA participation was observed on the relationship between body weight over-perception and depressed mood (Odds Ratio [OR] = 0.55; 95% Confidence Intervals [95% CI] = 0.34, 0.89). Among individuals who did not meet the recommended vigorous-intensity PA (≥ 20 min/session and ≥ 3 day/week), body weight over-perception was associated with depressed mood (OR = 1.71, 95% CI = 1.19, 2.46) compared to the accurate-perception group. However, no association was observed among those who met the recommended vigorous-intensity PA (OR = 1.52, 95% CI = 0.45, 5.22). Similar patterns were found among physically active versus inactive individuals (recommended walking not met: OR = 2.02, 95% CI = 1.29, 3.15; recommended walking met: OR = 1.28, 95% CI = 0.66, 2.49; muscular strengthening exercises for < 2 day/week: OR = 1.74, 95% CI = 1.21, 2.51; muscular strengthening exercises for ≥ 2 day/week: OR = 1.38, 95% CI = 0.37, 5.14). No relationship existed between body weight over-perception and depressed mood after adjusting for PA.

Conclusions

Participating in regular PA may buffer a potential negative impact of body weight over-perception on depressive mood.

Association of Emotional Labor and Occupational Stressors with Depressive Symptoms among Women Sales Workers at a Clothing Shopping Mall in the Republic of Korea: A Cross-Sectional Study

In the distribution service industry, sales people often experience multiple occupational stressors such as excessive emotional labor, workplace mistreatment, and job insecurity. The present study aimed to explore the associations of these stressors with depressive symptoms among women sales workers at a clothing shopping mall in Korea. A cross sectional study was conducted on 583 women who consist of clothing sales workers and manual workers using a structured questionnaire to assess demographic factors, occupational stressors, and depressive symptoms. Multiple regression analyses were performed to explore the association of these stressors with depressive symptoms. Scores for job stress subscales such as job demand, job control, and job insecurity were higher among sales workers than among manual workers (p < 0.01). The multiple regression analysis revealed the association between occupation and depressive symptoms after controlling for age, educational level, cohabiting status, and occupational stressors (sβ = 0.08, p = 0.04). A significant interaction effect between occupation and social support was also observed in this model (sβ = −0.09, p = 0.02). The multiple regression analysis stratified by occupation showed that job demand, job insecurity, and workplace mistreatment were significantly associated with depressive symptoms in both occupations (p < 0.05), although the strength of statistical associations were slightly different. We found negative associations of social support (sβ = −0.22, p < 0.01) and emotional effort (sβ = −0.17, p < 0.01) with depressive symptoms in another multiple regression model for sales workers. Emotional dissonance (sβ = 0.23, p < 0.01) showed positive association with depressive symptoms in this model. The result of this study indicated that reducing occupational stressors would be effective for women sales workers to prevent depressive symptoms. In particular, promoting social support could be the most effective way to promote women sales workers’ mental health.

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.

Cardiovascular health status between standard and nonstandard workers in Korea

OBJECTIVES

The effect of employment insecurity on employee health is an important public health issue due to the recent effects of neoliberalism and the global financial crisis (2007-2008) on labor markets. This study aims to evaluate the differences in cardiovascular health status and the use of preventive screening services between standard and nonstandard workers.

METHODS

Waged employees (N = 5,338) between the ages of 20 and 64 were grouped into standard (full-time, permanent) and nonstandard (part-time, temporary, or daily) employees. Data from the Fourth Korea National Health and Nutrition Examination Survey, 2007-2009, a nationwide representative survey, were examined, including cardiovascular health risk behaviors (tobacco, alcohol, physical inactivity), measured morbidities (blood pressure, blood glucose level, lipid profiles, body mass index), and the use of screening services for hypertension and diabetes mellitus.

RESULTS

Female nonstandard employees tended to have higher blood pressure than did female standard employees (adjusted odds ratio, aOR 1.42, 95% confidence interval, CI 1.02 to 1.98). However, nonstandard employees (both men and women) were less likely to use preventive screening services for hypertension (aOR 0.72, 95% CI 0.54 to 0.94 in men; aOR 0.56, 95% CI 0.43 to 0.73 in women) and diabetes (aOR 0.58, 95% CI 0.43 to 0.79 in men; aOR 0.55, 95% CI 0.43 to 0.71 in women).

CONCLUSION

Nonstandard work is associated with the underuse of screening services and poorer cardiovascular health in a specific population. Policies to reduce employment insecurity and encourage nonstandard employees to receive health screening services should be prioritized.

Relationship Between Long Working Hours and Metabolic Syndrome Among Korean Workers

PURPOSE

This study investigated gender differences in the relationship between long working hours and metabolic syndrome.

METHODS

Data based on the Sixth National Health and Nutrition Examination Survey (2014) pertaining to a total of 1,145 paid workers were analyzed. Working hours were divided into three groups (40-51 hours/week, 52-59 hours/week, ≥ 60 hours/week). The relationship between working hours and metabolic syndrome was then analyzed after adjusting for general and occupational characteristics, using a multiple logistic regression model.

RESULTS

Working 40-51 hours per week was associated with the lowest metabolic syndrome among female workers (11.2%), whereas it was associated with the highest metabolic syndrome among male workers (28.0%). After adjusting for general and occupational characteristics, female workers working≥60 hours per week showed odds ratios of 2.21 [95% confidence interval (1.07, 4.57)], compared to those who worked 40-51 hours per week. However, no clear association between long working hours and metabolic syndrome was found among male workers.

CONCLUSION

The results suggest that working long hours, especially≥60 hours per week, is related to metabolic syndrome among female Korean workers.

Effect of working hours and precarious employment on depressive symptoms in South Korean employees: a longitudinal study

OBJECTIVES

Long working hours and precarious employment are relatively common in South Korea. Since both can impact on mental health, this study examined their independent and combined effects on depressive symptoms of employees.

METHODS

Data were from the Korean Welfare Panel Study (KOWEPS), 2010-2013. A total of 2733 full-time employees without depressive symptoms were analysed. Hierarchical logistic regression models were used to investigate the effect of the number of working hours per week (eg, 35-40 hours, 41-52 hours, 53-68 hours, and >68 hours) and employment status (permanent vs precarious employment) on depressive symptoms, measured using the Center for Epidemiological Studies Depression (CES-D) 11 scale.

RESULTS

Compared with individuals working 35-40 hours/week, employees working above 68 hours (OR 1.57, 95% CI 1.05 to 2.34) had higher odds of depressive symptoms after full adjustment. Similarly, precarious employees (OR 1.34, 95% CI 1.02 to 1.75) showed worse mental health than permanent employees. In the combined effect model, employees in precarious employment who worked above 68 hours/week (OR, 2.03 95% CI 1.08 to 3.83) exhibited the highest odds of depressive symptoms compared with permanent employees working 35 to 40 hours/week.

CONCLUSIONS

Long work hours and precarious employment status were associated with higher odds of depressive symptoms. The findings highlight the importance of monitoring and addressing the vulnerable groups of employees to reduce the mental health burden of economically active individuals.

Does long-term experience of nonstandard employment increase the incidence of depression in the elderly?

Objectives:

Our prospective study aimed to elucidate the effect of long-term experience of nonstandard employment status on the incidence of depression in elderly population using the Korean Longitudinal Study of Ageing (KLoSA) study.

Methods:

This study used the first- to fourth-wave cohorts of KLoSA. After the exclusion of the unemployed and participants who experienced a change in employment status during the follow-up periods, we analyzed a total of 1,817 participants. Employment contracts were assessed by self-reported questions:standard or nonstandard employment. The short form of the Center for Epidemiologic Studies Depression Scale (CES-D) served as the outcome measure. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using Cox proportional hazards models to evaluate the association between standard/nonstandard employees and development of depression.

Results:

The mean age of the participants was 53.90 (±7.21) years. We observed that nonstandard employment significantly increased the risk of depression. Compared with standard employees, nonstandard employees had a 1.5-fold elevated risk for depression after adjusting for age, gender, CES-D score at baseline, household income, occupation category, current marital status, number of living siblings, perceived health status, and chronic diseases [HR=1.461, 95% CI= (1.184, 1.805) ]. Moreover, regardless of other individual characteristics, the elevated risk of depression was observed among all kinds of nonstandard workers, such as temporary and day workers, full-time and part-time workers, and directly employed and dispatched labor.

Conclusions:

The 6-year follow-up study revealed that long-term experience of nonstandard employment status increased the risk of depression in elderly population in Korea.

How does employment quality relate to health and job satisfaction in Europe? A typological approach

The changing nature of employment in recent decades, due to an increased emphasis on flexibility and competitiveness in European labour markets, compels the need to assess the consequences of contemporary employment situations for workers. This article aims to study the relation between the quality of employment and the health and well-being of European workers, using data from the 2010 European Working Conditions Survey. A typology of employment arrangements, mapping out employment quality in the European labour force, is constructed by means of a Latent Class Cluster Analysis. This innovative approach shows that it is possible to condense multiple factors characterising the employment situation into five job types: Standard Employment Relationship-like (SER-like), instrumental, precarious unsustainable, precarious intensive and portfolio jobs. Binary logistic regression analyses show that, controlling for other work quality characteristics, this employment quality typology is related to self-perceived job satisfaction, general health and mental health. Precarious intensive jobs are associated with the worst and SER-like jobs with the best health and well-being situation. The findings presented in this study indicate that, among European wage workers, flexible and de-standardised employment tends to be related to lower job satisfaction, general health and mental health. The quality of employment is thus identified as an important social determinant of health (inequalities) in Europe.

Effects of voluntary/involuntary retirement on their own and spouses' depressive symptoms

OBJECTIVES

The aim of our study was to elucidate the effect of voluntary/involuntary retirement on individuals' and spouses' depressive symptoms using the Korean Longitudinal Study of Aging (KLoSA).

METHODS

This study used a sample derived from the first- to fourth-wave cohort datasets of KLoSA, which was conducted in 2006, 2008, 2010, and 2012. After applying inclusion and exclusion criteria, we analyzed a total of 6706 subjects. Information about employment status, the short-form Center for Epidemiological Studies-Depression scale, and covariates (age, property, household income, perceived health status and medical disability) were obtained. Cox proportional hazards models were used to evaluate the effects of voluntary/involuntary retirement on individuals' and spouses' depressive symptoms.

RESULTS

The voluntary/involuntary retirement groups showed significantly more depressive symptoms than the working group in wave 1-4, and the same results were revealed in the spouse's retirement and job loss measures. The hazard ratios of depressive symptoms of the voluntary/involuntary retirement groups were 1.26-1.31 during the 6year follow-up period. The wives' risk of depressive symptoms was also significantly increased if their husbands voluntarily retired (HR=1.35, 95% CI=1.10-1.65).

CONCLUSION

During the 6year follow-up study, Voluntary/involuntary retirement increased the risk of depressive symptoms in a Korean elderly population. Furthermore, husbands' voluntary retirement increased wives' risk of depressive symptoms.

Effects of a Social Welfare Program for Health Promotion on Cardiovascular Risk Factors

Background

Socioeconomic status is closely associated with an individual’s health status. However, there are few studies examining the role of exercise-training as part of a community-based social welfare program in socially vulnerable groups. Given this, our aim was to measure whether long-term exercise training as a social welfare program affects the prevalence of depressive symptoms, metabolic syndrome and peripheral blood vessel condition among participants with low household income.

Methods

Twenty-nine adults and twenty-two older adults were recruited into this study with non-radomized, pre/post-test design. The subjects underwent a combined training consisting of aerobic and muscle strengthening exercises for 6 months or more. Depressive symptoms were evaluated using the Beck Depression Inventory and the Korean version of Geriatric Depression Scale. Metabolic syndrome was defined according to the International Diabetes Federation criteria. Blood vessel condition was assessed using non-invasive accelerated photoplethysmograph.

Results

Mean skeletal muscle mass increased after exercise-training, but body mass index and percent body fat were unchanged. Overall age-specific physical fitness and performance increased markedly among both adult and elderly subjects, respectively. The proportion of depressive symptoms was significantly reduced by 33% after exercise-training among all participants. The prevalence of individuals having metabolic syndrome was significantly reduced by 19.6% and the number of individual components of metabolic syndrome decreased after the exercise intervention. Among components of metabolic syndrome, waist circumference, HDL cholesterol and systolic blood pressure significantly improved. In addition, the proportions of moderate and severe arteriosclerotic progression significantly decreased.

Conclusion

Long-term exercise-training as a social welfare program is beneficial for health promotion and effective in simultaneously improving psychological and physiological health status in a low income population. This suggests that the development and expansion of an exercise intervention as a health-promoting welfare program are needed to address the inequality of exercise participation among socially vulnerable groups.

Alcohol drinking behaviors and alcohol management policies under outsourcing work conditions: A qualitative study of construction workers in Taiwan

BACKGROUND

Workplace alcohol policies are crucial for workers' health and safety. The practice of outsourcing is gaining popularity around the world and was found to be associated with poorer health in the working population. This study aimed to examine how outsourcing complicates the implementation of workplace alcohol policies and affects workers' drinking behaviors.

METHODS

In-depth interviews were conducted with 16 outsource workers, 3 subcontractors and 3 worksite supervisors. Information regarding workers' drinking behaviors, their knowledge, and attitudes toward workplace alcohol policy were analyzed using a qualitative thematic analysis.

RESULTS

Factors associated with poor workplace alcohol management included smaller size and private ownership of outsourcers, subcontractors' own drinking behavior and positive attitude to alcohol, and precarious employment conditions of outsourcing workers. The multilateral relationship between outsourcers, subcontractors, and workers complicated and impaired the implementation of workplace alcohol policies.

CONCLUSION

The implementation of workplace alcohol management policies was hampered in outsourcing work conditions due to poor coordination of supervisors in the subcontract chain. The enforcement of alcohol policies in the workplace should be strengthened by consolidating management responsibilities of outsourcers and subcontractors.

Gestão de saúde familiar e pobreza em período de recessão económica em Portugal

Este artigo assumiu como objetivo principal investigar sobre gestão e saúde, verificando a contribuição da saúde familiar e o seu papel no desenvolvimento local em contexto de recessão económica e agravamento da pobreza em Portugal. Na metodologia inquiriram-se 1021 indivíduos em Portugal Continental, com tratamento estatístico através de análise inferencial, fatorial e também de regressão. Salientam-se como resultados que o facto de um indivíduo se considerar uma pessoa saudável não é independente da atividade profissional, condições de habitação, ou outros determinantes relacionados com as condições de vida. Através de uma análise fatorial consistente foram identificados um conjunto de fatores com importância sobre a gestão de saúde familiar. Como conclusão resulta que as condições de trabalho e em que vivem os cidadãos estão relacionadas com o seu nível de saúde. Identificámos os determinantes mais importantes para explicar a esperança média de vida e que se refletem em período de recessão económica.

The direct and indirect effects of initial job status on midlife psychological distress in Japan: evidence from a mediation analysis

In the current study, we investigated how initial job status at graduation from school is associated with midlife psychological distress, using microdata from a nationwide Internet survey of 3,117 men and 2,818 women aged 30-60 yr. We measured psychological distress using the Kessler 6 (K6) score (range: 0-24) and the binary variable of K6 score ≥5. We found that unstable initial job status substantially raised midlife K6 scores and the probability of a K6 score ≥5 for both men and women. Furthermore, our mediation analysis showed that for men, slightly less than 60% of the effect was mediated by current job status, household income, and marital status. For women, the effect of initial job status was somewhat lesser than that for men, and only 20-30% of it was mediated. Despite these gender asymmetries, the results indicated that initial job status was a key predictor of midlife mental health. The association between job status and mental health should be further investigated with special reference to the institutional attributes of the labor market and their socio-economic/demographic outcomes.

The chronic impact of work on suicides and under-utilization of psychiatric and psychosocial services

BACKGROUND

Work-related stress appears to be a contributing factor in the lives of employed people who kill themselves, particularly during economic downturns. However, few studies have compared them with working community controls who may be experiencing similar strains, in order to explore the role of mental disorders in these deaths and the implication of such strains on their service use pattern. We hypothesized that both work stress and mental illness were associated with suicides, and that mental illness served as the mediator between work stress and suicide. Based on the Behavioral Model, we also assumed work stress associated with their use of services.

METHODS

A sample of 175 employed individuals (suicides=63; controls=112) drawn from a psychological autopsy (PA) dataset was examined based on demographics and socioeconomic factors, psychiatric diagnoses and use of services, psychosocial factors, and life events. A mediator analysis was conducted to examine the impact of work on suicides.

RESULTS

Suicides generally had depression and anxiety, debts, higher impulsivity and poorer social support in comparison to controls. Chronic impact from work, which was fully mediated by psychiatric illness, was found higher among those suicides that did not seek contact with clinical service providers.

LIMITATIONS

PA is a post-hoc cross-sectional comparison method which does not allow causal analyses.

CONCLUSION

It is important to develop new approaches for engaging vulnerable individuals in the workplace before they become suicidal, as their depression and social isolation can serve to cut them off from help when they are most in need. Occupational mental health programs should be made available for employees and their families.

Health benefits of encore careers for baby boomers

Baby boomers now represent an aging population group at risk of the diseases of older age. Their relatively high education, amongst other attributes, means that they can make a significant contribution to the work force beyond the statutory retirement age. On an individual level, potential health benefits may motivate them to pursue encore careers. We review some of the evidence supporting such a trend.