Contingent work and ill-health: Conceptualizing the links

Examining the health and wellness of solo self-employed workers through narratives of precarity: a qualitative study

BACKGROUND

In recent decades, there has been a significant transformation in the world of work that is characterized by a shift from traditional manufacturing and managerial capitalism, which offered stable full-time employment, to new forms of entrepreneurial capitalism. This new paradigm involves various forms of insecure, contingent, and non-standard work arrangements. Within this context, there has been a noticeable rise in Self-Employed individuals, exhibiting a wide range of -working arrangements. Despite numerous investigations into the factors driving individuals towards Self-Employment and the associated uncertainties and insecurities impacting their lives and job prospects, studies have specifically delved into the connection between the precarious identity of Self-Employed workers and their overall health and well-being. This exploratory study drew on a 'precarity' lens to make contributions to knowledge about Self-Employed workers, aiming to explore how their vulnerable social position might have detrimental effects on their health and well-being.

METHODS

Drawing on in-depth interviews with 24 solo Self-Employed people in Ontario (January - July 2021), narrative thematic analysis was conducted based on participants' narratives of their work experiences. The dataset was analyzed with the support of NVIVO qualitative data analysis software to elicit narratives and themes.

FINDINGS

The findings showed that people opt into Self-Employment because they prefer flexibility and autonomy in their working life. However, moving forward, in the guise of flexibility, they encounter a life of precarity, in terms of job unsustainability, uncertainties, insecurities, unstable working hours and income, and exclusion from social benefits. As a result, the health and well-being of Self-Employed workers are adversely affected by anger, anomie, and anxiety, bringing forward potential risks for a growing population.

CONCLUSION AND IMPLICATIONS

Neoliberalism fabricates a 'precariat' Self-Employed class. This is a social position that is vague, volatile, and contingent, that foreshadows potential threats of the health and wellbeing of a growing population in the changing workforce. The findings in this research facilitate some policy implications and practices at the federal or provincial government level to better support the health and wellbeing of SE'd workers.

Self-employment, illness, and the social security system: a qualitative study of the experiences of solo self-employed workers in Ontario, Canada

BACKGROUND

Today's labor market has changed over time, shifting from mostly full-time, secured, and standard employment relationships to mostly entrepreneurial and precarious working arrangements. Thus, self-employment (SE) has been growing rapidly in recent decades due to globalization, automation, technological advances, and the recent rise of the 'gig' economy, among other factors. Accordingly, more than 60% of workers worldwide are non-standard and precarious. This precarity profoundly impacts workers' health and well-being, undermining the comprehensiveness of social security systems. This study aims to examine the experiences of self-employed (SE'd) workers on how they are protected with available social security systems following illness, injury, and income reduction or loss.

METHODS

Drawing on in-depth interviews with 24 solo SE'd people in Ontario (January - July 2021), thematic analysis was conducted based on participants' narratives of experiences with available security systems following illness or injury. The dataset was analyzed using NVIVO qualitative software to elicit narratives and themes.

FINDINGS

Three major themes emerged through the narrative analysis: (i) policy-practice (mis)matching, (ii) compromise for a decent life, and (iii) equity in work and benefits.

CONCLUSIONS

Meagre government-provided formal supports may adversely impact the health and wellbeing of self-employed workers. This study points to ways that statutory social protection programs should be decoupled from benefits provided by employers. Instead, government can introduce a comprehensive program that may compensate or protect low-income individuals irrespective of employment status.

National survey of mental health and life satisfaction of gig workers: the role of loneliness and financial precarity

OBJECTIVES

To compare the mental health and life satisfaction of those employed in the gig work and contingent work with those in full-time or part-time work and the unemployed in the UK during the COVID-19 pandemic. To explore the possible mechanisms of latent and manifest benefits of employment, such as financial precarity and loneliness.

DESIGN

Cross-sectional survey.

PARTICIPANTS

A representative sample of 17 722 employed and unemployed British adults, including 429 gig workers. People with disability, retirees and full-time students are not included in the sample.

MAIN OUTCOME MEASURES

Mental health (General Health Questionnaire-12 score) and life satisfaction (a direct question from UK Household Longitudinal Study (UKHLS)) as outcomes. Self-reported loneliness (four widely used questions from UKHLS) and financial precarity (a direct question from UKHLS) as mediators.

RESULTS

Gig workers reported mental health and life satisfaction worse than those employed full time and part time, but better than the unemployed. Mediation analyses showed that gig workers' worse mental health and life satisfaction than other workers were explained by their higher levels of loneliness and financial precarity, while gig workers' better mental health and life satisfaction than the unemployed were explained by their less financial precarity.

CONCLUSIONS

Informal and freelance economy provided manifest benefits of employment to gig workers compared with unemployment but lacked latent benefits of employment. Public policies should provide social support to freelance and contingent workers to reduce their loneliness and improve their psychological well-being, especially during the COVID-19 pandemic.

What Social Supports Are Available to Self-Employed People When Ill or Injured? A Comparative Policy Analysis of Canada and Australia

Self-employment (SE) is a growing precarious work arrangement internationally. In the current digital age, SE appears in configurations and contours that differ from the labor market of 50 years ago and is part of a ‘paradigm shift’ from manufacturing/managerial capitalism to entrepreneurial capitalism. Our purpose in this paper is to reflect on how a growing working population of self-employed people accesses social support systems when they are not working due to injury and sickness in the two comparable countries of Canada and Australia. We adopted ‘interpretive policy analysis’ as a methodological framework and searched a wide range of documents related to work disability policy and practice, including official data, legal and policy texts from both countries, and five prominent academic databases. Three major themes emerged from the policy review and analysis: (i) defining self-employment: contested views; (ii) the relationship between misclassification of SE and social security systems; (iii) existing social security systems for workers and self-employed workers: Ontario and NSW. Our comparative discussion leads us toward conclusions about what might need to be done to better protect self-employed workers in terms of reforming the existing social security systems for the countries. Because of similarities and differences in support available for SE’d workers in the two countries, our study provides insights into what might be required to move the different countries toward sustainable labour markets for their respective self-employed populations.

Modification Effect of Job Demand and Contingent Work Schedule on Overweight and Obesity Among Civil Servants in Taiwan

OBJECTIVE

Evidence indicated that shift work is a contributing factor to risk of obesity and leads to cardiovascular diseases (CVDs), but few researches have examined the moderating effects of job demand and contingent work schedule on overweight and obesity. Thus, we assessed the modification effect of contingent work schedules and job demand on overweight and obesity among Taiwan's civil servants.

METHODS

Multistage stratified random cluster sampling was used based on a proportional probabilistic sampling (PPS) in a national survey for civil servants. A total of 20,046 participants from 647 registered governmental institutions were enrolled and anonymously and voluntarily filled out web-based questionnaires.

RESULTS

Compared to fixed work schedule, odd ratios (ORs) of obesity and overweight were 1.63 and 1.78 times in contingent work schedule, respectively. In addition, the modification effects of contingent work schedule and high job demand on overweight and obesity with Rothman's synergy index were 2.43 and 2.56, respectively. Using a hierarchical regression model adjusted for covariates, both high job demand and contingent work schedule were interactively associated with overweight and obesity compared to low job demand and fixed work schedule.

CONCLUSION

Since precarious schedules affect employee's obesity through work-related stress and unhealthy behaviors, further research is needed to determine whether interventions aimed at modification of work schedule may be useful in combating obesity.

Health Equity and a Paradigm Shift in Occupational Safety and Health

Despite significant improvements in occupational safety and health (OSH) over the past 50 years, there remain persistent inequities in the burden of injuries and illnesses. In this commentary, the authors assert that addressing these inequities, along with challenges associated with the fundamental reorganization of work, will require a more holistic approach that accounts for the social contexts within which occupational injuries and illnesses occur. A biopsychosocial approach explores the dynamic, multidirectional interactions between biological phenomena, psychological factors, and social contexts, and can be a tool for both deeper understanding of the social determinants of health and advancing health equity. This commentary suggests that reducing inequities will require OSH to adopt the biopsychosocial paradigm. Practices in at least three key areas will need to adopt this shift. Research that explicitly examines occupational health inequities should do more to elucidate the effects of social arrangements and the interaction of work with other social determinants on work-related risks, exposures, and outcomes. OSH studies regardless of focus should incorporate inclusive methods for recruitment, data collection, and analysis to reflect societal diversity and account for differing experiences of social conditions. OSH researchers should work across disciplines to integrate work into the broader health equity research agenda.

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.

Overlapping vulnerabilities in workers of the electronics recycling industry formal sector: A commentary

Vulnerabilities in workers performing electronics recycling (e-recycling) in the informal sector worldwide have been well documented. However, the growing e-recycling industry in the formal sector still brings many challenges to protect the health of workers and their environment. This commentary aims to draw attention to the overlooked vulnerabilities faced by the workers of the e-recycling industry formal sector in high-income countries and discuss the potential impact on health inequalities experienced by these workers. Expanding the definition of vulnerability, not limited to the biological susceptibility to chemical and physical exposures, the demographic characteristics of workers in the e-recycling formal sector often reveal social groups known to be disadvantaged regarding occupational exposures and health effects, including young workers, immigrant or ethnic minorities, and workers with mental or physical health issues or disabilities. Overlapping structural vulnerabilities of the e-recycling industry stem from its newness, its working conditions, its conditions of employment, and the sociodemographic characteristics of its workforce. This phenomenon in high-income countries is not restricted to the e-recycling industry alone. It is rather a symptom of more generalized macro socioeconomical phenomena. The present challenges are in line with the new gig and green economies and changes in the global market, and their consequences on the solid waste sector. Continued efforts to strengthen the inclusion of social aspects of health into the complex interaction of the structural vulnerabilities met by e-recycling workers will be essential to anticipate and prevent health issues in this essential but still emerging workforce.

Depression at work, authenticity in question: Experiencing, concealing and revealing

Australia and the United Kingdom have introduced policies to protect employees who experience mental illness, including depression. However, a better understanding of the experiential issues workers face (e.g. sense of moral failure) is needed for the provision of appropriate and beneficial support. We analysed 73 interviews from the United Kingdom and Australia where narratives of depression and work intersected. Participants encountered difficulties in being (and performing as if) 'authentic' at work, with depression contributing to confusions about the self. The diffuse post-1960s imperative to 'be yourself' is experienced in conflicting ways: while some participants sought support from managers and colleagues (e.g. sick leave, back-to-work plans), many others put on a façade in an attempt to perform the 'well' and 'authentic' employee. We outline the contradictory forces at play for participants when authenticity and visibility are expected, yet, moral imperatives to be good (healthy) employees are normative.

Does employment security modify the effect of housing affordability on mental health?

This paper uses longitudinal data to examine the interrelationship between two central social determinants of mental health - employment security and housing affordability. Data from ten annual waves of the longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey (which commenced in 2000/1 and is ongoing) were analysed using fixed-effects longitudinal linear regression. Change in the SF-36 Mental Component Summary (MCS) score of working age individuals (25-64 years) (51,885 observations of 10,776 people), associated with changes in housing affordability was examined. Models were adjusted for income, age, survey year, experience of serious injury/illness and separation/divorce. We tested for an additive interaction between the security of a household's employment arrangements and housing affordability. People in insecurely employed households appear more vulnerable than people in securely employed households to negative mental health effects of housing becoming unaffordable. In adjusted models, people in insecurely employed households whose housing became unaffordable experienced a decline in mental health (B=-1.06, 95% CI -1.75 to -0.38) while people in securely employed households experienced no difference on average. To progress our understanding of the Social Determinants of Health this analysis provides evidence of the need to bridge the (largely artificial) separation of social determinants, and understand how they are related.

Decent Work: A Psychological Perspective

This contribution, which serves as the lead article for the Research Topic entitled “From Meaning of Working to Meaningful Lives: The Challenges of Expanding Decent Work,” explores current challenges in the development and operationalization of decent work. Based on an initiative from the International Labor Organization [ILO] (1999) decent work represents an aspirational statement about the quality of work that should be available to all people who seek to work around the globe. Within recent years, several critiques have been raised about decent work from various disciplines, highlighting concerns about a retreat from the social justice ethos that had initially defined the concept. In addition, other scholars have observed that decent work has not included a focus on the role of meaning and purpose at work. To address these concerns, we propose that a psychological perspective can help to revitalize the decent work agenda by infusing a more specific focus on individual experiences and by reconnecting decent work to its social justice origins. As an illustration of the advantages of a psychological perspective, we explore the rise of precarious work and also connect the decent work agenda to the Psychology-of-Working Framework and Theory (Blustein, 2006; Duffy et al., 2016).

Impromptu everyday disclosure dances: how women with fibromyalgia respond to disclosure risks at work

PURPOSE

Findings from a study examining how women with fibromyalgia remain employed are used to explicate a conceptualization that adds to literature on workplace disclosure of stigmatized illnesses and impairments: disclosure dances that employees improvise in response to workplace-relationships needs and disclosure risks.

METHODS

Critical-discourse-analysis (CDA) methodology framed the study. Data were collected through 26 semi-structured, individual interviews with participant triads or dyads comprising women with fibromyalgia, family members and supervisors or co-workers. Interviews with managers who supervised disabled employees other than the women supplemented these data. Following coding, data were compared within and across triads/dyads through code-dimension summaries, narrative summaries and relational diagrams.

RESULTS

Women with fibromyalgia and other stigmatized illnesses improvised everyday disclosures when they needed to explain fluctuating work ability, when others needed reminding about invisible impairments, and when workplace relationships changed. These impromptu disclosures comprised three dimensions: exposing oneself to scrutiny by disclosing both illness and impairments, divulging stigmatized illness, and revealing invisible impairments selectively.

CONCLUSION

Through impromptu disclosure dances, women tailored disclosure to changing immediate circumstances. While assumptions from psychological theories of risk underlie current conceptualizations of disclosure as planned in advance, this article examines disclosure through a different lens: social theories of everyday risk. Implications for rehabilitation For women with fibromyalgia, disclosing illness and impairments at work may entail risks to their jobs and workplace relationships. Rehabilitation professionals need to consider these risks when advising women with fibromyalgia about disclosing their illness and impairments at work. Professionals may first want to learn from clients about their workplace cultures and relationships, and their perceptions of disclosure risk. Professionals can then suggest a range of disclosure responses, depending on the relationship and risk.

Employment arrangements and mental health in a cohort of working Australians: are transitions from permanent to temporary employment associated with changes in mental health?

We investigated whether being in temporary employment, as compared with permanent employment, was associated with a difference in Short Form 36 mental health and whether transitions from permanent employment to temporary employment were associated with mental health changes. We used fixed-effects regression in a nationally representative Australian sample with 10 waves of data collection (2001-2010). Interactions by age and sex were tested. Two forms of temporary employment were studied: "casual" (no paid leave entitlements or fixed hours) and "fixed-term contract" (a defined employment period plus paid leave). There were no significant mental health differences between temporary employment and permanent employment in standard fixed-effects analyses and no significant interactions by sex or age. For all age groups combined, there were no significant changes in mental health following transitions from stable permanent employment to temporary employment, but there was a significant interaction with age (P = 0.03) for the stable-permanent-to-casual employment transition, because of a small transition-associated improvement in mental health for workers aged 55-64 years (β = 1.61, 95% confidence interval: 0.34, 2.87; 16% of the standard deviation of mental health scores). Our analyses suggest that temporary employment is not harmful to mental health in the Australian context and that it may be beneficial for 55- to 64-year-olds transitioning from stable permanent employment to casual employment.

Deliberately casual? Workers' agency, health, and nonstandard employment relations in Australia

OBJECTIVE

We explored Australian workers' experiences of nonstandard employment, how it related to health and well-being, and the role that Bourdieu's forms of capital (cultural, economic, and social resources) played in underpinning workers' agency.

METHODS

Qualitative data from semistructured interviews with 32 causal workers were analyzed on the basis of framework analysis.

RESULTS

Most participants were "deliberate casuals" who had chosen casual over permanent employment, with half of that group naming improved health and well-being as motivation. Those with greater access to capital felt more able to exercise choice, whereas those with fewer capital resources felt constrained to be casual. Gendered structures and labor market dynamics were also significant in shaping agency.

CONCLUSIONS

Access to capital and a buoyant labor market underpinned workers' agency in Australia, enabling some to gain health and well-being benefits from nonstandard employment.