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Bodin T, Matilla-Santander N, Selander J, Gustavsson P, Hemmingsson T, Johansson G, Jonsson J, Kjellberg K, Kreshpaj B, Orellana C, Wadensjö E, Albin M. Trends in Precarious Employment in Sweden 1992-2017: A Social Determinant of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12797. [PMID: 36232108 PMCID: PMC9565988 DOI: 10.3390/ijerph191912797] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to identify trends in precarious employment in the Swedish workforce from 1992 to 2017. This is a repeated cross-sectional study, analyzing the total working population aged 16-75 in Sweden at five-year intervals. We used version 2.0 of the Swedish Register-based Operationalization of Precarious Employment, covering the following dimensions: employment insecurity, income inadequacy, lack of rights and protection. The proportion in precarious employment increased from 9.7 to 12% between 1992 and 2017, a relative increase of 24%. The prevalence was higher among those of lower age, of low education, and immigrants. Differences between sexes converged, and there were slightly more precarious men than women in 2017. The relative increase was most pronounced among men, especially those with low educational attainment and of European origin. The increasing proportion of precarious employees is a clear challenge to the tripartite Nordic model, which requires sufficient trade-union bargaining power.
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Affiliation(s)
- Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
| | - Nuria Matilla-Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
| | - Per Gustavsson
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
| | - Tomas Hemmingsson
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden
| | - Gun Johansson
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
| | - Johanna Jonsson
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
| | - Katarina Kjellberg
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
| | - Bertina Kreshpaj
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Section of Epidemiology, Department of Public Health, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Cecilia Orellana
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
| | - Eskil Wadensjö
- Swedish Institute for Social Research, Stockholm University, 10691 Stockholm, Sweden
| | - Maria Albin
- Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, 11365 Stockholm, Sweden
- Center for Occupational and Environmental Medicine, Stockholm Region, 11365 Stockholm, Sweden
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Liu C, Wall-Wieler E, Urquia M, Carmichael SL, Stephansson O. Severe maternal morbidity among migrants with insecure residency status in Sweden 2000-2014: a population-based cohort study. J Migr Health 2020; 1-2:100006. [PMID: 34405161 PMCID: PMC8352011 DOI: 10.1016/j.jmh.2020.100006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/12/2020] [Accepted: 11/13/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Migrants with insecure residency status (i.e., undocumented migrants and asylum-seekers, who are denied or waiting for authorized residency) often experience social and psychosocial adversities and limited access to health care. Nonetheless, they have not been profiled on the risk of severe maternal morbidity (SMM), a sentinel measure of maternal health and maternity care. METHODS A cohort study on all births recorded in the Swedish Medical Birth Register from 2000-2014 (N = 1,570,472). Lacking a maternal personal identification number was used as an indicator for insecure residency status (1.3% of all births). We used Poisson regression models to estimate risk ratios of SMM in migrant women with insecure residency status compared to the Swedish-born or migrant women with long-term residency, adjusting for the calendar year of birth, maternal age, and parity. RESULTS Overall SMM rate among migrant women with insecure residency status was 21.5/1000 and 14.7/1000 among Swedish-born women. Compared to Swedish-born, migrants with insecure residency status had 50% higher risk of overall SMM (adjusted risk ratio (aRR)=1.54 [1.37-1.74]) and over 80% higher risk of SMM excluding transfusion-only cases (aRR=1.88 [1.37-2.57]). When compared to migrant women with long-term residency, migrant women with insecure residency also had a higher risk of SMM (overall SMM aRR=1.42 [1.26,1.61]; SMM excluding transfusion only cases aRR=1.43 [1.04,1.97]), suggesting that insecure residency conferred additional risks of SMM beyond migration. CONCLUSION Migrant women with insecure residency status had increased risk of severe maternal morbidity.
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Affiliation(s)
- Can Liu
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elizabeth Wall-Wieler
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Marcelo Urquia
- Manitoba Centre for Health Policy, Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Suzan L. Carmichael
- Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
- Division of Maternal- Fetal Medicine, Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA, USA
| | - Olof Stephansson
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
- Department of Women's Health, Karolinska University Hospital, Stockholm, Sweden
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