Precarious Employment and Chronic Stress: Do Social Support Networks Matter?

Association of low-quality employment with the development of suicidal thought and suicide planning in workers: A longitudinal study in Korea

BACKGROUND

Employment quality stands as a crucial social determinant impacting workers' health. In this study, we investigate the association between low-quality employment and the emergence of suicidal thoughts and planning.

METHODS

We analyzed data from 7,797 Korean workers, amounting to 30,945 observations. Low-quality employment was characterized by three primary dimensions: employment insecurity, income inadequacy, and a lack of rights and protection. We employed a generalized estimating equation to probe the link between experiencing low-quality employment and the occurrence of suicidal thought and planning within the subsequent year. Odds ratios (OR) and 95% confidence intervals (CI) were estimated.

RESULTS

The overall incidence rates for suicidal thought and planning were 1.5% and 0.2%, respectively, across the observations. Workers with the lowest employment quality demonstrated higher propensities to develop both suicidal thought (OR: 2.05, 95% CI: 1.37-3.06) and planning (OR: 3.39, 95% CI: 1.08-10.64) at the following year, compared with workers with the highest overall employment quality. Specifically, daily employment exhibited associations with the onset of suicidal thought (OR: 1.64, 95% CI: 1.17-2.31) and suicide planning (OR: 3.49, 95% CI: 1.54-7.92) when compared to permanent employment. Additionally, individuals in the lowest monthly wage quartile displayed a heightened likelihood of developing suicidal thought (OR: 2.09, CI: 1.36-3.23) compared with those in the highest quartile.

CONCLUSION

Our findings suggest that low-quality employment is associated with the onset of suicidal thought and suicide planning at follow-up. Therefore, employment quality is a critical social determinant of workers' mental health.

The association between precarious employment and stress among working aged individuals in the United States

OBJECTIVE

Precarious employment is a plausible stressor, which may adversely affect health. We investigated the association between multidimensional precarious employment and perceived and biological stress in the U.S.

METHODS

We used data from waves 4 (2008-2009) and 5 (2016-2018) of the National Longitudinal Study of Adolescent to Adult Health. Eight indicators were mapped to five dimensions of precarious employment to create a continuous score (PES, range: 0-5): material rewards, working-time arrangements, stability, workers' rights, and interpersonal relationships. Perceived stress was constructed from the four-item Cohen's perceived stress score (PSS; range: 0-16; wave 4). We measured biological stress in waves 4 and 5 via C-reactive protein (CRP). Given variability in CRP collection between waves, we treated wave 4 and 5 as cross-sectional. We employed adjusted linear regression models to estimate whether the PES was associated with the PSS in wave 4 (n = 11,510) and CRP in waves 4 (n = 10,343) and 5 (n = 3452).

RESULT

Individuals were aged 28 and 37 years on average in wave 4 and 5, respectively. Half were female and most identified as non-Hispanic (NH)-White (∼73 %), followed by NH-Black (∼14 %), Hispanic (∼9 %) and NH-other (∼4 %). Average PES was inversely related to education. The PSS averaged 8.1 (Interquartile Range [IQR] = 7.0,9.0). Average CRP was 4.4 mg/L (IQR = 0.8,5.0) in wave 4 and 3.6 mg/L (IQR = 0.8,4.2) in wave 5. The PES was associated with perceived stress (β=0.06; 95 % CI = 0.01,0.10) and CRP in wave 5 (β=0.34; 95 % CI = 0.07,0.62).

CONCLUSIONS

Given the deleterious effects of stress on health, policies to reduce precarious employment warrant consideration.

Precarious employment and the onset of depressive symptoms and problematic alcohol use in middle-aged or older workers: A Korean longitudinal study (2006-2022)

Although precarious employment (PE) has emerged as a growing public health concern, research on older adults is scarce. This study explored the associations between PE and the onset of depressive symptoms and problematic alcohol use among middle-aged and older workers. A total of 2536 Korean waged workers aged ≥45 years contributed 8486 observations from 2006 to 2022. PE was defined as a multidimensional construct that includes employment insecurity, income inadequacy, and a lack of worker rights and protection. Depressive symptoms and problematic alcohol use were assessed using the Center for Epidemiological Studies Depression Scale and the CAGE questionnaire. Generalized estimating equations were employed to determine the association of PE with depressive symptoms and problematic alcohol use after the two-year follow-up. Risk ratios (RR) and 95% confidence intervals (CI) were estimated. Women, individuals with older age and low educational background, and blue-collar workers were more likely to belong to the high PE group. For individual indicators of PE, daily employment (RR: 1.26, 95% CI: 1.05-1.53), the lowest wage quartile (RR: 1.32, 95% CI: 1.01-1.72), and lack of trade union (RR: 1.55, 95% CI: 1.10-2.17) were positively associated with depressive symptom onset in the follow-up. Compared with the group with the lowest overall PE, the group with the highest PE exhibited increased risks of experiencing the onset of depressive symptoms (RR: 1.62, 95% CI: 1.27-2.08) and problematic alcohol use (RR: 2.45, 95% CI: 1.16-5.17) in the follow-up. This study suggests that PE is a major social determinant of older workers' mental health.

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.

Multidimensional typologies of precarious employment and their relationships with mental well-being in Korean wageworkers: A latent class analysis based on the Korean Working Conditions Survey (2020-2021)

BACKGROUND

Precarious employment (PE) has been conceptualized as having a multidimensional nature, and research addressing this topic in Asian countries is scarce. This study examined the typologies of PE and their relationships with mental health among Korean workers.

METHODS

From October 2020 to April 2021, the Korean Working Conditions Survey was conducted on Korean wageworkers (weighted N = 38,347), representative of the nation. With theory-based operationalization of PE, we identified typologies and classified workers through latent class analysis. Logistic regression was performed to explore the association between PE typologies and mental health among workers, represented as odds ratio (ORs) and confidence intervals (CIs).

RESULTS

Four distinct employment typologies emerged: (i) standard employment relationships (SER, 34.5%), (ii) moderate employment precariousness (MEP, 43.5%), (iii) underemployment (17.9%), and (iv) daily laborers (4.1%). Women were overrepresented in the MEP and underemployment types, while the SER type consisted of those with higher educational attainment and white-collar jobs. The OR (95% CI) of depression was 1.38 (1.27-1.50) for the MEP type, 1.48 (1.32-1.66) for the underemployment type, and 2.15 (1.85-2.51) for the daily laborers, compared to the SER type. For individual elements of PE, temporary employment, low wages, low-income predictability, and low involvement in work process were positively associated with depression, whereas part-time employment was negatively associated with depression.

CONCLUSION

Employment insecurity, low material rewards, and a lack of rights and protection can contribute to the poor mental health of workers. Policy interventions are warranted to mitigate inequalities in employment quality among Korean workers.

The double burden of precariousness: linking housing, employment, and perceived stress - a cross-sectional study

Employment precariousness is widely recognised as a social determinant of health and a chronic stressor. Yet precariousness extends beyond employment, into other aspects of life. Using a multidimensional social pathways approach, this study examines the synergistic effects of employment and housing precariousness on self-perceived stress. This study uses the PRESSED dataset (N = 255) derived from the Barcelona Health Survey, which collects data on stress using the Perceived Stress Scale (PSS). Employment precariousness was operationalized using the Employment Precariousness Scale (EPRES) and a multidimensional indicator of housing precariousness was constructed. Generalized structural equation modelling was used to estimate associations between these indicators and self-perceived stress measured by Perceived Stress Survey (PSS), after accounting for sociodemographic variables. Employment and housing precariousness were positively associated with self-perceived stress (OR = 3.23 ; p = 0.002) (OR = 4.28 ; p = 0.065) respectively. The mediating effect of housing precariousness accounted for 16% of the total effect of employment precariousness on stress after controlling for sociodemographic variables. Furthermore, we find that both precarious conditions were unequally distributed by age, sex educational level, and place of birth in the sample. We conclude that employment and housing precariousness are important chronic stressors and that a social pathway approach is needed.

Multidimensional employment precariousness mediates the association between low educational attainment and poor subjective well-being: results from a nationwide cross-sectional study in South Korea

OBJECTIVE

This paper explored how multidimensional employment precariousness (MEP) mediates the relationship between educational attainment and subjective well-being.

METHODS

A nationwide sample of 46 919 Korean workers participated in surveys between 2017 and 2020. Educational attainment was divided into four categories: elementary school, middle school, high school, and college. Subjective well-being was assessed using the 5-item World Health Organization Well-Being Index, and MEP was evaluated using a modified version of the Employment Precariousness Scale (ERPES-E), with scores ranging from 0 to 100 and higher scores indicating worse employment precariousness. A counterfactual-based logistic mediation analyses were used to estimation.

RESULTS

The mean MEP score was 36.0 [standard deviation (SD) 12.1] for college education, 44.3 (SD 11.5) for high school, 49.5 (SD 10.1) for middle school, and 51.1 (SD 10.0) for elementary school. The prevalence of poor subjective well-being was 24.0% for college education, 31.3% for high school, 40.6% for middle school, and 44.8% for elementary school. Odds ratios (OR) for the total effect of education on the poor subjective well-being were 1.44 [95% confidence interval (CI) 1.37-1.53] for high school, 2.19 (95% CI 1.98-2.24) for middle school, and 2.40 (95% CI 2.04-2.82) for elementary school when compared to college education. The OR for the indirect effect mediated through MEP were 1.27 (95% CI 1.25-1.29) for high school, 1.46 (95% CI 1.42-1.51) for middle school, and 1.53 (95% CI 1.48-1.59) for elementary school, accounting for 63.9%, 48.5%, and 48.6% of the total effect, respectively.

CONCLUSION

Our study suggests that MEP is an important contributor to the disparities in subjective well-being resulting from educational gradients.

Changes in Precarious Employment and Health in the United States Amidst the COVID-19 Pandemic

This study aimed to investigate the association between changes in employment precarity and changes in health amidst the COVID-19 pandemic. We conducted an online survey of 623 U.S. adults at-risk for cardiovascular disease, which queried respondents on employment, food insecurity, and blood pressure measurements in the Fall of 2020 and retrospectively, in February 2020. Respondents were also queried on perceived stress in the Fall of 2020. We created a multidimensional precarious employment score (PES) using 13 survey indicators, that operationalized the following dimensions of employment precarity (PES range: 0-13): material rewards, working time arrangements, employment stability, workers' rights, collective organization, interpersonal relations, and training opportunities. Using adjusted linear regression models, we investigated the association between a change in the PES and 1) change in systolic blood pressure, 2) change in pulse pressure, 3) change in food insecurity, and 4) perceived stress. Models controlled for race/ethnicity, age, gender, and education. Results indicated that employment precarity was 13 % higher between February and Fall 2020, particularly among women and non-Hispanic Black respondents. A change in the PES was associated with a change in food insecurity ( β : 0.02; 95 % CI:0.01, 0.03) and higher perceived stress ( β : 0.39; 95 % CI:0.25, 0.53). The PES was not associated with a change in systolic blood pressure ( β : -0.22; 95 % CI:-0.76, 0.32) nor in pulse pressure ( β : -0.33; 95 % CI: -0.73, 0.07). Policy approaches to mitigate the growth in employment precarity, and in turn food insecurity and stress, warrant consideration to prevent widening of health inequities.

Inequality in workplace support for various types of precarious workers compared with permanent workers in Japan: A cross-sectional study

OBJECTIVES

The purpose of this study was to examine, by sex, whether precarious workers in Japan receive less support in the workplace than permanent workers.

METHODS

We conducted a cross-sectional study using an online questionnaire in 2022. We stratified participants by sex and performed modified Poisson regression analysis. The outcomes were support from supervisors, co-workers, occupational health professionals, and no one. Adjusted prevalence ratios (aPR) were calculated for contract workers, part-time workers, and dispatched workers, using permanent workers as reference.

RESULTS

This study had 21 047 participants. For men, 87.9% were permanent workers; for women, 50.7% were permanent workers and 37.3% were part-time workers. For workplace support, 47.5% of men and 45.2% of women selected superiors; 41.8% of men and 50.5% of women selected colleagues; 16.8% of men and 6.2% of women selected occupational health professionals. Female contract workers were less likely to receive support from their supervisors (aPR 0.88) or co-workers (aPR 0.89). Male part-time workers were less likely to be supported by their co-workers (aPR 0.86). Dispatched workers were less likely to be supported by their supervisors (men aPR 0.71, women aPR 0.84) and co-workers (men aPR 0.73, women aPR 0.77). Part-time and dispatched workers were less likely to receive support from occupational health professionals.

CONCLUSIONS

Precarious workers could get less workplace support than permanent workers. This may contribute to occupational health problems with precarious workers.

Gender Differences in the Indirect Effect of Psychosocial Work Environment in the Association of Precarious Employment and Chronic Stress: A Cross-Sectional Mediation Analysis

Gender differences in the association between precarious employment and chronic stress have been found but the mechanisms underlying this relationship have not been explored. The main objective of this study was to evaluate the mediating effects of psychosocial risk factors at work (i.e., demands, control, and support) and work-life conflicts in the relationship between precarious employment and chronic stress as measured through the production of steroid hormones (both adrenal and gonadal) for men and women separately. Cross-sectional data were derived from a sample of workers from Barcelona (n = 125-255 men; 130 women). A set of 23 markers were determined from hair samples to evaluate the production of both adrenal and gonadal steroids. Decomposition analyses were applied to estimate the indirect effects of psychosocial risk factors and work-life conflict using linear regression models. Gender differences in the association between precarious employment and steroids production were confirmed. Psychosocial risk factors and work-life conflicts had indirect effects only among women (βCortisol = 0.18; 95% CI: 0.04-0.32; βCortisol/Cortisone 0.19; 95% CI: 0.08-0.31; β%Cortisol 0.12; 95% CI: 0.05-0.20). Gender differences suggest that the physiological response to precarious employment could be determined by the social construction of gender identities, as well as by positions and roles in the labour market and family. Future studies should delve further into these differences to improve employment and working policies, thus mitigating gender inequalities in the labour market to prevent work-related stress.

Association between Precarious Employment and Chronic Stress: Effect of Gender, Stress Measurement and Precariousness Dimensions-A Cross-Sectional Study

Precarious employment has been highlighted as a social determinant of health, given, among others, to its alleged association with chronic stress. However, few studies have been conducted analyzing such association, using both perceived stress indicators and biological markers. Accordingly, the present study analyzed the association of multidimensional (6 dimensions) precarious employment scale with perceived stress and 23 markers of adrenal and gonadal hormone production, including cortisol. The sample consisted of 255 salaried workers from Barcelona (125 men, 130 women) aged 25-60. OLS regression models stratified by sex were conducted. Results demonstrated that precarious employment increased the probabilities of having perceived stress in both sexes. In addition, the production of adrenal hormones among men is associated with precarious wages and among women with precarious contracts ("Temporariness", "Disempowerment", and "Rights" dimensions). Therefore, precarious employment could be embodied by workers, altering their perceived well-being and physiological characteristics. Differences between men and women in the physiological effect of precarious employment could express not just the biochemical differences inherent to biological sex, but also the social construction of gender identities, positions and roles in society and family, as well as gender inequalities in the labour market.