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

Ramifications of Precarious Employment for Health and Health Inequity: Emerging Trends from the Americas

Precarious employment (PE), which encompasses the power relations between workers and employers, is a well-established social determinant of health that has strong ramifications for health and health inequity. In this review, we discuss advances in the measurement of this multidimensional construct and provide recommendations for overcoming continued measurement challenges. We then evaluate recent evidence of the negative health impacts of PE, with a focus on the burgeoning studies from North America and South America. We also establish the role of PE in maintaining and perpetuating health inequities and review potential policy solutions to help alleviate its health burden. Last, we discuss future research directions with a call for a better understanding of the heterogeneity within PE and for research that focuses both on upstream drivers that shape PE and its impacts on health, as well as on the mechanisms by which PE causes poor health.

Association between precarious employment and the onset of depressive symptoms in men and women: a 13-year longitudinal analysis in Korea (2009-2022)

AIMS

Increasing social concern surrounds the potential adverse health effects of precarious employment (PE). In this study, we explored the association between PE and the onset of depressive symptoms.

METHODS

A total of 11,555 Korean waged workers (5700 females) contributed 62,217 observations from 2009 to 2022. PE was operationalized as a multidimensional construct, including employment insecurity, income inadequacy and lack of rights and protection. Depressive symptoms were evaluated using the Center for Epidemiological Studies-Depression Scale (11-item version). The association between PE and the onset of depressive symptoms in the subsequent year was estimated using generalized estimating equations. Effect sizes were reported as odds ratio (OR) and 95% confidence interval (CI).

RESULTS

The overall incidence of depressive symptoms was 8.3% during the study period. In cross-sectional analysis, daily employment, disguised employment, lower monthly wages and lack of social insurance coverage were associated with concurrent depressive symptoms in both men and women. Longitudinally, fixed-term employment (OR: 1.17, 95% CI: 1.07-1.29), daily employment (OR: 1.64, 95% CI: 1.45-1.85) and disguised employment (OR: 1.36, 95% CI: 1.17-1.57) were associated with the onset of depressive symptoms among the overall sample. Among men, the lowest quartiles of wage were associated with the onset of depressive symptoms (OR: 1.34, 95% CI: 1.13-1.60), while the absence of a trade union was associated among women (OR: 1.18, 95% CI: 1.01-1.39).

CONCLUSIONS

Employment insecurity, inadequate income and lack of rights and protection may contribute to depressive symptoms. Therefore, PE serves as a significant social determinant of mental health among workers in Korea. Active policy efforts are warranted to improve the overall quality of employment in the workforce.

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.

Causal effect of shifting from precarious to standard employment on all-cause mortality in Sweden: an emulation of a target trial

BACKGROUND

We aimed at estimating the causal effect of switching from precarious to standard employment on the 6-year and 12-year risk of all-cause mortality among workers aged 20-55 years in Sweden.

METHODS

We emulated a series of 12 target trials starting every year between 2005 and 2016 using Swedish register data (n=251 273). We classified precariously employed individuals using a multidimensional approach at baseline as (1) remaining in precarious employment (PE) (73.8%) and (2) shifting to standard employment (26.2%). All-cause mortality was measured from 2006 to 2017. We pooled data for all 12 emulated trials and used covariate-adjusted pooled logistic regression to estimate intention-to-treat and per-protocol effects via risk ratios (RRs) and standardised risk curves (the parametric g-formula).

RESULTS

Shifting from precarious to standard employment decreases the 12-year risk of death by 20% on the relative scale (RR: 0.82, 95% CI: 0.73; 0.93), regardless of what happens after the initial shift. However, we estimated a 12-year risk reduction of 30% on the relative scale for workers shifting from precarious to standard employment and staying within this employment category for the full 12 years (RR: 0.71, 95% CI: 0.54; 0.95).

CONCLUSIONS

This study finds that shifting from low to higher-quality employment conditions (ie, stable employment, sufficient income levels and high coverage by collective agreements) decreases the risk of death. Remaining in PE increases the risk of premature mortality. Our results emphasise the necessity of ensuring decent work for the entire working population to accomplish the 2030 Agenda for Sustainable Development.

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 (β_Cortisol = 0.18; 95% CI: 0.04-0.32; β_{Cortisol/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.

Work, Health, and the Ongoing Pursuit of Health Equity

The many facets of work, including employment relationships and attendant employment quality, the day-to-day conditions experienced in any given job, and the evolution of one's working circumstances over time can support or detract from health, and combine in myriad ways to impact worker well-being [...].