A Macro-Level Model of Employment Relations and Health Inequalities

Abstract

The authors develop a macro-social theoretical framework to explain how employment and working conditions affect health inequalities. The theoretical framework represents the social origins and health consequences of various forms of employment conditions. The emphasis is thus on determinants and consequences of employment conditions, not on social determinants of health in general. The framework tries to make sense of the complex link between macro-social power relations among employers, government, and workers' organizations, labor market and social policies, employment and working conditions, and the health of workers. It also suggests further testing of hypothetical causal pathways not covered in the literature. This macro-social theoretical framework might help identify the main "entry points" through which to implement policies and interventions to reduce employment-related health inequalities. The theoretical framework should be approached from a historical perspective.

Precarious Employment: Understanding an Emerging Social Determinant of Health

“…Employment conditions, and precarious employment in particular, are determined to a large extent by macrolevel structures and processes (25,54,119), including macrolevel power relations. Yet, existing research on global labor markets and population health remains in its infancy.…”

The Effect of Non-regular Employment on the Health Behaviors, Mental Health and Quality of Life: Data from the Korea National Health and Nutrition Examination Survey 2013

“…영향을 주는 것으로 보고하는 경우가 많지만 결과들에 논 란이 있다 (Quinlan M et al, 2001;Bardasi E et al, 2004;Muntaner C et al, 2010;Keuskamp D et al, 2013). 비정규직이…”

Deliberately Casual? Workers' Agency, Health, and Nonstandard Employment Relations in Australia

“…Nonstandard arrangements have been associated with physical and psychological working conditions that have negative health outcomes. (11,12) While evidence is growing that workers in those arrangements are more likely to have worse mental health and greater risk of limiting illness, there remain some studies pointing to the contrary and others finding no discernible difference among groups of workers. (13,14) Complicating any analysis is the phenomenon of health-related selection into nonstandard employment, i.e.…”

“…(6,11,13) Nonstandard employment usually offers conditions inferior to the 'ideal' reference of permanent full-time work. Material rewards and benefits such as paid vacations, sick leave, unemployment insurance, access to training, and knowledge about health hazards are absent or less common in nonstandard contracts, with some crossnational variation.…”

“…(26)(27)(28) Consequently, some researchers have advocated for a greater recognition of the political, social and labour market contexts determining relationships between employment and health. (11,29,30) …”