Precarious Employment: Understanding an Emerging Social Determinant of Health

Benach, Joan; Vives, Alejandra; Amable, Marcelo; Vanroelen, Christophe; Tarafa, Gemma; Muntaner, Carles

doi:10.1146/annurev-publhealth-032013-182500

Cited by 969 publications

(944 citation statements)

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“…The term precarious employment implies a multidimensional concept embodying (dis) continuity in time, job (in)security, lack of rights and social protection, low levels of wages and earnings Benach et al, 2014). In most academic research and in public health field, common one-dimensional concepts relates to flexible, atypical, casual, non-standard, and temporary employment.…”

Section: Previous Findingsmentioning

confidence: 99%

“…the labor market arrangements (Ehlert and Schaffner, 2011), the health and safety regulations (Cottini and Lucifora, 2010), or the level of welfare state or unemployment protection (Scherer, 2009). Indeed, welfare state, labor market and family arrangements have been advocated to play a role in mediating the effects of flexible employment on individual health (Benach et al, 2014;Cottini and Lucifora, 2010). Even if evidence is sometimes mixed and inconclusive, temporary workers in Scandinavian countries (notably in Finland) do not generally present a poor health status (Virtanen et al, 2003(Virtanen et al, , 2005, as well as in the United Kingdom (Bardasi and Francesconi, 2004;Rodriguez, 2002;Virtanen et al, 2005).…”

Section: Previous Findingsmentioning

confidence: 99%

“…There are a number of potential pathways through which flexible forms of employment might damage health (Benach et al, 2014). Unemployment and job insecurity are two of the principal mediating factors that lead temporary employment to be negatively associated with health Caroli and Godard, 2013;Virtanen et al, 2005).…”

Section: Pathways Between Temporary Work and Healthmentioning

confidence: 99%

“…Cross-sectional studies are not suitable to disentangle selection effects (Benach et al, 2004;Benavides et al, 2000;Virtanen et al, 2003;Benach et al, 2014) and the need to rely on longitudinal data is straightforward. However, even when one adjusts for prior health status and other covariates, standard regression designs might not represent a solution (Oakes and Johnson, 2006).…”

Section: Introductionmentioning

confidence: 99%

“…This method allows us to check for the potential selectivity of healthier individuals in the group of people who find permanent jobs. Another element to take into account in this research context (Benach et al, 2014) e and the proposed method enables to do this e is that having a temporary contract may in turn increase the risk to have another temporary contract the year after, in a sort of vicious circle. This paper adds new and relevant contributions to literature.…”

Section: Introductionmentioning

confidence: 99%

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Is temporary employment damaging to health? A longitudinal study on Italian workers

Pirani

Salvini

2015

Social Science & Medicine

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a b s t r a c tWorking conditions have changed dramatically over recent decades in all the countries of European Union: permanent full-time employment characterized by job security and a stable salary is replaced more and more by temporary work, apprenticeship contracts, casual jobs and part-time work. The consequences of these changes on the general well-being of workers and their health represent an increasingly important path of inquiry.We add to the debate by answering the question: are Italian workers on temporary contracts more likely to suffer from poor health than those with permanent jobs? Our analysis is based on a sample of men and women aged 16e64 coming from the Italian longitudinal survey 2007e2010 of the European Union Statistics on Income and Living Conditions. We use the method of inverse-probability-oftreatment weights to estimate the causal effect of temporary work on self-rated health, controlling for selection effects.Our major findings can be summarized as follows: firstly, we show a negative association between temporary employment and health that results from a statistical causal effect in the work-to-health direction, and does not trivially derive from a selection of healthier individuals in the group of people who find permanent jobs (selection effect). Secondly, we find that temporary employment becomes particularly negative for the individual's health when it is prolonged over time. Thirdly, whereas temporary employment does not entail significant adverse consequences for men, the link between temporary employment and health is strongly harmful for Italian women.

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Section: Previous Findingsmentioning

confidence: 99%

Section: Previous Findingsmentioning

confidence: 99%

Section: Pathways Between Temporary Work and Healthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is temporary employment damaging to health? A longitudinal study on Italian workers

Pirani

Salvini

2015

Social Science & Medicine

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Life Expectancy and Mortality Rates in the United States, 1959-2017

Woolf

Schoomaker

2019

JAMA

636

504

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ife expectancy at birth, a common measure of a population's health, 1 has decreased in the United States for 3 consecutive years. 2 This has attracted recent public attention, 3 but the core problem is not new-it has been building since the 1980s. 4,5 Although life expectancy in developed countries has increased for much of the past century, US life expectancy began to lose pace with other countries in the 1980s 6,7 and, by 1998, had declined to a level below the average life expectancy among Organisation for Economic Cooperation and Development countries. 8 While life expectancy in these countries has continued to increase, 9,10 US life expectancy stopped increasing in 2010 and has been decreasing since 2014. 2,11 Despite excessive spending on health care, vastly exceeding that of other countries, 12 the United States has a long-standing health disadvantage relative to other high-income countries that extends beyond life expectancy to include higher rates of disease and cause-specific mortality rates. 6,7,10,13 This Special Communication has 2 aims: to examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and from a new analysis of state-level trends. Methods Data Analysis MeasuresThis report examines longitudinal trends in life expectancy at birth and mortality rates (deaths per 100 000) in the US population, IMPORTANCE US life expectancy has not kept pace with that of other wealthy countries and is now decreasing. OBJECTIVE To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends.EVIDENCE Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined.FINDINGS Between 1959 and, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in

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History of Low Hourly Wage and All-Cause Mortality Among Middle-aged Workers

Kezios

Calónico

et al. 2023

JAMA

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ImportanceEarning a low wage is an increasingly recognized public health concern, yet little research exists on the long-term health consequences of sustained low-wage earning.ObjectiveTo examine the association of sustained low-wage earning and mortality in a sample of workers with hourly wage reported biennially during peak midlife earning years.Design, Setting, and ParticipantsThis longitudinal study included 4002 US participants, aged 50 years or older, from 2 subcohorts of the Health and Retirement Study (1992-2018) who worked for pay and reported earning hourly wages at 3 or more time points during a 12-year period during their midlife (1992-2004 or 1998-2010). Outcome follow-up occurred from the end of the respective exposure periods until 2018.ExposuresLow-wage—less than the hourly wage for full-time, full-year work at the federal poverty line—earning history was categorized as never earning a low wage, intermittently earning a low wage, and sustained earning a low wage.Main Outcomes and MeasuresCox proportional hazards and additive hazards regression models sequentially adjusted for sociodemographics, and economic and health covariates were used to estimate associations between low-wage history and all-cause mortality. We examined interaction with sex or employment stability on multiplicative and additive scales.ResultsOf the 4002 workers (aged 50-57 years at the beginning of exposure period and 61-69 years at the end), 1854 (46.3%) were female; 718 (17.9%) experienced employment instability; 366 (9.1%) had a history of sustained low-wage earning; 1288 (32.2%) had intermittent low-wage earning periods; and 2348 (58.7%) had never earned a low wage. In unadjusted analyses, those who had never earned low wages experienced 199 deaths per 10 000 person-years, those with intermittent low wages, 208 deaths per 10 000 person-years, and those with sustained low wages, 275 deaths per 10 000 person-years. In models adjusted for key sociodemographic variables, sustained low-wage earning was associated with mortality (hazard ratio [HR], 1.35; 95% CI, 1.07-1.71) and excess deaths (66; 95% CI, 6.6-125); these findings were attenuated with additional adjustments for economic and health covariates. Significant excess death and elevated mortality risk were observed for workers with sustained low-wage exposure and employment fluctuations (eg, for sustained low-wage × employment fluctuated, HR, 2.18; 95% CI, 1.35-3.53; for sustained low-wage × stable employment, HR, 1.17; 95% CI, 0.89,-1.54; P for interaction = .003).Conclusions and RelevanceSustained low-wage earning may be associated with elevated mortality risk and excess deaths, especially when experienced alongside unstable employment. If causal, our findings suggest that social and economic policies that improve the financial standing of low-wage workers (eg, minimum wage laws) could improve mortality outcomes.

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Precarious Employment: Understanding an Emerging Social Determinant of Health

Cited by 969 publications

References 140 publications

Is temporary employment damaging to health? A longitudinal study on Italian workers

Is temporary employment damaging to health? A longitudinal study on Italian workers

Life Expectancy and Mortality Rates in the United States, 1959-2017

History of Low Hourly Wage and All-Cause Mortality Among Middle-aged Workers

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