The role of nonstandard and precarious jobs in the well‐being of disabled workers during workforce reintegration

Abstract

Background: Nonstandard employment arrangements are becoming increasingly common and could provide needed flexibility for workers living with disabilities.However, these arrangements may indicate precarious employment, that is, employment characterized by instability, powerlessness, and limited worker rights and benefits. Little is known about the role of nonstandard and precarious jobs in the well-being of disabled persons during workforce reintegration after permanent impairment from work-related injuries or illnesses. Methods:We used linked survey and administrative data for a sample of 442 Washington State workers who recently returned to work and received a workers' compensation permanent partial disability award after permanent impairment from a work-related injury. Multivariable logistic regression models were used to examine associations between nonstandard employment and outcomes related to worker well-being and sustained employment. We also examined associations between a multidimensional measure of precarious employment and these outcomes.Secondarily, qualitative content analysis methods were used to code worker suggestions on how workplaces could support sustained return to work (RTW).Results: Workers in: (1) nonstandard jobs (compared with full-time, permanent jobs), and (2) precarious jobs (compared with less precarious jobs) had higher adjusted odds of low expectations for sustained RTW. Additionally, workers in precarious jobs had higher odds of reporting fair or poor health and unmet need for disability accommodation. Workers in nonstandard and precarious jobs frequently reported wanting safer and adequately staffed workplaces to ensure safety and maintain sustained employment.Conclusions: Ensuring safe, secure employment for disabled workers could play an important role in their well-being and sustained RTW.

Differential underestimation of work‐related reinjury risk for older workers: Challenges to producing accurate rate estimates

“…Many of these indicators of job precarity may be tied to beneficial or adaptive employment choices or easing into elective retirement; nevertheless, they may have an impact on reinjury risk. Workers age 65+ did not significantly differ from younger workers regarding several measures of occupational health and safety vulnerability sometimes used to indicate job precarity, 61,62 including comfort with reporting an unsafe work situation, reporting a work injury, or filing a WC claim. These issues related to job precarity will require further research to untangle.…”

Workplace Wellness Program Interest and Barriers Among Workers With Work-Related Permanent Impairments

“…Administrative data included age, gender, WC coverage (State Fund vs. self-insured employer), and residence county, which was classified using the six-level 2013 National Center for Health Statistics Urban–Rural Classification Scheme for Counties (Ingram & Franco, 2014). All other covariates were obtained from the survey, and their collection and construction have been described in detail elsewhere (Edmonds et al, 2021; Sears, Edmonds, et al, 2021; Sears, Schulman, et al, 2021b, 2021c).…”

“…Our inclusion of workers with any type of permanent impairment enhances generalizability to a broad range of injuries and conditions. Limitations to generalizability include: (a) the survey being conducted only in English and (b) a high prevalence of union membership (42.2%), more than double the estimated 19.8% for Washington State in 2018 (Bureau of Labor Statistics), which may indicate relatively low job precarity among this sample (Edmonds et al, 2021). This was an exploratory study; more research is needed to replicate and extend these findings.…”

Investigating Employment Quality for Population Health and Health Equity: A Perspective of Power

“…These pioneering US studies explored ways to align available data with EQ dimensions identified in European studies, i.e., [ 10 ]. For example, the dimension of interpersonal power relations has been operationalized with US data as union membership [ 25 ], intimidation about reporting occupational injury and safety concerns [ 31 ], the ability to control one’s schedule [ 16 , 32 ], decision-making power and autonomy on the job [ 16 , 25 , 27 ], experiences of sexual or other types of harassments [ 16 ], and forced retirement among older workers [ 32 ]. Many of these indicators could represent other EQ dimensions as well, such as employment stability (i.e., forced retirement), work time arrangements (i.e., schedule control), collective organization (i.e., union membership), and workers ’ rights (i.e., reporting safety concerns).…”

“…The ubiquitous nature of power dynamics poses a challenge to conceptualizing and measuring EQ. At this early stage of EQ research in the United States, researchers have prioritized causal inferences, or showing the association between poor EQ and poor health, e.g., [ 16 , 31 ], and identifying who is at risk, e.g., [ 27 , 32 ]. This type of research has introduced and legitimized the concept of EQ in the discussion of occupational and population health in the United States.…”