Trajectories of precarious employment and the risk of myocardial infarction and stroke among middle-aged workers in Sweden: A register-based cohort study

Matilla-Santander, Núria; Muntaner, Carles; Kreshpaj, Bertina; Gunn, Virginia; Jönsson, Johanna; Kokkinen, Lauri; Selander, Jenny; Baron, Sherry; Orellana, Cecilia; Östergren, Per-Olof; Hemmingsson, Tomas; Wegman, David H.; Bodin, Theo

doi:10.1016/j.lanepe.2022.100314

Cited by 15 publications

(23 citation statements)

References 29 publications

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“…The association of the EPRES with the PSS and biological markers of stress affirms that precarious employment is a prominent social determinant of health, as has been indicated in the literature [ 1 ]. Our results align with previous studies that found associations between multidimensional precarious employment and several physical and mental health outcomes [ 12 , 14 , 19 , 20 , 21 , 22 ]. They are also consistent with studies based on single-dimensional measures of precarious employment such as temporariness [ 35 ] or perceived insecurity [ 36 ].…”

Section: Discussionsupporting

confidence: 92%

“…In recent decades, many studies have been conducted analysing the impact of precarious employment on both physical and mental health [ 8 , 15 , 16 , 17 , 18 ]. Indeed, the results demonstrated that employees in highly precarious employment measured multidimensionally had worse mental and/or self-perceived health than employees in less precarious employment [ 12 , 14 , 19 , 20 , 21 , 22 ]. Various studies also demonstrate that there is more precarious employment among certain groups of workers such as women, young people, immigrants, and manual workers [ 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

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

Julià

Méndez-Rivero

Gómez-Gómez

et al. 2022

IJERPH

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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.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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

Julià

Méndez-Rivero

Gómez-Gómez

et al. 2022

IJERPH

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“…To develop EQ-related survey items, we drew on previous surveys [ 14 , 15 , 28 , 29 ], but tailored the questions to cleaner-specific employment characteristics, based on our focus group reports and previous research [ 22 , 30 ]. Final item selection was accomplished by consensus among all project partners with the dual goals of collecting data specific to understanding cleaning product use patterns while also prioritizing the collection of EQ-related data to support our project’s educational and policy-oriented actions led by our community partner.…”

Section: Methodsmentioning

confidence: 99%

“…This approach has been operationalized in recent epidemiologic studies through the development of a multidimensional employment quality (EQ) framework [ 5 , 6 , 7 ]. A growing body of both cross-sectional and longitudinal studies, primarily in Europe and the Unites States, have demonstrated associations between measured components of EQ and physical and mental health [ 5 , 6 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Applying a holistic framework for examining associations between work and health that considers the role of workplace hazards and EQ together also provides opportunities to identify more comprehensive solutions to reduce the role of work in ill-health and improve health equity [ 4 ]. EQ measures have most often been applied to datasets in the United States and Europe that include workers in diverse occupations to facilitate creation of categories or typologies of EQ in epidemiologic studies [ 5 , 9 , 10 , 13 , 14 , 15 ]. However, even in studies examining a single group of workers, the EQ framework can be useful for identifying specific intervention priorities.…”

Section: Introductionmentioning

confidence: 99%

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Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study

Baron

Cuervo

Winkel

et al. 2022

IJERPH

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Precarious employment, such as housecleaning, is one important structural contributor to health inequities. We used an employment quality (EQ) framework to characterize the impact of employment conditions on mental and self-reported ill-health among Latinx housecleaners in the New York City metropolitan area. Using a community-based participatory research approach, we collected cross-sectional survey data from 402 housecleaners between August 2019 and February 2020 to characterize housecleaners’ EQ and its association with depression, perceived stress, and self-reported health. We also measured work-related irritant eye, skin, and respiratory symptoms, which have been shown in previous research to be associated with housecleaners’ exposure to chemical components of cleaning products. Our housecleaner cohort was largely female and immigrant and most had worked at least five years. Survey items capturing the EQ dimensions of unbalanced interpersonal relations, low material resources, and violations of workers’ rights were associated with increased odds of depression, perceived stress, and self-reported ill-health. Work-related irritant eye, skin, and respiratory symptoms were also independently associated with mental and self-reported ill-health and some of the effects of EQ on health were potentially partially mediated through their association with work-related irritant symptoms. Findings can inform directions for community-based educational and policy initiatives to improve housecleaners’ employment quality.

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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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Trajectories of precarious employment and the risk of myocardial infarction and stroke among middle-aged workers in Sweden: A register-based cohort study

Cited by 15 publications

References 29 publications

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

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

Employment Quality and Mental and Self-Reported Health Inequities among Latinx Housecleaners: The Safe and Just Cleaners Study

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

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