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Precarious Employment: Understanding an Emerging Social Determinant of Health
Abstract
Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts.
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“Especially in cases of precarious employment (Benach et al., 2014) or very low overall household income, monetary rewards might have an overall higher relevance for individuals' job satisfaction, irrespective of their age (cf., Layard, Mayraz, & Nickell, 2008).”
From What satisfies younger versus older employees, and why? An aging perspective on equity theory to explain interactive effects of employee age, monetary rewards, and task contributions on job satisfaction (2020) · cites this paper as Benach et al., 2014
In the citing paper
“However, today approximately two billion workers worldwide have precarious jobs that lack social protection (77).”
From Bridging Sectors and Disciplines to Gain a Critical Understanding of the Eco-Social Determinants of Health Inequities: The ESDHI-EU Conference (2025) · cites this paper as [77]
In the citing paper
“The precariousness of an occupation is a critical determinant to the health and safety of workers (1–3).”
From Large language model exposure and precarious occupations: Unpacking relationships in the Canadian labor force (2026) · cites this paper as [1]
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“Notably, gig workers may lack access to these benefits, 39 which could discourage preventive care.”
Economic vulnerability and emotions toward climate change: A case study of Spain
Fernández, J. J., Orriols, L., & Poncela, P. A. (2025) · Journal of Environmental Psychology · doi:10.1016/j.jenvp.2025.102537 · Cited by 7
Vanderleyden, J., Peckham, T. K., Balogh, R., & Moortel, D. D. (2024) · American Journal of Industrial Medicine · doi:10.1002/ajim.23684 · Cited by 6
Noonan, R. J. (2024) · Health Promotion International · doi:10.1093/heapro/daae090 · Cited by 9
“…this cost in the technological unemployment and precarious working conditions which not only harm psychological security but work against many of the United Nations’ Sustainable Development Goals (SDGs), including decent work and well-being for all (Maslow, 1943; Benach et al ., 2014; Parr, 2022).”
BackgroundBaek, S., Lee, Y., Won, J., & Yoon, J. (2024) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.6106 · Cited by 7
Precarious employment practices in South African universities
Solomon, S., & du Plessis, M. (2024) · SA Journal of Human Resource Management · doi:10.4102/sajhrm.v22i0.2490 · Cited by 10
“Further challenges experienced include a lack of bargaining rights, employment insecurity, instability and insufficient income to cover their basic needs (Benach et al., 2014).”
BackgroundThe Influence of Employment Quality on Employee Health Complaints: A Parallel Mediation Model
Davcheva, M., González‐Romá, V., Hernández, A., & Tomás-Marco, I. (2024) · Journal of Business and Psychology · doi:10.1007/s10869-024-09944-9 · Cited by 10
“The research conducted so far shows that employment quality is positively related to employee health (Benach et al., 2014; Donnelly, 2021; Peckham et al., 2019; Van Aerden et al., 2016; Vives et al., 2011).”
Han, W. (2024) · PLoS ONE · doi:10.1371/journal.pone.0300245 · Cited by 8
Thern, E., Elling, D., Badarin, K., Rodríguez, J. C. H., & Bodin, T. (2024) · Occupational and Environmental Medicine · doi:10.1136/oemed-2023-109315 · Cited by 6
Ling, W., Wang, S., & Li, S.-L. (2024) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2024.116827 · Cited by 6
Mũrage, A., & Smith, J. (2023) · BMC Public Health · doi:10.1186/s12889-023-17392-y · Cited by 9
The working life expectancy of American adults experiencing depression
Dobson, K. G., Gignac, M. A. M., & Mustard, C. (2023) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-023-02547-4 · Cited by 7
“Research on disability and employment highlights that many individuals living with chronic physical and mental health conditions experience job insecurity and transitions in work [41, 42].”
BackgroundGrant, A. K., Felner, J. K., Castañeda, Y., Pratap, P., & Hebert-Beirne, J. (2023) · Community Health Equity Research & Policy · doi:10.1177/2752535x231196395 · Cited by 6
İNSANA YAKIŞIR İŞTEN İYİ OLUŞA: ÇALIŞMA PSİKOLOJİSİ KURAMINA DAYALI BİR MODEL TESTİ
KİRAZCI, F., ERGİN, Z. Ö., & Büyükgöze‐Kavas, A. (2022) · Akademik Yaklaşımlar Dergisi · doi:10.54688/ayd.1163363 · Cited by 9
Dery, F., & Bisung, E. (2022) · Water Security · doi:10.1016/j.wasec.2022.100128 · Cited by 6
Esteve‐Matalí, L., Llorens, C., Alonso, J., Vilagut, G., Moncada, S., & Navarro, A. (2022) · Journal of Epidemiology & Community Health · doi:10.1136/jech-2022-219523 · Cited by 7
Fabio, A. D., & Svicher, A. (2022) · Cypriot Journal of Educational Sciences · doi:10.18844/cjes.v17isi.1.6676 · Cited by 6
“Job insecurity was found to be associated with depression, anxiety, and burnout (Benach et al., 2014; Sverke & Hellgren, 2002; Llosa et al., 2018).”
BackgroundChantarat, T., Enns, E. A., Hardeman, R. R., McGovern, P. M., Myers, S. L., & Dill, J. (2022) · Journal of Economics Race and Policy · doi:10.1007/s41996-022-00098-5 · Cited by 6
“Workers who have experienced job loss and those whose jobs are unstable or precarious are more likely to report hypertension than those with stable jobs (Benach et al., 2014; Kaur et al., 2014).”
BackgroundPerformance of the Mexican nursing labor market: a repeated cross-sectional study, 2005–2019
Nigenda, G., Serván-Mori, E., Fuentes-Rivera, E., Aristizabal, P., & Zárate-Grajales, R. (2022) · Human Resources for Health · doi:10.1186/s12960-022-00721-4 · Cited by 6
Employment Pathways during Economic Recession and Recovery and Adult Health
Kalousová, L., & Burgard, S. (2022) · Journal of Health and Social Behavior · doi:10.1177/00221465211054045 · Cited by 6
“Unstable employment arrangements have been linked to a range of health penalties (Bambra 2010; Benach et al. 2014), a troubling association given that recent decades have brought declining employment stability to many workers in the United States.”
BackgroundThe Impact of Mandate Contract and Self-Employment on Workers’ Health—Evidence from Poland
Piwowar-Sulej, K., & Bąk-Grabowska, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18063138 · Cited by 6
“Taking another perspective, the precariat refers to employment as a multidimensional construct that encompasses dimensions of employment insecurity, individualized bargaining relations between workers and employers, low wages and economic deprivation, limited workplace rights and social protection, and powerlessness t…”
BackgroundReview for "Perceived ethnic discrimination as a determinant of migrants’ health in Italy"
Quaglia, V., Terraneo, M., & Tognetti, M. (2020) · International migration (Geneva. Print) · doi:10.1111/imig.12863 · Cited by 6
Guardians of Workers' Bodies? Trade Unions and the History of Occupational Health and Safety
Mcivor, A. (2020) · Labour History · doi:10.3828/jlh.2020.16 · Cited by 6
Bahk, J., Khang, Y., & Lim, S. (2020) · Safety and Health at Work · doi:10.1016/j.shaw.2020.10.007 · Cited by 8
“However, country level analysis will be needed in future studies to explainworkers' health inequality through developing a conceptual framework for the relation of employment and working conditions and their health consequences [37].”
BackgroundSharaf, M. F., & Rashad, A. (2020) · International Journal of Development Issues · doi:10.1108/ijdi-01-2020-0005 · Cited by 6
Gleibs, I. H., & Alvarado, A. L. (2019) · Social Psychological Bulletin · doi:10.32872/spb.v14i3.35320 · Cited by 5
“Nonstandard work arrangements have gained interest from researchers as the ‘standard employment relationship’ has been challenged by the emergence of novel forms of work arrangements, such as part-time, temporary, and ‘zero-hour’ jobs (Benach et al., 2014; Spreitzer, Cameron, & Garrett, 2017).”
BackgroundFactores de precariedad laboral y su relación con la salud de trabajadores en Bolivia
Arias-Uriona, A. M., & Ordóñez, J. C. (2018) · Revista Panamericana de Salud Pública · doi:10.26633/rpsp.2018.98 · Cited by 7
“Su estudio ha sido de gran interés para la salud pública durante la última década (3, 4) debido a la globalización del mercado, que genera diferentes formas de precariedad laboral RESUMEN Objetivo.”
BackgroundEnding America’s HIV Epidemic: Why the National HIV/AIDS Strategy Still Matters
Valdiserri, R. O., & Holtgräve, D. R. (2018) · AIDS and Behavior · doi:10.1007/s10461-018-2135-0 · Cited by 8
A Time for Hope? Pursuing a Vision of a Fair, Sustainable and Healthy World
Friel, S. (2018) · Global Policy · doi:10.1111/1758-5899.12557 · Cited by 15
Health Status After Job Loss: Does the Reason for Job Change Matter?
Voss, M., & Chen, J. (2015) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000000558 · Cited by 6
“Since that time, precarious employment has been linked to job stress and health declines.(31,32) Discouraged workers, those who have given up looking for work because they feel there are no jobs available to them, are another non-work condition receiving current attention in the literature.”
BackgroundChakraborty, I., & Heeks, R. (2023) · Social Science Research Network · doi:10.2139/ssrn.4585952 · Cited by 6
Occupational health and safety in small businesses: The rationale behind compliance
Esterhuyzen, E. (2022) · African Journal of Business Ethics · doi:10.15249/16-1-287 · Cited by 6
“However, precarious employment agreements are often relevant to small businesses in South Africa, resulting in employment conditions not being conducive to the safety of employees, their families or the surrounding communities (Benach, Vives, Amable, Vanroelen, Tarafa & Muntaner, 2014:230).”
BackgroundAntonakakis, N. (2026) · Social Science & Medicine · doi:10.1016/j.socscimed.2026.119202 · Cited by 5
Moortel, D. D., Balogh, R., Engels, M., & Vanderleyden, J. (2025) · Social Science & Medicine · doi:10.1016/j.socscimed.2025.117906 · Cited by 10
Employment quality and suicide, drug poisoning, and alcohol-attributable mortality
Andreacchi, A. T., Fuller, A. E., Smith, P. M., Blair, A., Harris, A., Carnide, N., Pabayo, R., Smith, B. T., Siddiqi, A., & Shahidi, F. (2025) · American Journal of Epidemiology · doi:10.1093/aje/kwaf018 · Cited by 5
“62,63 Our findings on the associations between employment quality and SDAM align with existing literature emphasizing the significant health risks associated with low-quality employment.”
Ahonen, E. Q., Winkler, M. R., Bosmans, K., Gunn, V., & Julià, M. (2025) · American Journal of Industrial Medicine · doi:10.1002/ajim.23695 · Cited by 12
Balogh, R., Moortel, D. D., Gadeyne, S., Vanderleyden, J., Warhurst, C., & Vanroelen, C. (2024) · International Journal of Social Determinants of Health and Health Services · doi:10.1177/27551938241288788 · Cited by 9
“21 There may be differences in the psychosocial implications these forms of employment may have on men and women, or in the way their earnings ultimately translate into household-level poverty.”
InfluentialSelf-citationN, A. N., David, R., Subramani, A. K., Singh, S. K., & Nigoti, U. (2024) · Acta Psychologica · doi:10.1016/j.actpsy.2024.104384 · Cited by 11
O'Campo, P. J., Gunn, V., Perri, M., Buhariwala, P., Rasoulain, E., Daneshvardfard, M., Rachel, W., Lewchuck, W., Baron, S., Bodin, T., et al. (2024) · International Journal of Social Determinants of Health and Health Services · doi:10.1177/27551938241253789 · Cited by 6
“17,25 Whether this segment of the working class, whose material interests are very similar to the whole working class, 62 becomes a distinct political actor (ie, the precariat 25 ) remains to be seen.”
BackgroundMethodResultInfluentialSelf-citationA Brief Tool to Screen Patients for Precarious Employment: A Validation Study
Ho, J. W., Bellicoso, E., Bondy, M., Holness, D. L., Muntaner, C., Nisenbaum, R., Ruco, A., Hassen, N., Hanna, A., & Pinto, A. (2024) · Annals of Family Medicine · doi:10.1370/afm.3053 · Cited by 5
Self-citationBetthäuser, B., Trinh, N. A., & Fasang, A. (2023) · European Sociological Review · doi:10.1093/esr/jcad073 · Cited by 5
Understanding the health decline of Americans in boomers to millennials
Zheng, H., Dirlam, J., Choi, Y., & George, L. K. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116282 · Cited by 12
Do perceived working conditions increase life satisfaction? Case of SME workers in Bangladesh
Ahmed, Z., Hussain, A. H. M. B., Ahmed, M., Lalin, S. A. A., Endut, N., & Sultana, S. (2022) · SN Social Sciences · doi:10.1007/s43545-022-00597-0 · Cited by 5
Employees Perceptions of Job Insecurity and Performance: A Qualitative Approach
Medina, F. M., Bohle, S. L., Ugarte, S. M., Chambel, M. J., & Wall, E. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416665 · Cited by 13
The relationship between job precariousness and student burnout: a serial indirect effects model
Creed, P. A., Hood, M., Selenko, E., Hu, S. M., & Bagley, L. (2022) · Journal of Education and Work · doi:10.1080/13639080.2022.2149713 · Cited by 6
Iglesias-Rios, L., Marin, D., Moberg, K., & Handal, A. (2022) · Journal of community engagement and scholarship · doi:10.54656/jces.v15i1.466 · Cited by 5
“multidimensional Employment Precariousness Scale (EPRES) developed for salaried workers by the Employment Conditions Network-EMCONET (Amable et al., 2001; Benach et al., 2014; Vives et al., 2010), and the Employment Precarity Index developed as part of the longitudinal survey Poverty and Employment Precarity in Southe…”
MethodBaek, S.-U., Lim, S.-S., Yun, S., Lee, W.-T., Kim, M.-S., Yoon, J., & Won, J.-U. (2022) · Annals of Occupational and Environmental Medicine · doi:10.35371/aoem.2022.34.e1 · Cited by 5
Griffiths, M., Gray, B., Kyle, R., Jiao, S., & Davies, A. (2022) · medRxiv · doi:10.1097/jom.0000000000002596 · Cited by 5
Tsui, E. K., Franzosa, E. C., Vignola, E. F., Cuervo, I., Landsbergis, P. A., Zelnick, J., & Baron, S. (2021) · NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy · doi:10.1177/10482911211066963 · Cited by 6
“This is particularly important when considering the precarious qualities of these jobs, including flexible labor markets, chronic job insecurity, contract or temporary work, low wages, limited social protection and labor rights, low control over schedules, and lack of non-wage compensation such as paid sick leave, vac…”
BackgroundOh, J., Park, J. Y., & Lee, S. (2021) · Scientific Reports · doi:10.1038/s41598-021-95383-y · Cited by 5
Factors related to psychological well-being in unskilled manual workers
Park, J., & Kim, Y. (2021) · International Journal of Occupational Medicine and Environmental Health · doi:10.13075/ijomeh.1896.01616 · Cited by 6
“However, the nature of work, industrial structures, and work processes were changed significantly during recent years and, thus, the use of non-standard contracts and job insecurity was increased [1,2].”
Enforceability of rights in the temporary agency sector: The case of Belgium
Bosmans, K., Moortel, D. D., & Vanroelen, C. (2021) · Economic and Industrial Democracy · doi:10.1177/0143831x211017227 · Cited by 5
“This has provoked the expansion of non-standard, insecure and precarious forms of employment in Western Europe (Benach et al., 2014; Corresponding author: Kim Bosmans, Interface Demography, Department of Sociology, Vrije Universiteit Brussel, Pleinlaan 2, Brussels, 1050, Belgium.”
BackgroundSelf-citationOccupational Risks of Recurrent Coronary Heart Disease.
Li, J., & Siegrist, J. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.02.020 · Cited by 5
Bakker, I., Gill, S. R., & Wamsley, D. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.040 · Cited by 83
Shoss, M. K., Min, H., Horan, K. A., Schlotzhauer, A. E., Nigam, J. A. S., & Swanson, N. A. (2021) · Proceedings of The 3rd International Electronic Conference on Environmental Research and Public Health —Public Health Issues in the Context of the COVID-19 Pandemic · doi:10.3390/ecerph-3-09091 · Cited by 5
“A major concern raised regarding the pandemic’s economic effects is the rise in precarious work, capturing the structural, financial, and social vulnerabilities faced by workers [3,4].”
BackgroundContribution to the Assessment of the Quality of Life at Work: a Case Study
Abdi, M. R., Chaib, R., & Verzea, I. (2021) · Behavior Studies in Organizations · doi:10.32038/jbso.2020.04.03 · Cited by 5
European Part-time Workers’ Health and Well-being in Times of Crisis. The Case of Female Part-timers
Merino-Llorente, M., & Somarriba, M. (2020) · Revista Hacienda Pública Española · doi:10.7866/hpe-rpe.20.4.4 · Cited by 5
“In this regard, compilation works such as Benach et al. (2014) and Joyce et al. (2010) prove extremely interesting.”
BackgroundUtzet, M., Llorens, C., Moriña, D., & Moncada, S. (2020) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-020-01609-3 · Cited by 9
“Precarious work, flexible working hours and time schedule expanded (Benach et al. 2014; Buchholz et al. 2009); employment is less stable (Buchholz et al.”
BackgroundFactors Related to Physical and Mental Health in Workers With Different Categories of Employment.
Park, J., & Kim, Y. (2020) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001886 · Cited by 5
Health impact assessment in Nigeria: An initiative whose time has come
Chilaka, M. A., & Ndioho, I. F. (2020) · Journal of Public Health in Africa · doi:10.4081/jphia.2019.1014 · Cited by 4
What can public health do for the welfare state? Occupational health could be an answer
Benavides, F., Serra, C., & Delclos, G. (2019) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2018-211561 · Cited by 5
“Both informal and precarious employment negatively affect public health and the welfare state.(31) In summary, with a promising future for the welfare state and labour market, mutually reinforced, occupational health, as part of public health, can contribute to the sustainability of the welfare state.”
BackgroundCounil, É. (2019) · Sociologie du travail · doi:10.4000/sdt.18116 · Cited by 5
“Il faut néanmoins souligner les efforts de conceptualisation réalisés par la discipline au cours des dix dernières années autour de la notion de précarité de l’emploi et du travail afin de mieux appréhender les liens entre formes atypiques d’emploi, conditions de travail et santé (Benach et al., 2014).”
BackgroundCurtis, S. E., Pearce, J. R., Cherrie, M. P. C., Dibben, C. J. L., Cunningham, N., & Bambra, C. L. (2018) · Social Science & Medicine · doi:10.1016/j.socscimed.2018.08.003 · Cited by 20
“Several of these underline the need to improve the evidence base by conducting more research which uses longitudinal rather than cross sectional data (Benach et al., 2014; Frasquilho et al., 2016; Glonti et al., 2015).”
Metadata
- Authors
- Benach, J., Vives, A., Amable, M., Vanroelen, C., Tarafa, G., & Muntaner, C.
- Affiliations
- Universitat Pompeu Fabra (ES)
- Pontificia Universidad Católica de Chile (CL)
- Vrije Universiteit Brussel (BE)
- Venue
- Annual Review of Public Health
- Publisher
- Annual Reviews
- Published
- 2014-03-18
- Volume
- 35
- Issue
- 1
- Pages
- 229-253
- ISSN
- 0163-7525 (ISSN-L)
- 1545-2093
- OpenAlex
- W2110313855
- Cited by
- 1,354
- References
- 0
- Citations by year
- 2026: 126 · 2025: 88 · 2024: 117 · 2023: 219 · 2022: 160 · 2021: 160 · 2020: 125 · 2019: 120 · 2018: 67 · 2017: 86 · 2016: 47 · 2015: 24 · 2014: 8
- FWCI
- 9.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annual Review of Public Health (publishedVersion)
- PubMed (publishedVersion)
- VUBIR (Vrije Universiteit Brussel) (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Employment and Welfare Studies
- Social Sciences › Business, Management and Accounting › Industrial relations › Employment, Labor, and Gender Studies
- Social Sciences › Health › Public Health and Social Inequalities
- Keywords
- precarious employment, social determinants of health, flexible employment, health disparities, health equity, working conditions, labour market policy, health policy evaluation
- MeSH terms
- Employment, Health Services, Health Status, Humans, Mental Health, Politics, Public Assistance, Global Health, Epidemiologic Research Design, Epidemiologic Studies, Health Status Disparities, Economic Recession, Social Determinants of Health
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