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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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Ecological Ethics, Planetary Sustainability, and Global Health
Butler, C. D. (2021) · Cambridge University Press eBooks · doi:10.1017/9781108692137.023 · Cited by 4
Appleton, P. L. (2019) · Qualitative Social Work · doi:10.1177/1473325019869810 · Cited by 8
Inequalities and the Impact of Job Insecurity on Health Indicators in the Spanish Workforce
Castiblanque, R. P., & Calatayud, P. B. (2020) · Sustainability · doi:10.3390/su12166425 · Cited by 4
“On the other hand, there are studies that focus on the analysis of attributed insecurity [26], that is, on the objective signs of insecurity (contractual situation, position of the worker in the company, working conditions, etc.”
BackgroundYazdani, K., Nikoo, M., Sayre, E. C., Choi, F., Jang, K., & Krausz, R. M. (2020) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-020-01887-9 · Cited by 4
El trabajo precario y el trabajo decente: su impacto en la salud y en el desarrollo sostenible
Vargas-Jiménez, E., & Ramos, S. P. P. (2020) · doi:10.21772/ripo.v38n2a05 · Cited by 4
“La disponibilidad de los nuevos sistemas de datos e información han aumentado la evidencia disponible sobre la asociación entre empleo precario y mala salud (Benach et al., 2014).”
BackgroundKim, T.-W., & Allan, B. (2020) · Journal of Career Assessment · doi:10.1177/1069072720918028 · Cited by 4
“For example, economists, sociologists, and public health researchers have primarily based it on financial constraints and unstable work conditions such as low wages, job insecurity, and flexible work (Benach et al., 2014; Campbell, 1981; Zvonkovic, 1988).”
BackgroundCurtis, S., Norman, P., Cookson, R., Cherrie, M., & Pearce, J. (2019) · Health and Place · doi:10.1016/j.healthplace.2019.102174 · Cited by 4
Prevalence and Correlates of Disability Among a Sample of Victimized Women on Probation and Parole
Smith, K. E., Bunting, A. M., Golder, S., Hall, M. T., Higgins, G. E., & Logan, T. (2019) · Journal of Correctional Health Care · doi:10.1177/1078345819833387 · Cited by 6
“…community instability (e.g. neighborhood violence, environmental hazards), all of which can contribute to declines in health (Adler & Newman, 2002; Benach et al., 2014; Berkman & Glass, 2000; DeLongis, Folkman, & Lazarus, 1988; Folkman, 2013; Galster, 2012; Greenberg & Rosenheck, 2008;…”
Vandevenne, E., Gevaert, J., Huegaerts, K., & Vanroelen, C. (2022) · Tijdschrift Sociologie · doi:10.38139/ts.2022.03 · Cited by 2
“Sindsdien trachten bedrijven via innovatie en besparingen winstge-vend te blijven (Benach et al. 2014) en via flexibel (personeels)beleid sneller te rea-geren op plotse marktverschuivingen (Smith 1997).”
InfluentialSelf-citationGIG WORKERS' FINANCIAL CONFIDENCE AND BEHAVIOR
Mitchell, J., & Li, X. (2021) · Global Journal of Accounting and Finance · doi:10.47177/gjaf.05.02.2021.088 · Cited by 5
Bobkov, V., Simonova, M., Loktyuhina, N. V., & Shichkin, I. (2019) · Advances in Intelligent Systems and Computing · doi:10.1007/978-3-030-11367-4_22 · Cited by 4
Reynolds, A. D., Hasson, R. G., & Crea, T. M. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.01.008 · Cited by 4
Morrison, J., Tumas, N., Moreno Mattar, O., Gutiérrez-Zamora Navarro, M., Pericas, J. M., Martínez Herrera, E., Cash-Gibson, L., Caroz Armayones, J. M., Ruisoto, P., Zografos, C., et al. (2025) · International Journal of Social Determinants of Health and Health Services · doi:10.1177/27551938251343485 · Cited by 4
Self-citationEmployment quality, non-standard work, and health: Evidence from China.
Jiang, Y., Hu, Z., Baležentis, T., & Shen, Z.-Y. (2026) · Social Science & Medicine (1967) · doi:10.1016/j.socscimed.2026.119210 · Cited by 3
Jang, H., Park, H., Kim, T., & Kim, J. (2026) · American Journal of Criminal Justice · doi:10.1007/s12103-025-09888-7 · Cited by 2
“Precarious employment encompasses unstable work arrangements, limited benefits, low autonomy, and restricted opportunities for advancement—factors that have profound implications for health, well-being, and overall life satisfaction (Benach et al., 2014 ).”
Gıovanıs, E., Özdamar, B., & Özdamar, Ö. (2026) · International Journal of Workplace Health Management · doi:10.1108/ijwhm-09-2025-0245 · Cited by 7
Horozoğlu, M. A., & Korkmaz, O. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1702929 · Cited by 3
Jimenez, R., Dorvil, S., Pierre, J., Nieves, C. I., Shiman, L. J., Shaheen, T., Dannefer, R., Maulana, S., & Norvila, N. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1603629 · Cited by 3
Boden-Albala, B. M., Draughter, D., Castro, M., Gutierrez, D., Cardenas, C., Landry, M. J., Wing, J. J., & Albala, B. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1531775 · Cited by 4
“Moreover, the insecurity associated with precarious employment can lead to reliance on unhealthy food options and delayed medical care, further compounding health risks (38, 39).”
The Mediating Effects of Borderline Personality Disorder Stigma on Work Stress and Precarity
Nault, E., & Sabat, I. E. (2025) · Personality and Mental Health · doi:10.1002/pmh.70023 · Cited by 3
Association of Precarious Employment With Unmet Healthcare Needs and Health Checkup Participation
Baek, S., & Yoon, J. (2025) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2025.02.012 · Cited by 2
Parental precarious employment and the mental health of adolescents: a Swedish registry study
Aronsson, A., Thern, E., Matilla-Santander, N., Kvart, S., Hernando-Rodriguez, J., Badarin, K., Juliá, M., Alfayumi-Zeadna, S., Gunn, V., Kreshpaj, B., et al. (2025) · Scandinavian Journal of Work, Environment and Health · doi:10.5271/sjweh.4210 · Cited by 3
“Precarious employment (PE) is growing increasingly common in many countries and can have several health damaging effects (1) resulting, for instance, from increased stress, financial hardship and hazard - ous working conditions.”
Self-citationTwenty-first century alienation and health: a research agenda
Baum, F., Anaf, J., Freeman, T., Musolino, C., van den Berg, M., Friel, S., & Schram, A. (2025) · Journal of Epidemiology and Community Health · doi:10.1136/jech-2024-223112 · Cited by 3
“8 The division between the labour class and the capital class endures today in the form of dehumanising working conditions 9 (eg, gig insecure work, zero hour contracts), and work-places that seek only to maximise profits and leave workers feeling disempowered.”
Woodgate, R. L., Isaak, C. A., Witt, J., Tennent, P., & Bell, A. (2024) · PLoS ONE · doi:10.1371/journal.pone.0309720 · Cited by 3
Oliveira, E. A., Gonçalves, L., Moreira, F., Santana, W., & Maués, L. (2024) · Buildings · doi:10.3390/buildings14082539 · Cited by 3
“However, precarious work is typically associated with higher levels of inse-curity, stress, poor mental health [5,9], and sleep disorders [10], which can lead to serious consequences for workers’ health, including loss of mobility, autonomy, and self-care [11], compromising the establishment of a…”
BackgroundHaro‐Ramos, A. Y., Block, R., & Sánchez, G. R. (2024) · Social Science & Medicine · doi:10.1016/j.socscimed.2024.117254 · Cited by 3
Vignola, E. F., Andrea, S., Hajat, A., Weathers, T. D., & Ahonen, E. Q. (2024) · Journal of critical public health · doi:10.55016/ojs/jcph.v1i1.78291 · Cited by 3
“Poor quality, or precarious, employment (PE) is a social determinant of health (Benach et al. 2014) that undermines individuals’ ability to accumulate flexible socioeconomic resources – knowledge, money, power, prestige, and beneficial social connections – that help them engage in healthy behaviors…”
BackgroundHan, H., Koo, B., Kim, S., Chua, B., & Kim, J. J. (2023) · The International Journal of Aerospace Psychology · doi:10.1080/24721840.2023.2231507 · Cited by 6
“Job insecurity also endangers employees’ stability and mental health (Benach et al., 2014).”
BackgroundResultFrontenaud, A. (2023) · Maghreb, Machrek · doi:10.3917/e.machr.254.0017 · Cited by 3
Lee, R., Kim, J., & Shim, J. (2023) · Asian Social Work and Policy Review · doi:10.1111/aswp.12277 · Cited by 3
Fear of Job Loss and Hypertension Prevalence Among Working Latino Adults
Gonzalez, T. M., Murillo, R., Isijola, O., Sandoval, J., Vásquez, E., & Echeverría, S. (2022) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-022-01417-6 · Cited by 3
“Fear of job loss is a social determinant of health that is additionally categorized as employment precariousness [17].”
BackgroundInfluentialFernández-Suárez, I., López-Goñi, J. J., & Haro, B. (2022) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-022-01927-8 · Cited by 3
Pérez, C. G., Alaiz, M. P., Seva, J., Simón, H. J., & Simón-Albert, R. (2022) · Applied Economics · doi:10.1080/00036846.2022.2091744 · Cited by 3
“Precarious employment is one of the most relevant issues in analyses of labour markets and labour policy (International Labour Organization 2011), inter alia because it may generate a deterioration in health (Benach et al. 2014) and it particularly affects vulnerable groups of workers, such as young people, women, or…”
BackgroundRichardson, L., Minh, A., McCormack, D., Laing, A., Barbic, S. P., Hayashi, K., Milloy, M., Huyser, K. R., Leahy, K., & Li, J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191610456 · Cited by 4
“In addition, individuals’ lifetime experiences of economic engagement and income generation along the livelihood continuum occur within a context of formal labour market restructuring that, since the 1970s, has resulted in the growth of working arrangements characterized by multiple dimensions of precarity—inadequate…”
Nigenda, G., Zárate-Grajales, R., Aristizabal, P., Squires, A., Ostiguín-Meléndez, R., Salcedo, R. A., Leija, C., Choperena, D., & Serván-Mori, E. (2022) · Journal of Professional Nursing · doi:10.1016/j.profnurs.2022.01.002 · Cited by 3
Employment status and mortality among Korean men over a 13-year period
Lim, D., Kong, K., Park, H., & Jung-Choi, K. (2021) · Epidemiology and Health · doi:10.4178/epih.e2021055 · Cited by 3
“The number of precarious employees has increased, and their work and social environments have worsened, which is referred to as “polarization” [3-6].”
BackgroundEisenberg-Guyot, J., Mooney, S., Barrington, W. E., & Hajat, A. (2021) · Epidemiology · doi:10.1097/ede.0000000000001386 · Cited by 3
Meatpacking plant workers: A case study of a precarious workforce
Gerr, F. (2021) · Journal of Occupational and Environmental Hygiene · doi:10.1080/15459624.2021.1895997 · Cited by 4
“…contractor) or (ii) characterized by low wage, poor protection from termination, absence of access to regulatory protections and benefits associated with “standard employment” and an inability to exercise rights (especially the right to organize and bargain collectively) (Benach et al. 2014).”
BackgroundJetha, A., Shamaee, A., Bonaccio, S., Gignac, M., Tucker, L., Tompa, E., Bültmann, U., Norman, C. D., Banks, C., & Smith, P. (2020) · doi:10.21203/rs.3.rs-122507/v1 · Cited by 3
Connecting Caregiver Wages and Distress: Felt Precarity, Parenting, and Child Behavior
Campbell, M., & Houser, L. (2020) · Families in Society The Journal of Contemporary Social Services · doi:10.1177/1044389420913393 · Cited by 3
Introduction to the Special Issue “Parental work and family/child well-being”
Pollmann-Schult, M., & Li, J.-H. (2020) · Journal of Family Research · doi:10.20377/jfr-422 · Cited by 3
“Also, nonstandard employment (e.g., involuntary part-time work, temporary and contract work) has been linked to increased risk for mortality, coronary heart disease, occupational injuries, and poorer self-rated health (for a review, see Benach et al. 2014).”
BackgroundDosani, A., Lind, C., & Loewen, S. (2019) · Witness: The Canadian Journal of Critical Nursing Discourse · doi:10.25071/2291-5796.29 · Cited by 3
“…that placed importance on health equity and social justice, including sourcing literature on Indigenous/Aboriginal peoples’ determinants of health (Benach et al., 2014; Canadian Nurses Association, 2007; Canadian Public Health Association, 2015; Castañeda et al., 2015; Chircop, 2020; Greenwood,…”
BackgroundPlace of Birth Inequalities in Dental Care Use before and after the Economic Crisis in Spain
Rodríguez-Álvarez, E., Lanborena, N., & Borrell, L. N. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16101691 · Cited by 3
“Finally, the increase in precarious work conditions and the progressive decrease of wages that has taken place in Spain after the Labor Reform of 2012 may explain the persistence of inequalities in the use of dental health services after three years of economic growth and employment growth [18,41].”
BackgroundKuna, S., & Nadiv, R. (2018) · Diversity, Affect and Embodiment in Organizing · doi:10.1007/978-3-319-98917-4_9 · Cited by 3
Longer working careers and sustainable work: the issue of social inequality
Vanroelen, C. (2017) · Society Health & Vulnerability · doi:10.1080/20021518.2017.1332854 · Cited by 7
“Major macroeconomic and political transformations have led to the erosion of the so-called Standard Employment Relationship (SER; Benach et al., 2014).”
BackgroundSelf-citationVariation in worker responses to subcontracted employment: A qualitative case study
Acar, T. (2016) · doi:10.1177/0143831x15624244 · Cited by 3
“Previous studies reveal that there is a consistent association between perceived job insecurity and mental ill health (for a review see Benach et al., 2014).2 Clarke et al. (2007) found that among younger workers, who are at the beginning of their careers, mental health problems are more common.”
BackgroundWork-related musculoskeletal disorders: are they truly declining?
Vargas-Prada, S. (2014) · Occupational and Environmental Medicine · doi:10.1136/oemed-2014-102639 · Cited by 3
Nunes, P. M., Proença, T., & Todaro, M. E. C. (2024) · Revista de Administração de Empresas · doi:10.1590/s0034-759020240502x · Cited by 3
Why Do Temporary Workers Have Higher Disability Insurance Risks Than Permanent Workers?
Koning, P., Muller, P., & Prudon, R. (2022) · Social Science Research Network · doi:10.2139/ssrn.4067608 · Cited by 3
“In line with other research, we do find that the use of fixed-term employment contracts increases the prevalence of mental health problems (Kim et al., 2012; Virtanen et al., 2005; Benach et al., 2014).”
BackgroundResultThe power of lore: how occupational myths help precarious workers endure
Burrow, R., Courpasson, D., & Morris, J. (2026) · Human Relations · doi:10.1177/00187267261434774 · Cited by 2
Kinitz, D. J., Tran, N., Shahidi, F., Soltani, S., Bryant-Lees, K., Flentje, A., Lubensky, M., Obedin-Maliver, J., & Lunn, M. R. (2026) · The Lancet Regional Health - Americas · doi:10.1016/j.lana.2026.101462 · Cited by 2
“9,10 .”
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“The positive effect of informal employment on HSB contrasts with many studies from high-income countries, in which informal work is often associated with poorer access to health care (e.g., Benach et al., 2014 ).”
Utzet, M., Soler, M., Ramada, J., Menéndez, M., Silva-Peñaherrera, M., Benavides, F. G., & Serra, C. (2025) · Scandinavian Journal of Work, Environment and Health · doi:10.5271/sjweh.4266 · Cited by 2
“Paid work is a significant social determinant of health, offering potential benefits for social and psychological well-being but also posing risks, depending on the organization of work, employment conditions, and social context ( 1).”
Understanding sickness presenteeism: causes, risks and solutions: guidelines series.
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“17,26,27”
Development of a formative index for precarious employment in Denmark
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Health as a rich people’s game through the lens of work and income
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“…the growing reliance on work that is uncertain, insecure, and unstable, so-called precarious employment [3–5], has transformed work for many from a resource to a vulnerability for our health and well-being, partly due to inadequate material compensation and precarious working conditions [3, 6].”
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Bullying at work: Differential pattern in Euro-Area according to gender-based disparities
Sánchez-Sánchez, N., & Puente, A. F. F. (2024) · Economic and Labour Relations Review · doi:10.1017/elr.2024.24 · Cited by 2
Self-perception of oral health, gender and employment among Brazilian population
Alves, N. S., Abreu, M. N. S., & Assunção, A. Á. (2024) · Work · doi:10.3233/wor-230143 · Cited by 2
“In a standard job, the relationship between employer and employee is formal, and labor rights, such as vaca-tions and inspections of the work environment, are formally defined [10, 21].”
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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