Precarious Employment: Understanding an Emerging Social Determinant of Health

“42,43 An important result of the shift in the balance of power between capital and labor is that employers feel they have a freer hand to fl out regulations on wages and hours, discrimination, union organizing, and health and safety without too much concern for the consequences.”

“A growing body of empirical work has established adverse links between working nonstandard hours or holding a precarious job and our physical, mental, and social well-being (Benach et al., 2014; Jehan et al., 2017; Presser, 2003).”

“Thus, although PE is expressed in both employment and working conditions, its fundamental causes are to be found in the flexibilization of the labor market, the deregulation of labor relations and the lack of social protection for workers (1, 5, 6).”

“There has been a growing body of evidence of an association between employment status and mental health (5, 6), but previous studies have yielded inconsistent results (7–12).”

“…20% of the respondents reported being non-permanent, and with uncertain employment come natural concerns around job security, longevity, and sustainability of income, and is directly linked to a variety of negative health effects including burnout (Benach et al., 2014; Kolomitro et al., 2020).”

“Additionally, precarious work may increase stress, restrict agency and control in the workplace, and limit access to healthcare, stable housing, and other health-promoting factors beyond the workplace (Benach et al., 2014).”

“…risks associated with precarity—employment insecurity, low or unstable incomes, health risks or limited opportunities for participation as well as for further training—have also been empirically studied and discussed (Benach et al. 2014; Brehmer and Seifert 2008; Canivet et al. 2016; Lewchuk 2017).”

“Many studies have emphasized the relationship between organizational restructure and employees’ overall well-being (e.g. Benach et al., 2014; de Jong et al, 2016).”

“This is what is called in the literature “perceived job insecurity” [24].”

“Stable employment is a recognized SDOH (Ahonen et al., 2018; Benach et al., 2014; Peckham et al., 2019) with the potential to improve a wide range of health outcomes.”

“Retraining creates opportunities for entering new sectors, and evidence from the US suggests that the financial strain and pandemic-induced panic experienced by furloughed individuals within the hospitality industry during the pandemic predicted their intention to leave the hospitality industry altogether.(44) These i…”

“Drawing from a large body of theory and research, employment is considered a key social determinant of health (9).”

“Previous studies reported that temporary workers perceive their jobs as less secure than full-time permanent workers.(3,10,11) Thus, several recent studies”

“safety and health (OSH) problems, such as increased rates of injuries.(10,11) Temporary work is also associ-”

“Western Journal of Nursing Research; 22(5), 623-41.”

“Guidance was lacking on the regulation of the employment relationship, a separate debate (ILC, 2006a), or countering austerity, or addressing issues like informality or triangular employment relationships, despite the hazardous nature of these issues (Quinlan et al. , 2001; Benach et al. , 2014).”

“…to workers in permanent employments, precariously employed workers experience difficult bargaining relations between workers and employers, low wages and economic deprivation, limited workplace rights and social protection, and powerlessness to exercise workplace rights (Benach et al., 2014).”

“배경 근로자의 건강불평등 현상은 크게 개인적 특성과 직 업생활 및 사회구조의 특성의 영향으로 발생한다 (Benach et al, 2007; Benach et al, 2014).”

“…service industries, high rates of unemployment, and capitalists’ interests in reducing the costs of labour in business organisations, among others (Benach et In its response to the harmful effects of globalisation on the labour market systems in many countries, the ILO established the declaration…”

“В последние годы распространены различные по масштабу организационные изменения: слияния и сокращения, введение новых методов работы [32].”

“Precarious work is associated with elevated psychological distress, material hardship, and economic insecurity, as well as poorer self-rated health and increased risk of chronic disease (Benach et al., 2014, 2016; Donnelly, 2022; Oddo et al., 2024).”

“At the micro level, employment quality is affected by the quality of workers [19], gender [20], and educational background [21,22] Among these, educational background plays a particularly complex role, with both over-[23] and under-education [24] capable of diminishing employment quality.”

“…inheritance of labouring under hierarchical authority alongside a present-day experience of being left outside a national story of progress, creates a specific set of conditions under which OHS governance is experienced and psychological wellbeing is shaped (Benach et al., 2014; Ross, 2012).”

“…low incomes and working poverty, associated with the growing presence of the "working poor" even in formal employment contexts (Standing 2011; Eurofound 2020); and the lack of social protection, including health coverage, occupational security, and income stability (Benach et al. 2014; ILO 2016).”

“Considering a public health approach, inclusion at work is an important social determinant of health [13] with evidence showing relationships between people’s feelings of organizational inclusion, the need to belong to a larger social group and psychological well-being [14].”

“As labor markets become increasingly fragmented (Benach et al., 2014; Kalleberg, 2009), this limitation is particularly salient.”

“Studies on general populations have linked employment precariousness to negative well-being indicators such as depression, anxiety, burn-out, and poorer physical health [25–28].”

“From this perspective, the employment-health relationship reflects power relations between employers and employees within the context of socially-structured markets, institutions and norms [6, 21].”

“…that arise from the broader societal, economic, and political context and test whether current theoretical frameworks apply across different contexts or whether revision is needed to capture the complexity of different work contexts and the wider social determinants of health (Benach et al., 2014).”

“…Organization (ILO) (25), the US National Institute for Occupational Health (NIOSH) through its Total Worker Health initiative (26, 27) and scholars (6, 7, 21, 28) have all called for the need to define precarious employment holistically, incorporating the built environment (e.g., safe and secure…”

“The prevalence of precarious work, like overall underemployment, is thought to be, in part, an outcome of labor market factors (Benach et al., 2014).”

“States pursueflexibility through the introduction of limited social security benefits, labor clauses to lessen work degradation and altered collective-bargaining rules while supporting the individualization of employment relations (Benach et al., 2014; Jaehrling et al., 2018).”

“Work participation among people with WD remains challenging and their risk of job loss is higher compared to the general population [5].”

“…chronic stress due to job insecurity, poor working conditions, and limited access to resources, which may exacerbate existing health inequities [45] These findings highlight the need for targeted public health policies and interventions to mitigate the impact of unfavourable working conditions.”

“Benach et al .”

“Benach et al. (2014) highlight that the absence of social benefits significantly reduces employee job engagement, as the lack of support fosters a sense of neglect, further leading to decreased willingness to voice concerns or suggestions.”

“For a long time, the employment arrangement of workers remained a relatively neglected factor in this research tradition (Benach et al., 2014; Vanroelen et al., 2021).”

“…indicadores de salud como peor salud autopercibida, mental, estrés, consumo de medicamentos y enfermedades específicas, lo que se manifiesta en forma de morbilidad y mortalidad incrementadas, así como en una mayor desigualdad en su distribución poblacional (Benach et al., 2014; Julià et al., 2022).”

“…led them to lose their jobs and subsequently start employment as PDWs (supporting the social drift hypothesis) or rather their low socio-economic context narrowed their employment options to the most precarious jobs, exposing them to experience DSs [48] (supporting the social causation hypothesis).”

“…y en muchos casos, invisible (Marmot, 2015); que a pesar de la existente evidencia científica que ha demostrado de manera consistente que el trabajo puede tener un impacto significativo en la salud de los individuos, estos efectos tienden a minimizarse o pasarse por alto (Benach et al., 2014).”

“Outsourcing complicates the legal responsibility for worker safety and disrupts safety management systems, potentially leading to regulatory failures [6-10].”

“…unstable jobs (e.g., fixed-term, casual workers, job-on-call, training, etc.), associated with both occupational instability and low pay (Benach et al., 2014; Pirani & Salvini, 2015); self-employment and managerial-professional occupations (to a lesser extent and rewarded, on average,…”

“This situation is compounded by less collective representation and reduced social protection compared to previous generations, indicating deteriorating working conditions for young people (Benach et al. 2014).”

“[13], Benach, J et.al [14], Rial-González, E. [15], Kompier, M. A. [16], Schill, A. L., & Chose-wood, L. C. [17], Khanthachai, N. [18].”

“…pertains to indicators such as an unstable contract, poor compensation, long working hours (Julià et al. 2017; Koranyi et al. 2018; Vives et al. 2013), physical strain (Benach et al. 2014), high workload and low autonomy (Demerouti et al. 2001; Schaufeli and Bakker 2004; Niedhammer et al. 2021).”

“…has been an increase in ‘precarious employment’ 61 —including temporary, contract, and on-call employment conditions 62 —with few benefits, unpredictable future job prospects and higher levels of job insecurity, 63 a social determinant that affects the health of workers, families and communities.”

“As workforce and retirement protections (such as pensions) decrease in the United States, there is a correlating increase in job churning among older workers (Benach et al., 2014; Bonoli, 2007).”

“While the findings appear to support the concept of health selection contributing to inequalities in the labor market, it does not negate the fact that LMA contributes to the development of health inequalities during the life course [33].”

“Temporary employment has been recognized as a novel determinant of health services (Benach et al., 2014; Hajat et al., 2024).”

“10 Second, we discovered that economic deprivation mediated the relationship between temporary employment and general health risks.”

“Since these jobs have contractual uncertainty, fewer rights, and power hierarchies ingrained in their structure, employees in this position often find themselves in economically and socially vulnerable positions, despite their educational qualifications (Benach et al., 2014).”

“2 Temporary workers are in a constant state of job insecurity 22 and have frequent periods of unemployment, both of which have been established as chronic work ‐ related stressors 23–25 that can negatively impact mental and physical well ‐ being.”

“How overall rates of employment correlate with measures of population health is not well established (Benach et al., 2014; Lipscomb et al., 2006).”

“in high-income countries are more likely to be trapped in precarious work and precarity (Benach et al. 2014).”

“…also depend on the type and quality of jobs – including whether work is precarious, whether workers experience discrimination in the workplace, and whether a job acts as a source of intrinsic meaning and satisfaction for the worker (Benach et al., 2014; Julià et al., 2017; Wanberg, 2012).”

“Last but not least, given the well-established associations between social class and job security (Chan & Goldthorpe, 2007; Goldthorpe, 2000) and between job security and health (Benach et al., 2014; Virtanen, 2002), we further integrate job security into our model to test its mediating role between social class and h…”

“Change is a common challenge for organizations that often results in adaptive strategies to survive these changes (Benach et al., 2014).”

“While they provide greater flexibility, they often offer limited stability, poorer working conditions, and often insecure hours and income (Benach et al. 2014) and with a negative impact on health (Benach et al.”