Precarious Employment: Understanding an Emerging Social Determinant of Health

“…to capture labour market precarity have been created: i) whether the individual may lose his or her job in the next few months (INSTABILITY) (See Benach et al. (2014) and (2016)) and Vancea and Utzet (2017) who study the effect of precarious employment as a social determinant of health) and ii)…”

“…and systematic reviews of the literature show strong associations between mental health and income inequality (Patel et al. 2018), job insecurity (Benach et al. 2014; Kim and von dem Knesebeck 2015; Lee et al. 2018; Sverke et al. 2002), and stigma (Link and Phelan 2001; Mak et al. 2007).”

“And those whose jobs are temporarily discontinued may worry about being laid-off and not rehired, which further impacts emotional health [1, 2].”

“Benach et al. (2014) menar att ”prekärt arbete” riskerar bidra till ohälsa på grund av hälsovådlig arbetsmiljö, psykosocial stress och ekonomiska konsekvenser.”

“…health implications of nonstandard work have received growing attention since many characteristics associated with nonstandard work, such as job insecurity and low income, are found to be important social determinants of health (Benach et al., 2014; De Witte, Pienaar, & De Cuyper, 2016).”

“Deze benadering gaat verder dan traditionele, eendimensionale benaderingen, die te vaak gebaseerd waren op het onderscheid tussen specifieke non-standaard arbeidscontracten of geïsoleerde risicofactoren (bv. flexibele werkschema’s) (Benach et al., 2014).”

“There is also greater risk of occupational injuries and greater exposure to environmental risks (Benach et al., 2014).”

“Since its fixed duration implies work insecurity and instability, it is often defined as ‘‘precarious’’ and regarded as leading to impaired well-being and health but also to financial hardship.(2,3) However, existing evidence on temporary workers’ physical and mental health as well as their attitudes and behaviors is…”

“The resulting material deprivation (Benach et al., 2014) in the form of economic hardships (including debt accumulation) gets further exacerbated by the gaps in the employer-provided regular benefits (including, health insurance) in non-standard employment.”

“…research investigating the effect of job precariousness on ill-being, well-being, and work outcomes (Allan et al., 2017; Allan et al., 2021; Benach et al., 2014; Benach et al., 2016; Bosmans et al., 2016; Cheng & Chan, 2008; Creed et al., 2020; Cuyper et al., 2009; Feather & Rauter, 2004;…”

“The precariousness of an occupation is a critical determinant to the health and safety of workers ( 1–3 ).”

“Some authors noted that the terminology linked to precariousness should imply a multidimensional concept including several, if not all, harmful aspects of atypical works (Benach and Muntaner 2007; Benach et al. 2014).”

“Precarity has many negative impacts for researchers including to their mental and physi - cal wellbeing (Benach et al., 2014) and adds to the challenges marginalised researchers experience during fieldwork (Sim & Bierema, 2026).”

“Benach et al. (2014), in their review of precarious employment as a social determinant of health, draw from public health on the same conclusion: exposure is stratified by employment status, and the workers who accumulate the most exposure are precisely those least able to negotiate its price.”

“Precarious employment combines insecurity in income, hours worked, continuity, rights, and access to employment-related protection and is increasingly treated as an upstream determinant of health (13, 15).”

“…as job authority (Schieman & Reid, 2009; Pudrovska & Karraker, 2014); characteristics of the work, such as high physical demands (Palumbo et al., 2017; Skovlund et al., 2020); and characteristics of the employment contract, such as precarious employment (Hajat et al., 2024; Benach et al., 2014).”

“Benach et al (2014), Kim and von dem Knesebeck (2015), and de Oliveira et al (2023) explicitly note that the predominance of non-longitudinal evidence makes it difficult to establish the temporal ordering between exposure and subsequent health deterioration.”

“Across adulthood, work structures income, health insurance, retirement security, social status, daily routines, cognitive and social engagement, and exposure to psychosocial stress and occupational hazards (Benach et al., 2014; Eisenberg-Guyot et al., 2020; Lipscomb et al., 2006).”

“Unlike institutional care, private households often lack ergonomic infrastructure, structured safety protocols, or professional support, increasing the risk of occupational injury [26, 27].”

“…significantly associated with depersonalization or reduced personal accomplishment, contrasting with the robust protective effect reported in formal police studies (45), likely reflecting the structural vulnerability associated with auxiliary police officers’ semi-formal occupational status (75).”

“In addition, frailty was assessed using the Korean Frailty Instrument, a multidimensional measure that includes social isolation and exhaustion in addition to physical weakness.”

“24 Benach et al. (2014).”

“Job precariousness encompasses employment arrangements characterized by instability, low-income security, limited social protection, and reduced bargaining power (Benach et al. 2014; Kreshpaj et al. 2020).”

“This finding supports argument that the simplification of fixed-term employment provisions under Law Number 6 of 2023 may reduce legal certainty and weaken worker protection if not accompanied by effective supervision [16].”

“Benach et al. (58) extended this finding, demonstrating that not only unemployment but also precarious employment, characterized by instability, low wages, and limited rights, is associated with adverse mental health outcomes.”

“Indeed, precarious employment is an important social determinant of health (Benach et al. 2014).”

“…al., 2015; Sato et al., 2020), aligning with the logic of fundamental cause theory and emphasizing social conditions such as socioeconomic status and social support, rather than proximal factors, as the fundamental causes of diseases (Benach et al., 2014; Frank et al., 2023; Link & Phelan, 1995).”

“…wear that persists beyond the immediate employment episode (McEwen, 1998; Wahrendorf et al., 2022) and continues to leave “ scarring effects ” that are not fully offset by later improvements in job quality (Amick et al., 2016; Benach et al., 2014; Chen & Wang, 2024; Moscone et al., 2016).”

“Relevant pandemic pathways include precarious employment and work–family conflict [11–14], family stress and resilience processes [15,16], food inse-curity and parental strain [17,18], and heightened stress, anxiety, and depressive symptoms among Black adults and caregivers [3,19,20].”

“This gradient suggests that informality alone is not the active mechanism; what matters is the underlying configuration of demands, control and rewards in each occupational niche [31].”

“These twin challenges appear to produce a destructive chain reaction—sparking family chaos ( 10 – 12 ) and burning through economic and health reserves ( 13 , 14 ).”

“Benach, J. et al. (2014) In their study on precarious employment, the authors explain that informal and unstable jobs negatively affect workers’ mental and physical health.”

“Prior evidence suggests that precarious employment and job strain may be associated with adverse health outcomes, including elevated blood pressure and cardiovascular risk (37, 38).”

“…by risky working conditions, insufficient regulation, and limited access to healthcare or social protection, reflecting Benach et al .’s [36] concept of precar-ious employment—an emerging social determinant that worsens health inequities through job insecurity, lack of rights, and…”

“Global scholarship has documented adverse physical and mental health for workers with nonstandard work schedules, with some work arrangements (e.g., night hours) posing greater risks than others [9–11, 13,25,35– 38].”

“These findings replicate well-established patterns in the literature, reinforcing the robustness of decent work as a predictor of key attitudinal and well-being outcomes in a novel employment setting [21].”

“Among these groups, younger workers at the beginning of their careers may be especially vulnerable to the stressors associated with PE (Benach et al. 2014 ; Kalleberg and Vallas 2017).”

“Given that psychosocial risk exposures may be elevated among precariously employed workers and in small workplaces or service and care sectors, prevention resources should be strategically prioritized to promote health equity (74, 75).”

“Research on insecure employment has shown that such conditions often undermine subjective well-1 being (Benach et al., 2014 ).”

“Similar regional variability has been reported in previous studies examining decentralised health and social care systems during emergencies [40,41].”

“Precarious employment (PE), characterized by job insecurity, low wages, and limited workplace protections, is increasingly prevalent in post-industrial economies [13–16] and has been strongly linked to poorer mental health outcomes [17–25].”

“…workforce is estimated to be precariously employed, commonly characterized as the accumulation of unfavorable facets of employment quality such as insufficient wages, job instability, limited fringe benefits and rights and protections, coupled with imbalanced employer-worker power relations [3, 4].”

“Without commensurate redesign of roles, training, and worker protections, task transformation in these occupations may bring reduced job autonomy, wage stagnation, and insecurity—widening gendered and class-based gradients in income, psychosocial stress, and ultimately health [3,9,23].”