Abstract
BackgroundThough previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health. With especially job insecurity reflecting a contemporary health risk for the employed, a systematic review was performed to assess if insecure employment can be as detrimental for health as unemployment, and to determine whether these associations vary according to different health measures and among men and women.MethodsThe literature search was conducted in the databases Medline, Embase and PsychInfo. In order to allow a more accurate comparison between the two risk factors, studies were included if the data for job insecurity and unemployment was ascertained from the same sample, and contained a quantitative analysis for both exposures towards one (or more) health outcome(s).ResultsOut of 375 articles, in total, 13 studies were included in the systematic review. In 24 analyses contrasting the health-related associations between job insecurity and unemployment, 16 statistically significant associations were found for each exposure. According to the different health outcomes used, job insecurity and unemployment were strongly related to mental health, whereas job insecurity was more strongly associated with somatic symptoms. Unemployment showed stronger relations with worse general health and mortality. In 4 out of 16 gender-stratified analyses, significant associations between job insecurity/unemployment and health were found for men but not for women. Beyond that, associations were significant or insignificant in both gender groups.ConclusionsThough there were moderate differences across the health outcomes, overall, it was found that job insecurity can pose a comparable threat to health than unemployment. Policy interventions should therefore not only consider health risks posed by unemployment, but should also aim at the reduction of insecure employment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2313-1) contains supplementary material, which is available to authorized users.
Highlights
Though previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health
In contrasting the subsamples of the insecure employed and unemployed within a respective study we addressed the following questions: How strong and consistent are the associations between perceived job insecurity and unemployment with health? Do the associations vary depending on the diverse health measures that were used in studies? And since recent studies found that the associations between psychosocial work characteristics, unemployment and health are influenced by gender [19,20,21,22,23,24,25,26], we examined if the relationship between job insecurity, unemployment and health varies among men and women
To respond to design-related heterogeneity that is usually found in the comparison of observational studies [28], data on job insecurity and unemployment had to be derived from the same study to minimize bias and control for sample specific characteristics
Summary
Though previous research repeatedly found that being employed is better for health than having no job at all, evidence suggests that employment is not always beneficial for health. With especially job insecurity reflecting a contemporary health risk for the employed, a systematic review was performed to assess if insecure employment can be as detrimental for health as unemployment, and to determine whether these associations vary according to different health measures and among men and women. In contrast to the actual experience of job loss, job insecurity defines a perceptual phenomenon [17], including the everyday experience of a prolonging uncertainty of the future [18]. Since recent studies found that the associations between psychosocial work characteristics, unemployment and health are influenced by gender [19,20,21,22,23,24,25,26], we examined if the relationship between job insecurity, unemployment and health varies among men and women In contrasting the subsamples of the insecure employed and unemployed within a respective study we addressed the following questions: How strong and consistent are the associations between perceived job insecurity and unemployment with health? Do the associations vary depending on the diverse health measures that were used in studies? And since recent studies found that the associations between psychosocial work characteristics, unemployment and health are influenced by gender [19,20,21,22,23,24,25,26], we examined if the relationship between job insecurity, unemployment and health varies among men and women
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