Precarious employment and general, mental and physical health in Stockholm, Sweden: a cross-sectional study.

Johanna Jonsson,Cecilia Orellana,Bertina Kreshpaj,Theo Bodin,Bo Burström,Nuria Matilla-Santander,Gun Johansson,Per-Olof Östergren,Katarina Kjellberg,Karin Nilsson,Susanne Strömdahl

doi:10.1177/1403494820956451

Abstract

Objectives: To investigate the association between precarious employment and health in a sample of non-standard employees in Stockholm County, Sweden, by addressing three specific research questions: is the degree of precarious employment (low, moderate, high) associated with self-rated. . . (a) general health, (b) mental health, (c) musculoskeletal pain? Methods: Web-based respondent-driven sampling was used to recruit a sample of 415 employees in Stockholm, Sweden, during 2016–2017. Questionnaire data were collected on employment conditions (the Swedish version of the employment precariousness scale (EPRES-Se)), general health, mental health and musculoskeletal pain. EPRES-Se scores were categorised as low, moderate or high. Generalised linear models with Poisson distribution, log link functions and robust variances were applied for calculating crude and adjusted prevalence ratios (PR; aPR) with 95% confidence intervals (CIs) for all outcomes. Results: The prevalence ratios of poor self-rated general and mental health increased with increased degree of precariousness, as indicated by estimates of moderate precarious employment (a2PRModerate 1.44 (CI 0.98–2.11); a2PRModerate 1.13 (CI 0.82–1.62)), and high precarious employment (a2PRHigh 1.78 (CI 1.21–2.62); a2PRHigh 1.69 (CI 1.25–2.28)), albeit only significantly so for high precarious employment. Conclusions: This is the first study in Sweden reporting on the association between precarious employment, as measured with a multidimensional scale, and multiple health outcomes. The results add to the evidence of an association between precarious employment and self-rated poor general and mental health. Larger, representative studies with longitudinal designs using the EPRES-Se are called for in order to strengthen these results and the already existing evidence of the harm of precarious employment.

Highlights

Precarious employment (PE) is a term attempting to encompass a range of attributes associated with employment quality
As musculoskeletal pain (MSP) differed from general health and mental health in the DAGs in the sense that it was not necessary to adjust for previous unemployment, the association between PE and MSP was adjusted for unemployment in the main analysis, while a sensitivity analysis was conducted without previous unemployment
In order to accommodate the potential limitation that might arise from the poor psychometric properties of the temporariness dimension in employment precariousness scale (EPRES)-Se [9] crude and adjusted models were conducted without this dimension

Summary

Introduction

Precarious employment (PE) is a term attempting to encompass a range of attributes associated with (poor) employment quality. There is not yet consensus on a definition of PE that transcends sociopolitical and historical contexts [1]. PE is often characterised by temporariness in employment, income insufficiency, and a lack of labour/collective rights and social security [2]. PE does not refer to the type of employment per se, such as temporary employment, but unidimensional measures of PE are widely applied in research due to e.g. the lack of detailed labour market statistics on crucial PE features [3]. To our knowledge there is no reliable estimate of the extent of PE in the Swedish labour market.

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Conclusion