The importance of using a multi-dimensional scale to capture the various impacts of precarious employment on health: Results from a national survey of Chilean workers.

Alejandra Vives,Joan Benach,Tarik Benmarhnia,Francisca González,Semih Tumen

doi:10.1371/journal.pone.0238401

Abstract

Social epidemiologic research in relation to the health impacts of precarious employment has grown markedly during the past decade. While the multidimensional nature of precarious employment has long been acknowledged theoretically, empirical studies have mostly focused on one-dimensional approach only (based either on employment temporariness or perceived job insecurity). This study compares the use of a multidimensional employment precariousness scale (EPRES) with traditional one-dimensional approaches in relation to distinct health outcomes and across various socio-demographic characteristics. We used a subsample of formal salaried workers (n = 3521) from the first Chilean employment and working conditions survey (2009-2010). Multilevel modified Poisson regressions with fixed effects (individuals nested within regions) and survey weights were conducted to estimate the association between general health, mental health and occupational injuries and distinct precarious employment exposures (temporary employment, perceived job insecurity, and the multidimensional EPRES scale). We assessed the presence of effect measure modification according to sex, age, educational level, and occupational class (manual/non-manual). Compared to one-dimensional approaches to precarious employment, the multidimensional EPRES scale captured a larger picture of potential health effects and differences across subgroups of workers. Patterns of effect measure that modification were consistent with the expectations that groups in greater disadvantage (women, older individuals, less educated and manual workers) were more vulnerable to poor employment conditions. Multidimensional measures of precarious employment better capture its association with a breath of health outcomes, being necessary tools for research in order to strengthen the evidence base for policy making in the protection of workers' health.

Highlights

The flexibilization of employment relationships of the past decades has led to the growth of precarious employment [1]
Multilevel modified Poisson regressions with fixed effects and survey weights were conducted to estimate the association between general health, mental health and occupational injuries and distinct precarious employment exposures
Compared to one-dimensional approaches to precarious employment, the multidimensional employment precariousness scale (EPRES) scale captured a larger picture of potential health effects and differences across

Summary

Introduction

The flexibilization of employment relationships of the past decades has led to the growth of precarious employment [1]. Such research has grown markedly during the past decades, but while scholars from different disciplines have long acknowledged that there are several dimensions to precarious employment, the main approaches to produce epidemiologic evidence have been largely one-dimensional, focusing primarily on job instability. Studies have produced contradictory findings, whereby some have found an inverse association between type of contract and health, or no association at all [10] This may Measuring employment precariousness and health be partly explained because not all temporary jobs are necessarily precarious, but mainly because the increased utilization of temporary employment has expanded this precarisation to all contract types, such that many permanent jobs are to some extent, precarious. This study compares the use of a multidimensional employment precariousness scale (EPRES) with traditional one-dimensional approaches in relation to distinct health outcomes and across various socio-demographic characteristics

Objectives

Methods

Conclusion