Objectives The lack of a common definition for precarious employment (PE) severely hampers the comparison of studies within and between countries, consequently reducing the applicability of research ...findings. We carried out a systematic review to summarize how PE has been conceptualized and implemented in research and identify the construct's dimensions in order to facilitate guidance on its operationalization. Methods According to PRISMA guidelines, we searched Web of Science and Scopus for publications with variations of PE in the title or abstract. The search returned 1225 unique entries, which were screened for eligibility. Exclusion criteria were (i) language other than English, (ii) lack of a definition for PE, and (iii) non-original research. A total of 63 full-text articles were included and qualitative thematic-analysis was performed in order to identify dimensions of PE. Results We identified several theory-based definitions of PE developed by previous researchers. Most definitions and operationalizations were either an accommodation to available data or the direct result of qualitative studies identifying themes of PE. The thematic-analysis of the selected articles resulted in a multidimensional construct including the following three dimensions: employment insecurity, income inadequacy, and lack of rights and protection. Conclusions Despite a growing number of studies on PE, most fail to clearly define the concept, severely restricting the advancement of the research of PE as a social determinant of health. Our combined theoretical and empirical review suggests that a common multidimensional definition could be developed and deployed in different labor market contexts using a variety of methodological approaches.
Nearly one of every three workers in the United States is low-income. Low-income populations have a lower life expectancy and greater rates of chronic diseases compared to those with higher incomes. ...Low- income workers face hazards in their workplaces as well as in their communities. Developing integrated public health programs that address these combined health hazards, especially the interaction of occupational and non-occupational risk factors, can promote greater health equity.
We apply a social-ecological perspective in considering ways to improve the health of the low-income working population through integrated health protection and health promotion programs initiated in four different settings: the worksite, state and local health departments, community health centers, and community-based organizations.
Examples of successful approaches to developing integrated programs are presented in each of these settings. These examples illustrate several complementary venues for public health programs that consider the complex interplay between work-related and non work-related factors, that integrate health protection with health promotion and that are delivered at multiple levels to improve health for low-income workers.
Whether at the workplace or in the community, employers, workers, labor and community advocates, in partnership with public health practitioners, can deliver comprehensive and integrated health protection and health promotion programs. Recommendations for improved research, training, and coordination among health departments, health practitioners, worksites and community organizations are proposed.
The world of work is facing an ongoing pandemic and an economic downturn with severe effects worldwide. Workers trapped in precarious employment (PE), both formal and informal, are among those most ...affected by the COVID-19 pandemic. Here we call attention to at least 5 critical ways that the consequences of the crisis among workers in PE will be felt globally: (a) PE will increase, (b) workers in PE will become more precarious, (c) workers in PE will face unemployment without being officially laid off, (d) workers in PE will be exposed to serious stressors and dramatic life changes that may lead to a rise in diseases of despair, and (e) PE might be a factor in deterring the control of or in generating new COVID-19 outbreaks. We conclude that what we really need is a new social contract, where the work of all workers is recognized and protected with adequate job contracts, employment security, and social protection in a new economy, both during and after the COVID-19 crisis.
ObjectivesIn countries with ageing populations, home care (HC) aides are among the fastest growing jobs. There are few quantitative studies of HC occupational safety and health (OSH) conditions. The ...objectives of this study were to: (1) assess quantitatively the OSH hazards and benefits for a wide range of HC working conditions, and (2) compare OSH experiences of HC aides who are employed via different medical and social services systems in Massachusetts, USA.MethodsHC aides were recruited for a survey via agencies that employ aides and schedule their visits with clients, and through a labour union of aides employed directly by clients or their families. The questionnaire included detailed questions about the most recent HC visits, as well as about individual aides’ OSH experiences.ResultsThe study population included 1249 HC aides (634 agency-employed, 615 client-employed) contributing information on 3484 HC visits. Hazards occurring most frequently related to musculoskeletal strain, exposure to potentially infectious agents and cleaning chemicals for infection prevention and experience of violence. Client-hired and agency-hired aides had similar OSH experiences with a few exceptions, including use of sharps and experience of verbal violence.ConclusionsThe OSH experience of HC aides is similar to that of aides in institutional healthcare settings. Despite OSH challenges, HC aides enjoy caring for others and the benefits of HC work should be enhanced. Quantification of HC hazards and benefits is useful to prioritise resources for the development of preventive interventions and to provide an evidence base for policy-setting.
High-quality longitudinal evidence exploring the mental health risk associated with low-quality employment trajectories is scarce. We therefore aimed to investigate the risk of being diagnosed with ...common mental disorders, substance use disorders, or suicide attempt according to low-quality employment trajectories.
A longitudinal register-study based on the working population of Sweden (N=2 743 764). Employment trajectories (2005-2009) characterized by employment quality and pattern (constancy, fluctuation, mobility) were created. Hazard ratios (HR) were estimated using Cox proportional hazards regression models for first incidence (2010-2017) diagnosis of common mental disorders, substance use disorders and suicide attempt as dependent on employment trajectories.
We identified 21 employment trajectories, 10 of which were low quality (21%). With the exception of constant solo self-employment, there was an increased risk of common mental disorders (HR 1.07-1.62) and substance use disorders (HR 1.05-2.19) for all low-quality trajectories. Constant solo self-employment increased the risk for substance use disorders among women, while it reduced the risk of both disorders for men. Half of the low-quality trajectories were associated with a risk increase of suicide attempt (HR 1.08-1.76).
Low-quality employment trajectories represent risk factors for mental disorders and suicide attempt in Sweden, and there might be differential effects according to sex - especially in terms of self-employment. Policies ensuring and maintaining high-quality employment characteristics over time are imperative. Similar prospective studies are needed, also in other contexts, which cover the effects of the Covid-19 pandemic as well as the mechanisms linking employment trajectories with mental health.
Non-standard employment (NSE) has negative implications for workers' health. As part of a larger comparative case study, this article explores US-based workers' experiences in NSE and its influences ...on their health and well-being in a context of a shrinking social safety net and individualistic cultural values. We conducted interviews with workers in NSE in various occupations in the New York City area (N = 40). We used deductive and inductive thematic analysis and considered variations across levels of employment precarity. All participants experienced the ‘hustle of NSE,’ a dynamic frame comprising: i) tension between payoffs (flexibility, opportunity to work for more pay, and satisfaction with their work) and tradeoffs (job instability and insecurity, and having to work more) that both implicate participants' health and well-being in mostly negative ways; ii) reliance on personal and family resources and opportunities to manage NSE; and iii) low expectations for improvements in employer-based practices and policies or basic worker and social protections despite having clarity about problems and desires. Workers assessed their work and life circumstances and behaved in a way to try to obtain the best results for themselves and their families. When comparing across employment precarity levels, workers' health and well-being experiences varied by participants' immigration status. Understanding health and well-being consequences of NSE contributes to examining individual costs of labor market flexibility. Achieving health equity must include labor, employment and welfare state policies that are more inclusive of gaps created by NSE and precarious employment, especially for workers in marginalized social locations.
Studies on autocoding injury data have found that machine learning algorithms perform well for categories that occur frequently but often struggle with rare categories. Therefore, manual coding, ...although resource-intensive, cannot be eliminated. We propose a Bayesian decision support system to autocode a large portion of the data, filter cases for manual review, and assist human coders by presenting them top k prediction choices and a confusion matrix of predictions from Bayesian models.
We studied the prediction performance of Single-Word (SW) and Two-Word-Sequence (TW) Naïve Bayes models on a sample of data from the 2011 Survey of Occupational Injury and Illness (SOII). We used the agreement in prediction results of SW and TW models, and various prediction strength thresholds for autocoding and filtering cases for manual review. We also studied the sensitivity of the top k predictions of the SW model, TW model, and SW–TW combination, and then compared the accuracy of the manually assigned codes to SOII data with that of the proposed system.
The accuracy of the proposed system, assuming well-trained coders reviewing a subset of only 26% of cases flagged for review, was estimated to be comparable (86.5%) to the accuracy of the original coding of the data set (range: 73%–86.8%). Overall, the TW model had higher sensitivity than the SW model, and the accuracy of the prediction results increased when the two models agreed, and for higher prediction strength thresholds. The sensitivity of the top five predictions was 93%.
The proposed system seems promising for coding injury data as it offers comparable accuracy and less manual coding.
Accurate and timely coded occupational injury data is useful for surveillance as well as prevention activities that aim to make workplaces safer.
•A semi-automated approach using Bayesian models is proposed for coding injury data.•Accuracy of proposed approach assuming expert coders was comparable to original manual coding.•Agreement between different models and prediction strength threshold improve accuracy.•Top 5 predictions from Naïve Bayes model yield very good accuracy.•Confusion matrix is useful for identifying misclassifications of rare categories.
Accurate surveillance of work-related injuries is needed at national and state levels. We used multiple sources for surveillance of work-related amputations, compared findings with Survey of ...Occupational Injuries and Illnesses (SOII) estimates, and assessed generalizability to national surveillance.
Three data sources were used to enumerate work-related amputations in Massachusetts, 2007-2008. SOII eligible amputations were compared with SOII estimates.
787 amputations were enumerated, 52% ascertained through hospital records only, exceeding the SOII estimate (n = 210). The estimated SOII undercount was 48% (95% CI: 36-61%). Additional amputations were reported in SOII as other injuries, accounting for about half the undercount. Proportionately more SOII estimated than multisource cases were in manufacturing and fewer in smaller establishments.
Multisource surveillance enhanced our ability to document work-related amputations in Massachusetts. While not feasible to implement for work-related conditions nationwide, it is useful in states. Better understanding of potential biases in SOII is needed.
Exposure to COVID-19 is more likely among certain occupations compared with others. This descriptive study seeks to explore occupational differences in mortality due to COVID-19 among workers in ...Massachusetts.
Death certificates of those who died from COVID-19 in Massachusetts between March 1 and July 31, 2020 were collected. Occupational information was coded and age-adjusted mortality rates were calculated according to occupation.
There were 555 deaths among MA residents of age 16-64, with usable occupation information, resulting in an age-adjusted mortality rate of 16.4 per 100,000 workers. Workers in 11 occupational groups including healthcare support and transportation and material moving had mortality rates higher than that for workers overall. Hispanic and Black workers had age-adjusted mortality rates more than four times higher than that for White workers overall and also had higher rates than Whites within high-risk occupation groups.
Efforts should be made to protect workers in high-risk occupations identified in this report from COVID-19 exposure.
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