1. Mireia Julià, Alejandra Vives, Gemma Tarafa and Joan Benach
Grup de Recerca en Desigualtats en Salut. Employment Conditions Network
(GREDS-EMCONET). Universitat Pompeu Fabra. Barcelona
Changing the way we understand
precarious employment: precarization of
employment and health

2. PE is a fragile and growing employment relationship and a
social determinant of health and health inequalities
Introduction

3. No full consensos in its definition:
• Temporariness
• Job insecurity
Introduction

4. Others dimensions of work-related precarious experiences are
present
Multidimensional construct: EPRES
Precarious employment is associated with health of
working population, especially poor mental health
Introduction

5. Introduction
Dimensions of precarious employment in EPRES:
1. Temporariness
2. Wages
3. Disempowerment
4. Vulnerability
5. Rights
6. Capacity to exercise of rights
EPRES or Employment Precariousness Scale is a
questionnaire based on theory, developed to measure
precarious employment in epidemiological research

6. Introduction

7. Precariousness urgent need to be understood as part of a
continuum: from full-time to informal employment
Assess the precarization of employment and its
association with health in different contractual
arrangements
Multidimensional construct
Introduction

8. • to show the precarization of the Spanish labour market
using two different contractual arrangements.
• to analyse the impact of precarious employment and
different contractual arrangements on poor mental
health.
Objectives

9. Study design and subjects:
• Employment Precariousness Scale (EPRES) was included at second
Psychosocial Work Environmental Survey (PWES) done by ISTAS in
2010
• Representative sample of the wage-earning population living in
Spain (n=5110)
• We restricted our analyses to permanent and temporary workers
• The final sample size was 4.430
Methods

10. Study variables:
1. Mental Health: evaluated by Short Form-36 health questionnaire
(SF-36)
2. Employment precariousness: assessed with the EPRES questionnaire
• 6 subscales: temporariness, disempowerment, vulnerability,
wages, rights and capacity to exercise rigths.
• 3 categories: no precariouseness (<1), low-medium (1-1.99)
and high (>=2)
3. Sociodemographic variables: sex, age, country of birth, occupational
social class, educational attainment, contractual arrangements, and
tenure in the company.
4. Job insecurity: assessed with the question: “To what extent you are
worried that you are laid off or you do not renew the contract”
Methods

11. Statistical Analysis:
• Descriptive statistics for the distribution of contractual arrangement
• Prevalence (%) of poor mental health and employment precariousness, their
95% confidence intervals and p-value or p-trend.
• Created 6 groups of precariousness by criss-crossing the 3 levels of
employment precariousness and the 2 categories of contractual
arrangement
• 4 Poisson regression models:
• Model 1: adjusted by age
• Model 2: adjusted by age, country of birth, occupational social class, educational
attainment
• Model 3: model 2 + tenure in the company
• Model 4: model 3 + job insecurity
• All analyses were stratified by sex
Methods

12. Prevalences of precarious employment (I)
Results

13. Prevalences of poor mental health and precarious employment (II)
Results

14. Adjusted risk ratios (aRR) and confidence intervals (95% IC) for poor mental health
by employment precariousness and contractual arrangements
Results

15. Results

16. • First study to assess employment precariousness and its association with
mental health comparing workers with different contractual
arrangements
• Gradient of employment precariousness in some sociodemografic
variables
• Association between poor mental health and level of precarious
employment :
• Stronger in both men and women with permanent employment especially
when precariousness was present.
Why?
Discussion

17. Unable to capture some mechanism of the experience in precarious
employment which is different according the contractual arrangement:
1. Heterogeneity within different contractual arrangements
2. Job insecurity: associations decrease but they continued higher
in permanent than temporary workers.
3. Permanent workers could have the most to lose: higher
expectations
Different hypothesis:
Discussion

18. Public health research:
• Evaluate diverse dimensions that comprise employment precariousness
• Study the possible differences among workers with different types of
contract and its impact on mental health or health inequalities
• Create a surveillance system to monitor the magnitude, evolution over
time and the most affected population
Policy:
• Make adequate policies to take action in the dimensions of precariousness
that have more impact on mental health
• Evaluate the impact of policies, and prioritise the use of public resources
Implications

19. mireia.julia@upf.edu
Thank you