Joan Benach, Alejandra Vives, Gemma Tarafa, Carlos Delclós and Carles Muntaner
João was 14 when he got his first job at a Brazilian bank. By the time he was 19, he was working part-time as an assistant to the board of directors of a multinational bank while working on a technical degree in foreign trade. He was earning about US$150 a month when he applied for a full-time position in the trade sector, but his application was denied because he was seen as too valuable in the position he held at the time. He then began to work on getting a university degree, but monthly payments cost more than what he was earning per month. When he saw his next transfer application for a different position in the trade sector denied, he left the university and decided to move to Canada. He felt that learning English would be a good way to improve his employment prospects.
Once there, he realised everything was more expensive than he had originally anticipated. Despite having only a tourist visa, João got a series of short-term jobs to support his English training. He worked brief stints as a carpet installer, an office assistant and, finally, as a bricklayer. It was in this final position that he earned CDN$29 an hour, over three times more than the minimum wage he’d earned in his previous jobs. Yet, as an undocumented worker, he was denied political, health and educational rights, and was constantly exposed to abuse by his employers and severe income insecurity. Moreover, the overlong work shifts, the exhausting nature of his tasks and a constant exposure to toxins took a substantial toll on his body.
João’s story, recounted by Denise Gastaldo in Employment, Work and Health Inequalities: A Global Perspective, is highly complex (see page 48 in this free e-book available at: https://www.upf.edu/greds-emconet/_pdf/Employmentweb_low.pdf). As he moves across occupational classes, pay grades and documentation statuses, the only constant is the precariousness of his employment situation. Yet precariousness is a concept that we are only beginning to grasp.
Thanks to recent books such as Guy Standing’s The Precariat: The New Dangerous Class and Owen Jones’s Chavs: The Demonization of the Working Class, the issue of precarious employment has gained considerable visibility. This is excellent news for researchers, policymakers and labour or community organizations interested in the links between work and inequality. However, there are still many barriers to understanding not only how precariousness affects our lives and livelihoods, but what precariousness even is.
One possible starting point for defining precariousness is understanding how it imposes inequality on human bodies, i.e. how it shapes health inequalities in contrast or in consonance with other phenomena, such as poverty or unemployment. Precarious employment is an emerging social determinant that affects the health of not only workers themselves, but also their families. Yet despite significant advances, like the identification of associations with poor psychological health, its study remains in its infancy.
In a recent article for the International Journal of Epidemiology, we argue that, today, researchers interested in precariousness require:
- Theoretical models, more precise definitions and measurement instruments;
- A detailed understanding of how and why it might affect health (i.e., the pathways and the mechanisms);
- Stronger information systems and data;
- Better tools for the design, implementation and evaluation of policies.
We propose an agenda for the next decade of research that should expand our understanding of health-related employment precariousness and guide the evaluation of policy programs intended to tackle them.
Specifically, we recommend that research on precarious employment and health be guided by theoretical models that capture its multiple dimensions in various welfare and labour market regimes. We also emphasize the linkages between health and employment conditions (i.e., the conditions which structure the relationship between the worker and the employer), working conditions (i.e., those which structure the actual tasks carried out by the worker) and other social conditions.
Furthermore, it is arresting that, in the era of Big Data, even a rough estimate of the prevalence of precarious employment is missing from national social and health surveys. Currently, information systems collect data on a limited number of one-dimensional indicators. For instance, the percentage of temporary contracts in a given labour market captures just the tip of the iceberg of employment precariousness. We must include standardized, multidimensional indicators of precarious employment in health surveys and other information systems. These would allow researchers to determine its prevalence, evolution and distribution in various countries and labour markets.
In addition to using one-dimensional indicators, we also find that most analyses of precarious employment examine information from one specific moment in time. We propose instead that precarious employment be studied as a complex, integrated phenomenon. This involves analysing employment trajectories and their dynamic intersections with other social and employment conditions in different territories, periods of time, and macroeconomic contexts.
Finally, the ultimate goal of our research agenda is not just to advance scholarship on precarious employment and health but to effectively inform the design, implementation, and evaluation of policies oriented towards reducing employment-related health inequalities. Effective action is needed to minimize if not eliminate precarious employment and other harmful work arrangements. This can be achieved through legislation, universalistic policies, income transfers such as a guaranteed annual income, and empowering groups that represent disadvantaged worker populations.
These actions require active engagement from policymakers, workers and community organizations in the implementation of integrated, intersectorial actions and programmes. In our view, researchers can and should aid in this task by generating the evidence, and monitoring, analysing and evaluating policies and interventions that seek to reduce precarious employment, its health-related impacts and the ensuing health inequalities.
, , , and What should we know about precarious employment and health in 2025? framing the agenda for the next decade of research. Int J Epidemiol 2016, doi: 10.1093/ije/dyv342.
Joan Benach is Director of the Health Inequalities Research Group – Employment Conditions Network (GREDS-EMCONET), Co-Director of The Johns Hopkins Public and Social Policy Center (JHU-UPF PPC), and Associate Professor of Public Health in the Department of Political and Social Sciences at the Pompeu Fabra University (Barcelona, Catalonia, Spain). His contributions include analyses on precarious employment and other employment conditions, the intersections between social class, gender, migration and geography, and health policy analysis. Follow Joan on Twitter @joan_benach.
Alejandra Vives is Assistant Professor at the Department of Public Health, School of Medicine, Pontificia Universidad Católica de Chile, Associate Researcher at the Advanced Center for Chronic Diseases (ACCDiS) (Conicyt, Fondap, 15130011) and at the Center for Sustainable Urban Development (CEDEUS), Conicyt, Fondap, 15110020, and researcher at GREDS-EMCONET at Pompeu Fabra University, Barcelona.
Gemma Tarafa is a public health researcher at the Pompeu Fabra University in the Health Inequalities Research Group (GREDS). She is also a lecturer and collaborator on Political Ecology on the Master’s course on Sustainability at Universitat Politècnica de Catalunya (UPC), and an investigator at the Observatory on Debt in Globalisation, UNESCO Chair of Sustainability, UPC, since its creation in 2000. Follow Gemma on Twitter @GemmaTarafa.
Carlos Delclos is a sociologist and researcher of GREDS-EMCONET and the JHU-UPF Public Policy Center at Pompeu Fabra University. He received his PhD in sociology from Pompeu Fabra University in Barcelona, and his research interests include social stratification, urban studies, migration, demography, and social change. His work has appeared in media outlets such as Cadena SER, Radio Nacional de España, ElDiario.es, and openDemocracy, and he is an editor at Roar Magazine. Follow Carlos on Twitter @CarlosDelclos.
Carles Muntaner is Professor of Social and Behavioral Health Sciences in Public Health, Nursing and Psychiatry at the University of Toronto and researcher with GREDS-Emconet at the Pompeu Fabra University. His contributions to health equity deal with politics, the consideration of health in all policies, social class, employment conditions, racial and ethnic discrimination, multilevel models and realist philosophy of science. Follow Carles on Twitter @carlesmuntaner.