Does employment always trump unemployment when it comes to our health?

Dr Rachel Sumner, Dr Rachel Bennett, Dr Ann-Marie Creaven, Professor Stephen Gallagher

New research suggests that precarious employment could damage health, just as unemployment does

We know unemployment can be bad for our health – it can be a source of long-term stress, make it difficult to meet our material needs, and result in a loss of identity, social role and social support. Previous research has been able to show this disadvantage not only across subjective health measures (collected by asking survey respondents to rate their health and wellbeing) but by using objective measures, too.

For example, several studies have used markers of peripheral inflammation (measured by analysing blood samples), and shown that unemployed people have raised levels of these markers relative to employed people. These markers are associated with stress, but also with a wide variety of health outcomes such as cardiovascular disease. Using biomarkers means we are able not only to identify health risk, but also to provide understanding of how social and economic disadvantage gets under the skin.

In our study, Unemployment, Employment Precarity and Inflammation, we looked at precarious employment as a health damaging stressor. Previous studies have underlined the importance of unemployment in health outcomes, but have only focused on it in comparison to employment. The landscape of employment is extremely diverse, with individuals working on a spectrum from very short temporary contracts right through to permanent employment. This led us to go beyond comparing inflammation among the unemployed and employed overall, to look at how inflammation varies by specific types of employment (permanent, temporary and self-employment).

How did we do it? 

We used information on people’s employment status as well as their individual, socio-economic and health characteristics collected during the Understanding Society Wave 2 household survey interviews (2010-11). We were able to link this survey data with health indicator data taken from blood samples which were collected during an additional health assessment interview with a nurse.

We focused on two markers of inflammation: C-reactive protein and fibrinogen. These health indicators are known to be elevated in times of long-term stress and to have significant links to future cardiovascular health. The sample included people aged 16-64 years living in England, Wales or Scotland who were not pregnant, retired, homemakers, in education or off work due to incapacity.

What did we find?

We found differences in levels of one of the markers of inflammation (fibrinogen) but not the other (C-reactive protein) when comparing different employment groups and taking into account the influence of individual, socio-economic and health characteristics. The lack of association with C-reactive protein is consistent with related work on this indicator, but the underlying causes are not yet clear. In terms of the results for fibrinogen, we found that unemployed people had higher and less healthy levels of inflammation compared to employed people overall.

This suggests that, consistent with previous research, unemployment may indeed be damaging for our health. We also found that unemployed people had higher and less healthy levels of inflammation compared to permanently employed people and the self-employed. However, and in contrast to our other findings, we found that people employed on temporary contracts had similar levels of inflammation to unemployed people. This suggests that the health advantage of employment does not hold if employment is on an insecure basis.

What are the implications of these results? 

Unemployment levels and the prevalence of temporary contracts in the UK have decreased since the recession. However, there are particularly vulnerable subgroups in the workforce. For example, the temporary employment rate among young people (15-24 years) is two and a half times higher than the total temporary employment rate (own analysis based on OECD figures).

Our study suggests that being employed on a temporary contract may be no less damaging for our health than being out of work. So, while we might assume that securing (any) employment spares the economic and social risks of being unemployed, our findings actually point to those in insecure employment being exposed to health risks.

There is also the self-perpetuating model of temporary employment to consider. Temporary employment increases stress and potentially absenteeism, resulting in job loss and an increased demand for temporary staff to be recruited.

It is clear that more can and should be done to protect workers against unnecessary stress from precarious employment to ensure a healthier workforce.

Authors

Dr Rachel Sumner

Rachel Sumner is a Senior Lecturer in Psychological Sciences at the University of Gloucestershire, specialising in psychobiology

Dr Rachel Bennett

Rachel is a Senior Lecturer in Human Geography at the University of Gloucestershire, specialising in family migration and population health and ageing.

Dr Ann-Marie Creaven

Ann-Marie Creaven is a Lecturer in Psychology at the University of Limerick, Ireland, specialising in stress and health research

Professor Stephen Gallagher

Stephen Gallagher is a Professor in Psychology at the University of Limerick, Ireland, specialising in stress, psychobiology and health research