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      Precarious employment and general, mental and physical health in Stockholm, Sweden: a cross-sectional study

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          Abstract

          Objectives: To investigate the association between precarious employment and health in a sample of non-standard employees in Stockholm County, Sweden, by addressing three specific research questions: is the degree of precarious employment (low, moderate, high) associated with self-rated. . . (a) general health, (b) mental health, (c) musculoskeletal pain? Methods: Web-based respondent-driven sampling was used to recruit a sample of 415 employees in Stockholm, Sweden, during 2016–2017. Questionnaire data were collected on employment conditions (the Swedish version of the employment precariousness scale (EPRES-Se)), general health, mental health and musculoskeletal pain. EPRES-Se scores were categorised as low, moderate or high. Generalised linear models with Poisson distribution, log link functions and robust variances were applied for calculating crude and adjusted prevalence ratios (PR; aPR) with 95% confidence intervals (CIs) for all outcomes. Results: The prevalence ratios of poor self-rated general and mental health increased with increased degree of precariousness, as indicated by estimates of moderate precarious employment (a 2PR Moderate 1.44 (CI 0.98–2.11); a 2PR Moderate 1.13 (CI 0.82–1.62)), and high precarious employment (a 2PR High 1.78 (CI 1.21–2.62); a 2PR High 1.69 (CI 1.25–2.28)), albeit only significantly so for high precarious employment. Conclusions: This is the first study in Sweden reporting on the association between precarious employment, as measured with a multidimensional scale, and multiple health outcomes. The results add to the evidence of an association between precarious employment and self-rated poor general and mental health. Larger, representative studies with longitudinal designs using the EPRES-Se are called for in order to strengthen these results and the already existing evidence of the harm of precarious employment.

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          Precarious employment: understanding an emerging social determinant of health.

          Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts.
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            DAGitty: a graphical tool for analyzing causal diagrams.

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              Precarious employment and mental health: a systematic review and meta-analysis of longitudinal studies

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                Author and article information

                Journal
                Scand J Public Health
                Scand J Public Health
                SJP
                spsjp
                Scandinavian Journal of Public Health
                SAGE Publications (Sage UK: London, England )
                1403-4948
                1651-1905
                16 September 2020
                March 2021
                : 49
                : 2
                : 228-236
                Affiliations
                [1 ]Unit of Occupational Medicine, Karolinska Institutet, Sweden
                [2 ]Centre for Occupational and Environmental Medicine, Stockholm County Council, Sweden
                [3 ]Centre for Epidemiology and Community Medicine, Stockholm County Council, Sweden
                [4 ]Equity and Health Policy Research Group, Karolinska Institutet, Sweden
                [5 ]Social Medicine and Global Health, Lund University, Sweden
                [6 ]Global and Sexual Health, Karolinska Institutet, Sweden
                [7 ]Section of Infectious Diseases, Uppsala University, Sweden
                Author notes
                [*]Johanna Jonsson, Karolinska Institute, Solnavägen 4, 171 77 Stockholm, Sweden. Email: Johanna.Jonsson@ 123456ki.se
                Author information
                https://orcid.org/0000-0002-9132-4734
                Article
                10.1177_1403494820956451
                10.1177/1403494820956451
                7917568
                32933426
                60e21970-5b07-43d0-bcd4-ee8137d88936
                © Author(s) 2020

                This article is distributed under the terms of the Creative Commons Attribution 4.0 License ( https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                : 30 March 2020
                : 30 June 2020
                : 3 August 2020
                : 11 August 2020
                Funding
                Funded by: forskningsrådet om hälsa, arbetsliv och välfärd, FundRef https://doi.org/10.13039/501100006636;
                Award ID: 2015-00933
                Categories
                Precarious Employment
                Custom metadata
                ts1

                Public health
                precarious employment,non-standard employment,occupational health,mental health,physical health

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