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How pay, flexibility and advancement impact your health

The terms and conditions of your employment – including your pay, hours, schedule flexibility and job security – influence your overall health as well as your risk of being injured on the job, according to new research.

The analysis takes a comprehensive approach to show that the overall pattern of employment conditions is important for health, beyond any single measure of employment, such as wages or contract type. The study was published in the Journal of the Social Sciences.

What the researchers say

“This research is part of a growing body of evidence that the work people do – and the way it is organized and paid for – is fundamental to producing not only wealth, but health,” said the senior author.

Technology and other forces are changing the nature of work, researchers said. The traditional model of ongoing, full-time employment with regular hours and job security is rapidly giving way to gig-economy jobs, short-term contracts, nonstandard work hours and flexible employer-worker relationships.

“Current models for understanding this work are too simplistic,” said the first author. “Studies of a single aspect of employment may not capture important elements of jobs that influence health.”

“Employment relationships are complex. They determine everything from how much you get paid, how much control you have over your work schedule, your opportunities for advancement and how much protection you have against adverse working conditions, like harassment,” he said.

The researchers used data from the General Social Survey collected between 2002 to 2014 to construct a multidimensional measure of how self-reported health, mental health and occupational injury were associated with employment quality among approximately 6,000 US adults.

“There are many different forms of employment in the modern economy,” the researchers said. “Our study suggests that it is the different combinations of employment characteristics, which workers experience together as a package, that is important for their health.”

Among their findings:

• People employed in “dead-end” jobs (for example, manufacturing assembly line workers who are often well-paid and unionized but with little empowerment or opportunity) and “precarious” job holders (for example, janitors or retail workers who work on short-term contracts and struggle to get full-time hours) were more likely to report poor general and mental health as well as occupational injury compared to people with more traditional forms of employment.

• “Inflexible skilled” workers (such as physicians and military personnel, who have generally high-quality jobs but with long, inflexible hours) and “job-to-job” workers (such as Uber drivers, gig workers or the self-employed doing odd jobs) had worse mental health and increased injury experience compared to those with standard employment.

• One of the most surprising findings: “Optimistic precarious” job holders (including service-sector workers with high empowerment, such as florists) had similar health to those in standard employment, despite having jobs characterized by insecurity, low pay and irregular hours. They report high control over their schedules, opportunities to develop and involvement in decision-making and may be opting into these types of jobs.

So, what?

Well, obviously, researchers and policymakers must continue the dialog with employers “to demonstrate the benefits of increased worker security and stability on employee turnover, productivity and, ultimately, their bottom line”, as the researchers noted.

Which is all very well but, at the moment, employers seem so concentrated on the bottom line, uberization of their workforce and overall human replacement by machine, that I don’t believe that they will, or even can, listen.

As a great friend of mine in the retail housing industry said when asked to reduce his workforce by 25 percent: “Yes, I can, but who’ll buy the houses?” This, as Nobel economics laureate Paul Krugman says, is how capitalism ends.

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