Precarious work on the rise.

Precarious employment (PE) is non-standard employment with uncertain and unstable contract duration, low wages, and limited labour protections and rights. Research has associated PE with workers' poor mental health and well-being; however, this association has been studied primarily using quantitative methods. This qualitative study seeks to examine the mechanisms between PE and mental health in the context of the COVID-19 pandemic in Ontario, Canada. Specifically, it aims to address: (Benach J, Muntaner C. Precarious employment and health: developing a research agenda. J Epidemiol Community Health. 2007;61(4):276.) How do PE and working conditions impact the mental well-being of workers and members of their close families or households?; and (Kreshpaj B, Orellana C, Burström B, Davis L, Hemmingsson T, Johansson G, et al. What is precarious employment? A systematic review of definitions and operationalizations from quantitative and qualitative studies. Scand J Work Environ Health. 2020;46(3):235-47.) How has the COVID-19 pandemic shaped these relationships? Semi-structured interviews were conducted with a sample of 40 individuals aged 25-55 engaged in PE during the first wave of the COVID-19 pandemic or whose employment was terminated due to the pandemic. Results showed that PE amplified mental health symptoms and illnesses for workers and their families. These experiences were described as chronic, where impacts were exerted on precariously employed workers through systemic discrimination and racism, colonialism, workplace hierarchies, and gendered ideologies. PE negatively impacted mental health through emotional stress about employment and income instability, insecurity, and loss; added pressure for households where both partners are engaged in PE; impacted ability to maintain or improve overall health and well-being; and barriers to social connectedness. Overall, this study characterizes multiple dimensions of PE and the consequences they have on the mental health of workers and their families.

Beyond Mortality: The Social and Health Impacts of COVID-19 among Older (55+) BIPOC and LGBT Respondents in a Canada-Wide Survey.

This study focused on the effects of the COVID-19 pandemic on the marginalized populations-specifically Black and Indigenous people as well as People of Color (BIPOC) compared to White older adults and LGBT individuals compared to heterosexual older adults. Data were derived from our national online survey of Canadians aged 55+, conducted from 10 August to 10 October 2020. The survey explored the influence of COVID-19 on lifestyle changes, well-being, and planning for the future. Our sample comprised 4292 respondents. We compared sets of dichotomous variables with White vs. BIPOC, LGBT vs. heterosexual, and LGBT White vs. LGBT BIPOC respondents. Significantly more BIPOC than White individuals reported changes in accessing food (44.3% vs. 33.2%) and in family income (53.9% vs. 38.9%) and fewer reported feeling accepted and happy, and more felt isolated and judged. Significantly more LGBT than heterosexual respondents reported changes in routines and in accessing social support, medical and mental health care and more feeling depressed, lonely, anxious, and sad. More LGBT-BIPOC than LGBT-White respondents reported changes in access to food (66.7 vs. 30.6, p < 0.001); in family income (66.7 vs. 41.5, p < 0.005); and in access to mental health care (38.5 vs. 24.0, p < 0.05). The only difference in emotional response to COVID-19 was that more BIPOC-LGBT than White-LGBT respondents reported feeling judged (25.9 vs. 14.5, p < 0.05). These findings reflect a complex mix of the effects of marginalization upon BIPOC and LGBT older adults, revealing both hardship and hardiness and warranting further research.

An Agentic Familiarity: The Context of HIV/AIDS and Sexual Orientation for Older Canadians during the COVID-19 Pandemic.

This paper examines how experiences with a previous pandemic, particularly HIV/AIDS, may have informed approaches to COVID-19, with a focus on sexual orientation. METHOD: The sample was drawn from an online survey of Canadians 55+ conducted in 2020, comprising 1143 persons (mean age = 67; 88 gay or bisexual (GB) men, 65 lesbian or bisexual (LB) women, 818 heterosexual women, and 172 heterosexual men). Respondents reported if they, or someone close to them, "had been affected by" one or more pandemics and whether COVID-19 led them to "think more about their prior epidemic/pandemic experiences" and/or feel they "couldn't handle it again". Correlated items reflecting feeling "they have been here before"; "prepared for what is happening"; and "like they needed to act or do something" formed a scale named "agentic familiarity". RESULTS: About half of respondents reported thinking about their previous pandemic experience; about 5% reporting feeling like "they couldn't handle it again" with no gender or sexual orientation differences. Higher agentic familiarity scores were found for GB men and for those with experience with HIV/AIDS vs. other pandemics. DISCUSSION: These outcomes speak to resilience and growth experienced by LGBT (and especially GB) persons through shared stigma and trauma-with implications for current pandemic experiences and future actions, like advance care planning.

Advance care planning among older Canadians amid the COVID-19 pandemic: a focus on sexual orientation.

OBJECTIVES: The COVID-19 pandemic has led to death and hardship around the world, and increased popular discourse about end-of-life circumstances and conditions. The extent to which this discourse and related pandemic experiences have precipitated advance care planning (ACP) activities was the focus of this study with a particular emphasis on sexual orientation. METHODS: A large, national online survey was conducted between 10 August and 10 October 2020 in Canada. The final sample of 3923 persons aged 55 and older was recruited using social media, direct email, and Facebook advertising and in conjunction with community groups. Women comprised almost 78% of the sample; just more than 7% of the sample identified as lesbian, gay, and bisexual (LGB). Measures included demographic variables and a series of questions on ACP, including documents and discussions undertaken prior to the pandemic and since its onset. RESULTS: Descriptive analyses revealed few gender or sexual orientation differences on documents and discussions prior to the pandemic; since its onset, LGB persons have completed or initiated wills, powers of attorney, advance directives, representation agreements, and have engaged in ACP discussions in greater proportion than heterosexuals. Logistic regressions reveal the increased likelihood of pre-pandemic ACP engagement by age, gender (women), and education; since the pandemic onset, gender, education, and sexual orientation were predictive of greater ACP engagement. Care discussions were more likely undertaken by women and LGB persons since the pandemic most often with spouses, family, and friends, especially among LGB persons. DISCUSSION: Gender roles and previous pandemic experiences (HIV/AIDS, in particular) are implicated in this pattern of results; opportunities for educational interventions are considered.