The effect of adverse employment circumstances on physical pain: Evidence from Australian panel data.

Physical pain is a common health problem with great public health implications. Yet evidence on whether adverse employment circumstances shape physical pain is limited. Using longitudinal data from 20 waves (2001-2020) from the Household, Income and Labour Dynamics of Australia Survey (HILDA; N = 23,748), a lagged design, Ordinary Least Squares (OLS) regressions as well as multilevel mixed effect linear regressions, we investigated the association between past accumulated unemployment and recent employment circumstances with physical pain. We found that adults who spent more years unemployed and looking for work subsequently reported greater physical pain (b = 0.034, 95% CI = 0.023, 0.044) and pain interference (b = 0.031, 95% CI = 0.022, 0.038) than those who spent fewer years unemployed. We also found that those experiencing overemployment (working full-time while wanting to work fewer hours) and underemployment (working part-time while wanting to work more hours) reported greater subsequent physical pain (overemployment: b = 0.024, 95% CI = 0.009, 0.039; underemployment: b = 0.036, 95% CI = 0.014, 0.057) and pain interference (overemployment: b = 0.017, 95% CI = 0.005, 0.028; underemployment: b = 0.026, 95% CI = 0.009, 0.043) than those content with their working hours. These results held after controlling for socio-demographic characteristics, occupation, and other health-related factors. These findings are consistent with recent work that suggested that psychological distress can influence physical pain. Understanding how adverse employment circumstances impact physical pain is crucial to the design of health promotion policies.

Estimating influences of unemployment and underemployment on mental health during the COVID-19 pandemic: who suffers the most?

OBJECTIVES: The aim of the study was to evaluate whether unemployment and underemployment are associated with mental distress and whether employment insecurity and its mental health consequences are disproportionately concentrated among specific social groups in the United States during the COVID-19 pandemic. STUDY DESIGN: This is a population-based longitudinal study. METHODS: Data came from the Understanding America Study, a population-based panel in the United States. Between April and May 2020, 3548 adults who were not out of the labor force were surveyed. Analyses using targeted maximum likelihood estimation examined the association of employment insecurity with depression, assessed using the 2-item Patient Health Questionnaire, and anxiety, measured with the 2-item Generalized Anxiety Disorder scale. Stratified models were evaluated to examine whether employment insecurity and its mental health consequences are disproportionately concentrated among specific social groups. RESULTS: Being unemployed or underemployed was associated with increased odds of having depression (adjusted odds ratio [AOR] = 1.66, 95% confidence interval [CI] = 1.36-2.02) and anxiety (AOR = 1.50, 95% CI = 1.26, 1.79), relative to having a full-time job. Employment insecurity was disproportionately concentrated among Hispanics (54.3%), Blacks (60.6%), women (55.9%), young adults (aged 18-29 years; 57.0%), and those without a college degree (62.7%). Furthermore, Hispanic workers, subsequent to employment insecurity, experienced worse effects on depression (AOR = 2.08, 95% CI = 1.28, 3.40) and anxiety (AOR = 1.95, 95% CI = 1.24, 3.09). Those who completed high school or less reported worse depression subsequent to employment insecurity (AOR = 2.44, 95% CI = 1.55, 3.85). CONCLUSIONS: Both unemployment and underemployment threaten mental health during the pandemic, and the mental health repercussions are not felt equally across the population. Employment insecurity during the pandemic should be considered an important public health concern that may exacerbate pre-existing mental health disparities during and after the pandemic.

Underemployment, overemployment and deterioration of mental health: the role of job rewards.

OBJECTIVES: Working more (overemployment) or less (underemployment) than preferred has been associated with poor mental health in cross-sectional studies, but longitudinal evidence is scarce. We investigate whether under- and overemployment is associated with 2-year changes of mental health and whether associations vary by job rewards (i.e. high earnings, job security, promotion prospects and occupational prestige). METHODS: We used two waves of the German Socio-Economic Panel (GSOEP), with information on mental health collected in 2006 and 2008. Workers in paid employment (3266 men and 3139 women) who did not change jobs between 2006 and 2008, aged 20-60 years were selected. Under- and overemployment was assessed using the discrepancy between the actual and preferred working hours. Mental health was assessed using the Mental Component Summary (MCS) score, a subscale from the Short Form 12 Health Survey. Questions on rewards at work were added and divided into tertiles. Conditional change models were estimated to predict change in MCS. RESULTS: Findings indicate that overemployment and low reward at work (for men and women) were linked to a reduction in mental health. Underemployment was not related to a reduction in mental health. Albeit associations between under-/overemployment and mental health slightly differed across levels of reward, interactions did not reach statistical significance. CONCLUSIONS: Our findings demonstrate that overemployment was related to negative mental health change, and that this relationship held true both for people with high and with low reward at work.

Underemployment among mothers of children with intellectual disabilities.

BACKGROUND: Mothers with lifelong care responsibilities might involuntarily be non-employed or work part-time, both of which are defined as "underemployment." This study aimed to investigate who these underemployed mothers are and what are the factors associated with such employment hardship when having a child with intellectual disability (ID). METHOD: An interview survey was conducted in 2011 in two local authorities of Taiwan on 876 working-age mothers with a child with intellectual disability; 514 of them were working part-time/non-employed and chosen as participants of this study. RESULTS: The mothers with a younger child with intellectual disability, a higher level of education, a lower level of family income and more family members with disabilities were more likely to be underemployed compared with the mothers who were voluntarily working part-time/non-employed. CONCLUSIONS: The underemployed mothers were more likely to have financial difficulty and heavy caregiving loads; their employment hardship should be of concern for policymakers.

Underemployment and mental health: comparing fixed-effects and random-effects regression approaches in an Australian working population cohort.

OBJECTIVES: Underemployment occurs when workers are available for more hours of work than offered. It is a serious problem in many Organisation for Economic Co-operation and Development (OECD) countries, and particularly in Australia, where it affects about 8% of the employed population. This paper seeks to answer the question: does an increase in underemployment have an influence on mental health? METHODS: The current paper uses data from an Australian cohort of working people (2001-2013) to investigate both within-person and between-person differences in mental health associated with being underemployed compared with being fully employed. The main exposure was underemployment (not underemployed, underemployed 1-5, 6-10, 11-20 and over 21 hours), and the outcome was the five-item Mental Health Inventory. RESULTS: Results suggest that stepwise declines in mental health are associated with an increasing number of hours underemployed. Results were stronger in the random-effects (11-20 hours =-1.53, 95% CI -2.03 to -1.03, p<0.001; 21 hours and over -2.24, 95% CI -3.06 to -1.43, p<0.001) than fixed-effects models (11-20 hours =-1.11, 95% CI -1.63 to -0.58, p<0.001; 21 hours and over -1.19, 95% CI -2.06 to -0.32, p=0.008). This likely reflects the fact that certain workers were more likely to suffer the negative effects of underemployment than others (eg, women, younger workers, workers in lower-skilled jobs and who were casually employed). CONCLUSIONS: We suggest underemployment to be a target of future workplace prevention strategies.

Pathways between under/unemployment and health among racialized immigrant women in Toronto.

OBJECTIVE: We sought to document pathways between under/unemployment and health among racialized immigrant women in Toronto while exploring the ways in which gender, class, migration and racialization, as interlocking systems of social relations, structure these relationships. DESIGN: We conducted 30 interviews with racialized immigrant women who were struggling to get stable employment that matched their education and/or experience. Participants were recruited through flyers, partner agencies and peer researcher networks. Most interviews (21) were conducted in a language other than English. Interviews were transcribed, translated as appropriate and analyzed using NVivo software. The project followed a community-based participatory action research model. RESULTS: Under/unemployment negatively impacted the physical and mental health of participants and their families. It did so directly, for example through social isolation, as well as indirectly through representation in poor quality jobs. Under/unemployment additionally led to the intensification of job search strategies and of the household/caregiving workload which also negatively impacted health. Health problems, in turn, contributed to pushing participants into long-term substandard employment trajectories. Participants' experiences were heavily structured by their social location as low income racialized immigrant women. CONCLUSIONS: Our study provides needed qualitative evidence on the gendered and racialized dimensions of under/unemployment, and adverse health impacts resulting from this. Drawing on intersectional analysis, we unpack the role that social location plays in creating highly uneven patterns of under/unemployment and negative health pathways for racialized immigrant women. We discuss equity informed strategies to help racialized immigrant women overcome barriers to stable work that match their education and/or experience.

Underemployment, Work Needs, and Job Satisfaction: Does Social Support Matter?

Global problems that have emerged in recent years have caused an increase in underemployment rates, especially in developing countries. Researchers emphasize that underemployment has as many negative consequences as unemployment on well-being. In order to examine the variables that may buffer these consequences, we draw on the Psychology of Working Theory to propose a model in which a mediating role of psychological needs and a moderating role of social support are assumed in the relationship between underemployment and job satisfaction. We collected and analyzed data from 459 Turkish employees (181 women and 278 men) and found that underemployment was negatively related to job satisfaction and that work needs satisfaction mediated the relationship between underemployment and job satisfaction. Further, social support moderated the relationship between subjective underemployment and job satisfaction, so it was insignificant when social support was higher. These findings provide researchers and practitioners with a different perspective on underemployment.

A scoping review of refugees' employment integration experience and outcomes in Canada.

BACKGROUND: Refugees involuntarily arrive to Canada to escape unfavourable conditions in their home country. Employment is an important marker of integration and a foundational determinant of health yet; little is known about the employment integration experiences of refugees as a distinct group of workers in Canada. OBJECTIVE: This scoping review was completed to explore the employment experience and outcomes of refugees in Canada and to identify gaps in the literature. METHODS: Three databases were searched for peer-reviewed articles published in English over a 25-year period, 1993 to 2018, for research on refugees and employment in the Canadian context. The research team reviewed all articles, including abstract screening, full text review and data extraction; consensus on inclusion was reached for all articles. Relevant articles were synthesized for overarching themes. RESULTS: The search strategy identified 2,723 unique articles of which 16 were included in the final sample. There was a mix of quantitative, qualitative and mixed-methods studies which reported on employment rates of refugees, the quality of jobs secured, gendered differences in employment experience and differential impacts of under/unemployment on health and well-being. CONCLUSION: The findings suggest that refugees in Canada do not secure jobs that are in line with their previous skills and experience leading to downward occupational mobility and poorer health with refugee women experiencing these outcomes more acutely. Research in this area with long-term outcomes and contextualized experiences is needed, as well as studies that include equity considerations such as racialization and gender.

The relationship between working time mismatch and depression according to actual hours worked.

OBJECTIVES: The effect of the combination of working hours and working time mismatch on depression is unknown. This study was undertaken to confirm the relationship between working time mismatch and depression with respect to hours worked. MATERIAL AND METHODS: The data of 45 514 adult workers that participated in the 6th Korean Working Conditions Survey (KWCS-VI 2020) were reviewed. Depression was defined using the World Health Organization 5 Well-Being Index (WHO-5) cut-off score of 50. Working time mismatch was defined as a difference between actual and desired working hours. To identify associations between working hour mismatch and depression according to weekly hours worked, stratification analysis was conducted by dividing the study subjects into 3 groups based on actual hours worked weekly (<40 h, 40-<52 h, or ≥52 h). Multiple logistic regression analysis adjusted for potential confounders was performed to calculate odds ratios of depression. RESULTS: In the <40 h, 40-<52 h, and ≥52 h groups, the odds ratios (OR) of working more hours than desired were 1.51, 95% CI: 1.20-1.92 (<40 h), 1.70, 95% CI: 1.58-1.84 (40-<52 h), and 1.55, 95% CI: 1.41-1.69 (≥52 h), respectively, compared to a matched actual versus desired working hours group (the matched group). On the other hand, the odds ratios of working fewer hours than desired were 1.17, 95% CI: 1.07-1.27 (<40 h), 1.38, 95% CI: 1.20-1.60 (40-<52 h), and 1.98, 95% CI: 1.24-3.17 (≥52 h), respectively. The risk of depression was found to increase significantly with working time mismatch within all 3 working hour groups. CONCLUSIONS: Working time mismatch increases the risk of worker depression regardless of hours worked. Int J Occup Med Environ Health. 2023;36(6):788-97.

Education Level, Underemployment, and Health.

Under the dual background of underemployment and health inequality, this study empirically analyzes the impact of education level on underemployed workers' health based on data from the 2016 China Labor-force Dynamics Survey. The results show that underemployment is significantly related to the decline of self-rated health, increased depressive tendencies, and the prevalence of illness over a certain period. The results indicate that underemployment can significantly reduce the health level of workers in both low and high education level groups. However, underemployment appears to have no significant impact on workers' health in the middle education level group. This result holds even if the measurement method of the indicators is adjusted and endogeneity is considered; this indicates that the research conclusions are robust. Moreover, this kind of health inequality mainly comes from the economic and leisure effects of underemployment for workers with different educational levels. Although underemployment significantly reduces the economic level of workers in each education level group, it brings a positive leisure effect to workers with a middle education level and a negative leisure effect to workers with a low education level. This study provides empirical support for increasing labor protection mechanisms for underemployed people and reducing the health inequality caused by differences in education level.

Short- and Long-Term Effects of Underemployment on Workers' Health: Empirical Analysis from the China Labor Force Dynamics Survey.

Underemployment is a global problem. This study aimed to assess the short- and long-term effects of underemployment (hidden unemployment) on workers' health, using data from the China Labor-force Dynamic Survey (CLDS) 2016 and 2014. Indicators reflecting workers' self-rated health, mental health, prevalence of illness over time, and employment status were analyzed using logit regression models, propensity score matching methods, and instrumental variable methods. Empirical analyses showed that: (1) In the short-term, the impact on health is multidimensional, with underemployment significantly associated with a decline in workers' self-rated health, an increase in the propensity for depression, and an increase in the prevalence of illness over a certain period of time. (2) In the long-term, the experience of underemployment two years in the past is associated with a current decline in workers' mental health. That is, the negative effects of underemployment on workers' mental health persist and do not disappear rapidly over time. The results demonstrated that underemployment is detrimental to workers' health in the short- and long-term. In the context of epidemic prevention and control, the government and society should focus on this expanding group, establish labor protection mechanisms, and reduce the multiple effects of underemployment on workers' health.

The subjective underemployment experience of post-9/11 veterans after transition to civilian work.

BACKGROUND: Underemployment is a challenge for the civilian workforce and a particular risk for veterans as they transition from military service to civilian employment. Workers' economic and demographic characteristics factor into underemployment risk. Veterans may be at greater risk due to specific economic and demographic factors, transitional factors (e.g., geographic relocation), and characteristics of their military service (e.g., military skill alignment with civilian jobs). OBJECTIVES: Describe underemployment experiences in employed post-9/11 veterans three years after their military transition to the civilian workforce. METHODS: The current study uses self-reported underemployment experience data from a longitudinal study of transitioning veterans. This study compares average perceptions of veteran underemployment experiences by specific groups (e.g., by race, gender, and paygrade) using analysis of variance and logistic regression. RESULTS: Veterans reported underemployment in their current jobs based on a perceived mismatch between the skills, education, and/or leadership experience they gained during military service. CONCLUSIONS: Veterans who were enlisted rank, identified as non-White, completed a bachelor's degree, and indicated PTSD symptoms reported higher pervasive underemployment. Intervention implications for the results, such as employer and veteran employment supports, are discussed.

Precarious work and workplace dignity during COVID-19: A longitudinal study.

Building upon the psychology of working theory (PWT), the goal of the present study was to examine longitudinal relations among precarious work, workplace dignity, and basic need fulfillment (survival, social contribution, and self-determination needs). To examine our hypotheses, we surveyed a group of working adults in the United States three times over three months. However, the study began in March 2020 - before widespread lockdowns, layoffs, and furloughs - and some participants lost their jobs on subsequent waves during April and May 2020. Therefore, a secondary aim of the study was to explore predictors of job loss in the first few months of the COVID-19 pandemic. We found that having precarious work in early March 2020 significantly predicted job loss due to COVID-19 in May 2020. For workers who remained employed during this time, greater precarious work predicting lower fulfillment of survival needs over time. In addition, workplace dignity and fulfillment of relatedness needs operated reciprocally, predicting greater levels of each other over time, and greater workplace dignity predicted greater fulfillment of social contribution, autonomy, and competence needs across time. These results expand PWT by suggesting that precarious work and workplace dignity are both important work conditions that predict fulfillment of different basic needs over time.

Dataset for vulnerability model analysis in economically depressed areas.

This paper presents data for the application of the vulnerability model in economically depressed areas, through social, economic and capacity variables, with the objective of promoting public policies that contribute to the economic development of the territory and its integration into the labor market [1]. We used the family and housing databases of the Socioeconomic and Environmental Characterization Survey of the community of San Juan in the city of Manta [2]. The study population comprises the inhabitants of Sitio San Juan in the city of Manta, due to the conditions of exclusion due to the negative evaluations of the place (oxidation ponds, municipal slaughterhouse, garbage dump, coal processing, among others), and due to "the scarce existence of databases of vulnerable sectors in the province of Manabí" [3], considering that the last national census was conducted in 2010. As for the sample design, the census-type sweep technique was applied. The data set helps to determine the vulnerability conditions of the territory, for the application of the proposed model; in addition, these data can be used to analyze the determinants of the conditions of unemployment, underemployment and poverty in which the inhabitants of the sector live. Likewise, they can be complemented with future research in regions with similar characteristics in Ecuador or other territories to promote public policies that allow them to improve their living conditions and encourage public or private investment for the generation of employment and poverty reduction.

Association between depression or sleep problems and working time mismatch among Korean workers.

PURPOSE: This study aimed to investigate the relationship between South Korean workers' working time mismatches and their depression and sleep disorders. DESIGN AND METHODS: This study used raw data from the fifth Korean Working Conditions Survey (KWCS), which sampled 50,205 workers. FINDINGS: The risk of occurrence of sleep problems among workers was shown to be proportional to actual working time. The risk of occurrence of depression increased along with the degree of working time mismatch. PRACTICE IMPLICATIONS: To improve the health and welfare of workers, making a policy and labor culture that relieve working time mismatch is important.

Public Health Impacts of Underemployment and Unemployment in the United States: Exploring Perceptions, Gaps and Opportunities.

BACKGROUND: Unemployment, underemployment, and the quality of work are national occupational health risk factors that drive critical national problems; however, to date, there have been no systematic efforts to document the public health impact of this situation. METHODS: An environmental scan was conducted to explore the root causes and health impacts of underemployment and unemployment and highlight multilevel perspectives and factors in the landscape of underemployment and unemployment. METHODS: included a review of gray literature and research literature, followed by key informant interviews with nine organizational representatives in employment research and policy, workforce development, and industry to assess perceived needs and gaps in practice. RESULTS: Evidence highlights the complex nature of underemployment and unemployment, with multiple macro-level underlying drivers, including the changing nature of work, a dynamic labor market, inadequate enforcement of labor protection standards, declining unions, wage depression, and weak political will interacting with multiple social determinants of health. Empirical literature on unemployment and physical, mental, and psychological well-being, substance abuse, depression in young adults, and suicides is quite extensive; however, there are limited data on the impacts of underemployment on worker health and well-being. Additionally, organizations do not routinely consider health outcomes as they relate to their work in workforce or policy development. DISCUSSION AND CONCLUSIONS: Several gaps in data and research will need to be addressed in order to assess the full magnitude of the public health burden of underemployment and unemployment. Public health needs to champion a research and practice agenda in partnership with multisector stakeholders to illuminate the role of employment quality and status in closing the gap on health inequities, and to integrate workforce health and well-being into labor and economic development agendas across government agencies and industry.

Long-Term Unemployment: A Social Determinant Underaddressed Within Community Behavioral Health Programs.

Employment has the potential to contribute to positive health outcomes for people with serious mental illnesses; however, its flipside, long-term unemployment, is a social determinant that has not been consistently recognized for its negative effects. Therefore, in this column, the authors examined how the widely accepted notion that unemployment is extremely deleterious to health is largely overlooked. Clinical risk factors related to long-term unemployment are identified as well as the inadequate response to them within mental health systems of care. Practical individual- and systems-level strategies to rectify this oversight are outlined.

Hearing loss and employment: a systematic review of the association between hearing loss and employment among adults.

BACKGROUND: Hearing loss affects over 1.3 billion individuals worldwide, with the greatest burden among adults. Little is known regarding the association between adult-onset hearing loss and employment. METHODS: Seven databases (PubMed, Embase, Cochrane Library, ABI/Inform Collection, Business Source Ultimate, Web of Science and Scopus) were searched through to October 2018. The key word terms used related to hearing loss and employment, excluding paediatric or congenital hearing loss and deaf or culturally deaf populations. RESULTS: The initial search resulted in 13 144 articles. A total of 7494 articles underwent title and abstract screening, and 243 underwent full-text review. Twenty-five articles met the inclusion criteria. Studies were set in 10 predominantly high-income countries. Seven of the 25 studies analysed regionally or nationally representative datasets and controlled for key variables. Six of these seven studies reported associations between hearing loss and employment. CONCLUSION: The highest quality studies currently available indicate that adult-onset hearing loss is associated with unemployment. However, considerable heterogeneity exists, and more rigorous studies that include low- and middle-income countries are needed.

Underemployment and psychological distress: Propensity score and fixed effects estimates from two large UK samples.

BACKGROUND: The share of workers who work part-time because full-time jobs are not available remains larger compared to the period prior to the 2008 crisis. For part-time workers, being available to work more hours than offered may have negative mental health implications. METHOD: Drawing on two nationally representative British surveys, we tested whether working less than 30 hours per week while preferring to work longer hours (underemployment) is associated with increased psychological distress. Distress was assessed using responses to the 12-item General Health Questionnaire in both samples. RESULTS: In the National Child Development Study (N = 6,295), propensity score estimates indicated that the hours-underemployed workers experienced higher levels of psychological distress (ß = 0.25, p <0.001) than full-time workers matched on observable characteristics, including prior distress levels. Fixed effects estimates using 18 years of the British Household Panel Survey (N = 8,665) showed that transitioning from full-time employment to underemployment predicted an increase in distress levels (ß = 0.19, p <0.01). Conversely, transitioning from underemployment to full-time employment forecasted a reduction in distress (ß = -0.18, p <0.001). On average, job earnings and perceptions of job security explained a small (≈ 10%) portion of the potential psychological impact of hours-underemployment. CONCLUSIONS: These findings highlight the possibility that underemployment among part-time workers may have detrimental psychological consequences. Policy interventions geared towards improving career opportunities for part-time workers would potentially ameliorate losses in psychological well-being experienced by this group.

Individual, interpersonal and economic challenges of underemployment in the wake of COVID-19.

BACKGROUND: COVID-19 has caused economic slowdown all across the globe. It results in job loss on the one hand and less wages, increased working hours, overqualified employees and part time jobs on the other hand. Low demand of labour and a huge availability of work force will put many in a disadvantageous position, where they will have to compromise with the circumstances by being underemployed. Cabinet decisions, by some Indian states like Uttar Pradesh, to suspend the labour laws related to minimum wage, bonus, working hours and other employee benefits will put workers in a highly disadvantageous position of being underemployed. This may lead to many socio-economic, psychological and health-related implications. OBJECTIVE: The aim of this paper is to provide a comprehensive review on the concept of underemployment, its types and consequences. METHODOLOGY: A critical and constructive analysis of the literature was performed. RESULTS: The findings reveal that if employment does not provide workers with proper opportunities to use their education, time, skills and expertise, it can create stressful situations in workers' lives. CONCLUSION: The problem needs both a diagnosis and robust treatment in order to have better outcomes at the individual, organisational and national levels.