7.2 Health and Employment Status

Work in the 21st century is becoming increasingly insecure. While the standard employment relationship (SER), the term for permanent, full-time, secure employment with a single employer, is still the most common form of job, its proport the term for permanent, full-time, secure employment with a single employer, is still the most common form of job, its proportions are dropping. Fewer than two thirds of jobs in Canada fit the definition of SER. The fastest-growing segment of non-SER jobs is precarious employment, which now comprises 20% of jobs in the country.^[1] Precarious workers earn less and are less likely to have benefits (or may have fewer benefits) than other workers. Women, immigrants, and young workers are more likely to hold precarious jobs than other Canadians.^[2] For employers, precarious work lowers labour costs and increases flexibility, both of which lead to higher profits. While not as prevalent as in the private sector, precarious work is also present in the public and non-profit sector as these employers feel the pressure to reduce costs and emulate private sector practices.

The rise of precarious employment is concerning for a number of economic and political reasons. It reflects growing inequality in Canada and contributes to racial and gender divisions in society. Most worker advocates talk about the economic unfairness of precarious employment and the problems it creates in the labour market and in communities. Precarious employment is also a health and safety issue. The status of being a precarious worker leads to worsened health and safety outcomes.

Repeated studies with different types of precarious workers have shown that they are more likely to get injured at work and their injuries tend to be more severe.^[3] Precarious work is associated with deteriorating health and safety conditions in the workplace,^[4] and precarious workers are found to be less aware of their safety rights and have more difficulty exercising those rights.^[5] Precarious employment has direct effects on workers’ health. Precarious workers report worse mental health, including increased stress-related illness, depression, and anxiety. Evidence for decreased physical health is more mixed, but precarious work is associated with higher levels of mortality among workers.^[6]

There are two explanations for precarious work being associated with decreased health and safety outcomes. Michael Quinlan and Philip Bohle developed the Pressures, Disorganization and Regulatory Failure (PDR) model to explain how precarious work leads to poor health and safety outcomes. Their model looks at three groups of factors that shape practices at precarious workplaces. First, precarious workers experience economic pressures because of income insecurity and competition for work which lead them to accept work intensification and dangerous work while making them reluctant to report injury and ill health. Second, the contingent nature of the work relationship breaks down structures that facilitate workplace safety, such as safety procedures, training, and communication. Third, the effectiveness of government safety regulations is reduced because enforcement is more difficult, some forms of work are not protected by regulation, and some workers lack knowledge of their health and safety rights. The result of these factors is workplaces that are less safe.^[7]

The PDR model attempts to explain the increased health and safety risks through precarity’s effects on the workplace structure and practice. While this model does help us understand the workplace dynamics of precarious work, it provides an incomplete understanding of the broader effect of precarity on health. The consequences of precarious work do not restrict themselves to the workplace but spill over into the workers’ private lives, as they take stress, anxiety, and insecurity home with them.

In an attempt to build a more holistic analysis of precariousness and work, Wayne Lewchuk and his colleagues have developed the Employment Strain Model (ESM)  . ESM looks at the employment relationship in its entirety to understand how workers’ health is affected by engaging in precarious work. The model suggests that the strain of being uncertain about employment combined with the stress of having to make extra effort to maintain and attain work are the cause of the worsened health outcomes. Box 7.2 provides a more complete explanation of the model.

No work has been done to determine how to reduce the ill effects of precarious work, in large part because precarity is not yet widely recognized as a health and safety hazard. Since the origins of its effect begin before work begins, it is a challenge to identify work-related solutions. The only effective method for reducing the health effects of precarity is to create jobs that are more secure and support workers more fully. This solution requires broad-scale social, political, and economic change.

Despite its seeming intractability, it is important to understand the health and safety implications of precarious work. The discussion demonstrates that workplace health extends beyond the workplace. The significance of precarious work is that it is not only the work itself that affects safety; the employment status also plays a large role in determining worker health.