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Non-standard employment and mortality. a Belgian census-based investigation. R. Balogh, S. Gadeyne , C. Vanroelen. Background. BACKground. Precarious/non-standard employment is linked to adverse health outcomes incl. self-rated general health, mental health…
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Non-standard employment and mortality a Belgian census-based investigation • R. Balogh, S. Gadeyne, C. Vanroelen
BACKground • Precarious/non-standard employment is linked to adverse health outcomes incl. self-rated general health, mental health… • Growing evidence on the relationship between unemployment and mortality • Less research done on non-standard/precarious/temporary employment and mortality • Kivimaki et al (2003) • Natti et al (2009) • Khlat et al (2014) With improvements in administrative data, need to look at all-cause and cause-specific mortality as anindicator of health when studying the consequences of labour market flexibilisation!
Data and methods • Data: Belgian census (SEE) 2001 and linked mortality follow-up until 31st December 2016 • Cox proportional hazards models with age as underlying time-scale • All-cause and cause-specific mortality • Circulatory diseases: ICD10 I* • Cancer: ICD10 C* - D48 • Mortality due to external causes: ICD10 V* W* X* Y* • Transport accidents ICD10 V01–V99 • Suicide ICD10 X60–X84 • Fall ICD10 W00–W19
Permanent employment Work program Seasonal work Temporary agency work Fixed-term work Casual work
Mortality 2001-2016 by type of employment among men (HR and 95% CI), ref.category: permanent workers
Mortality 2001-2016 by type of employment among women (HR and 95% CI), ref.category: permanent workers
RESULTS • Heterogeneity among those on non-standard employment • Excess mortality observed among many • External causes as drivers of excess mortality • Temporary agency workers seem particularly at risk • Strong gender differences
limitations • Measured at one point in time, cannot account for length of exposure (broader employment trajectories) • How much of the effect can be ascribed to unemployment? • No information on health behavior or health status prior to baseline
Khlat, M., Legleye, S., Falissard, B., Chau, N., & Lorhandicap Group. (2014). Mortality gradient across the labour market core–periphery structure: a 13-year mortality follow-up study in north-eastern France. International archives of occupational and environmental health, 87(7), 725-733. • Kivimäki, M., Vahtera, J., Virtanen, M., Elovainio, M., Pentti, J., & Ferrie, J. E. (2003). Temporary employment and risk of overall and cause-specific mortality. American journal of epidemiology, 158(7), 663-668. • Nätti, J., Kinnunen, U., Mäkikangas, A., & Mauno, S. (2009). Type of employment relationship and mortality: prospective study among Finnish employees in 1984–2000. European journal of public health, 19(2), 150-156. • The noun project • Headlines from following articles: • https://www.brusselstimes.com/belgium/57617/short-term-contracts-on-the-rise-in-belgium/ • https://www.standaard.be/cnt/dmf20190530_04437627 • https://www.rtbf.be/info/economie/detail_les-interimaires-belges-deux-fois-plus-exposes-aux-accidents-de-travail-oit?id=10199705 • https://www.rtbf.be/info/economie/detail_la-belgique-championne-des-contrats-a-duree-determinee-ultra-courts?id=10235017 • https://www.theguardian.com/business/2019/jul/11/rail-worker-killed-by-train-was-fatigued-and-on-zero-hours-contract references
Control variables • Adjustments for socio-economic and work-related characteristics: • age, educational attainment, living in urban agglomeration, partner in household, migration background, economic sector, housing tenure, weekly working hours, work schedule and holding multiple jobs