Labour Market Changes and Health Implications

1. Labour Market Changes and Health Implications Presentation to Social Justice Initiative Workshop Justice, Equality and the Social Determinants of Health Melbourne University June 2011 Mike Rafferty

2. Outline of Presentation • Introduction • What we knew about the past? • How has work changed? • Old and New Narratives of work and working life • Social Inclusion, well being and work v social inequality and risk shifting • The visible and hidden injuries of class • Risk and the new narratives of working life

3. Everyone in public health field is aware that work can be dangerous to health NOHSC (2005) estimated that there are more than 2,000 fatalities from workplace accidents and diseases per annum the Industry Commission in 1995 estimated that at any one time, more than 200,000 people could not work at all due to an injury or disease sustained at work, and a further 260,000 had been forced to change jobs or reduce working hours due to work-related injury. Estimated annual total economic cost of workplace related fatalities, illness and injury in Australia exceeds $31 billion. Considerable non-economic loss associated with death, illness and injury in the workplace. What we knew about the past

4. Earlier ideas about health, safety and inequality Self-regulation (safety of the investor) “The primary responsibility for doing something about the present levels of occupational accidents and disease lies with those who create the risk and those who work with them…Our present system encourages rather too much reliance on state regulation…” Robens Report (UK)1972 Inequality (safety of the worker) “Everyone in the public health field is aware of a connection between social class and aspects of health…” Bob Connell 1998

5. What’s the nature of the current situation at work? • Unprecedented abundance • Set against growing inequality • Management ascendant in the workplace and the labour market • Legacy of a thirty year campaign • Labour bearer of (financial) risk as never before. Product of risk shift from: • employers to labour, and • governments to households

6. Narratives of change at work • Orthodoxy: • From ‘rigid’ centralised past to … choice and ‘flexible’ present • Realilty • From male breadwinner (Harvester Man) + full-time carer to…. growing female labour market participation but fragmentation + frustration at work and home (‘Two-income trap’)

7. We are doing more paid work

8. Revolution in our time: women at work

9. Weekly hours per household, head aged 25-39 Source: RBA

10. Wage and labour productivity: Australia 1978 - 2008

11. Wages share of GDP: 1978 - 2008

12. Basic changes in Australian Workplace IR (AWIRS 95 and ESWIRS 05/06. Pop =20 +, n=2,170)

13. Perceived management opposition to unions by industry, 2009, Australia, % (More anti-union senitment, greater drop in unionisation r2 =-0.58, Australia at work, 2009:87)

14. Declining living standards: objective and subjective Source: van Wanrooy et al, Australia at work, 2008

15. Trends in unemployment + employment • Unemployment rose during GFC , • but now declined again and currently steady • Employment is still growing • But much of it part-time • Major differences by industry • Burden falling on casuals, especially those changing jobs

16. Growing industries: Blue collar(Aust May 08 – May 10)

17. Growing industries: White collar(Aust May 08 – May 10)

18. Declining industries: White+Blue (Aust May 08 – May 10)

19. Increase in casual and part-time employment Growth of Contingent Employment

20. More paid labour to keep households afloat

21. Employed (10,423.1) Employees (Excludes OMIE) 81.7% OM/Self-employed 18.3% Not on fixed term contract 8,154 78.2% Fixed term contract 366.8 3.5% Without Employees 7.0% With Employees 11.3% ‘Permanents’ (Leave) 6,070.3 58.2% ‘Casuals’ (No Leave) 2,083 20.0% No Leave 92.0 0.9% Leave 274.8 2.6% Forms of Employment 2007 (FoES) (‘000)

22. Industry character of employment(Nov 08 – Nov 09) • Growing sectors (mainly rise in part-timers) • Blue collar: booming export vs hesitant others • White collar: welfare state based vs hospitality • Declining sectors (mainly loss of full timer) • Manufacturing • Discretionary consumption services (eg retail) • Outsourced/transaction services • Finance

23. Some implications of changes at work • Fragmentation and Intensification - growth in: • proportion of working age population in work, • proportion working longer hours, o.t. and weekends, • proportion working non-standard (precarious) work (amongst highest ion OECD) • e.g. almost 2.2million workers (almost 20%) no paid leave entitlements, • time spent getting to and from work (Flood and Barbato (2005) • (10% of parents spend more time commuting than with children) • The (re-)emergence of the ‘working poor’

24. Mental health and poor quality jobs • Poor quality = • insecure jobs (casual, fear of job loss etc), • involve excessive demands, • no say or autonomy over how work is done and • paid unfairly.

25. Poor quality jobs = bad mental health outcomes • In general being employed is better for mental health than being unemployed but, • People in poor quality jobs have much worse mental health outcomes than those in good quality jobs • moving from unemployed into a high quality job was associated with big improvements in mental health but • moving from unemployment to a poor quality job was actually associated with a significant decline in those people's mental health and well being • excessive job demands, low levels of control and insecurity significantly increase depression and anxiety (Butterworth et.al. 2011) • Half of all employees in AWALI survey find work sometime or often affects their life beyond work (Pocock et.al. 2007)

26. New narratives - health and inequality "..there are dramatic differences in health that are closely linked with degrees of social disadvantage. Differences of this magnitude, within and between countries, simply should never happen. These inequities in health, avoidable health inequalities, arise because of the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness... The development of a society, rich or poor, can be judged by the quality of its population’s health, how fairly health is distributed across the social spectrum, and the degree of protection provided from disadvantage as a result of ill-health." (W.H.O. CSDH, 2008).

27. New Narratives - Capabilities, Inclusion and Wellbeing “…GDP is neither a measure of income nor a measure of wellbeing.What we want is the key question…increasingly there is a demand to go beyond measures of market activity to measures of wellbeing” Stiglitz et.al 2008 Wellbeing relates to: • ‘the desire for optimal health, for better living conditions and improved quality of life’ ABS. The 5 elements of Treasury’s Wellbeing framework (i) the level of opportunity and freedom; (ii) the level of consumption possibilities; (iii) the distribution of those consumption possibilities; (iv) the level of risk that people are required to bear; and (v) the level of complexity that people are required to deal with.

28. Inequality and well being - the tension within • “The evidence is compelling: for most individuals, working improves general health” (Royal Austalian College of Physicians Position Statement 2010) • “Gaining employment may not necessarily lead to improvement in mental health and well being if psychosocial job quality is not considered” Butterworth et.al 2011

29. Conclusion • Class and gender relations have changed profoundly • Risk shift from state to households and labour to capital • Health care researchers have rediscovered inequality and health (but so what?) • Key issue for health, wellbeing and social inclusion • ‘the free development of each depends on the free development of all’

30. References • Beck, U 1992 Risk Society: Towards New Modernity, Sage, London • Bryan D, Rafferty M and MacWilliam S 2010 'The Global Financial Crisis: Foreclosing or Leveraging Labour’s Future?' in M. Konings, ed The Great Credit Crash, Verso, London, pp. 353-369 • Bryan, D and Rafferty, M2009 'Homemade financial crisis', Ephemera: theory and politics in organization, vol 9, No 4, pp. 357-62 . • Connell, R 1988 Class Inequalities and ‘Just Health’ Strategy, Community Health Studies Vol XII, No2 • Hacker, J 2008 The Great Risk Shift - The Assault on American Jobs, Families, Health Care, and Retirement Oxford University Press, Oxford. • Haines, K and Thomas, J 2005, Workplace death and serious injury: a snapshot of legislative developments in Australia and overseas, Parliamentary Library, Research Brief, No 7, Commonwealth of Australia, Canberra. • Martin R, 2002, The financialization of everyday life, Temple University Press, Philadelphia • Rafferty M and Yu 2010 ‘Shifting Risk: Work and working life in Australia’ Workplace Research Centre, University of Sydney available at www.actu.org.au • Robens Report 1972, Report Of The Committee On Safety And Health At Work 1970-72. • Sennet The Hidden Injuries of Class