Employment status and perceived health condition: longitudinal data from Italy (original) (raw)
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The impact of precarious employment on mental health: The case of Italy
Social Science & Medicine
In this paper, we investigate the impact of precarious employment on mental health using a unique dataset that matches information on mental health with labour characteristics for a set of employees in Italy. We examine the causal e¤ect of temporary contracts, their duration and the number of contract changes during the year on psychotropic medication prescription. To this end, we estimate a dynamic probit model, and deal with the potential endogeneity of regressors by adopting a control function approach, recently advanced by Wooldridge (2014). Our results show that the probability of psychotropic medication prescription is higher for workers under temporary job contracts. More days of work under temporary contract as well as more changes in temporary contracts sig-ni…cantly increase the probability of being depressed. We also …nd that moving from permanent to temporary contracts increases depression; symmetrically, although with a smaller e¤ect in absolute value, moving from temporary to permanent contracts tends to reduce it. An exploratory data analysis corroborates the hypothesis that depression developed after a movement to precarious employment may permanently a¤ect future job trajectories. One lesson to learn from our empirical work is that policies aimed at enhancing the ‡exibility of the labour maket to boost …rms' competitiveness, if increasing the precariousness of employment, may also produce sides e¤ects on the wellbeing and mental health of employees, ultimately having consequences on …rms'productivity and health care costs.
Background: The mixed empirical evidence about employment conditions (i.e., permanent vs. temporary job, full-time vs. part-time job) as well as unemployment has motivated the development of conceptual models with the aim of assessing the pathways leading to effects of employment status on health. Alongside physically and psychologically riskier working conditions, one channel stems in the possibly severe economic deprivation faced by temporary workers. We investigate whether economic deprivation is able to partly capture the effect of employment status on Self-evaluated Health Status (SHS). Methods: Our analysis is based on the European Union Statistics on Income and Living Conditions (EU-SILC) survey, for a balanced sample from 26 countries from 2009 to 2012. We estimate a correlated random-effects logit model for the SHS that accounts for the ordered nature of the dependent variable and the longitudinal structure of the data. Results and Discussion: Material deprivation and economic strain are able to partly account for the negative effects on SHS from precarious and part-time employment as well as from unemployment that, however, exhibits a significant independent negative association with SHS. Conclusions: Some of the indicators used to proxy economic deprivation are significant predictors of SHS and their correlation with the employment condition is such that it should not be neglected in empirical analysis, when available and further to the monetary income. A prominent amount of theoretical and empirical literature has focused on the relationship between workers' employment condition and their well-being. Special attention has been devoted to the adverse health effects of unemployment [1] and, more recently, to understanding precarious employment and underemployment as an emerging social determinant of health [2,3]. These issues are particularly relevant in the context of the latest economic downturn, leading to an EU-28 unemployment rate of about 20% in 2015 and to an incidence of temporary employment of 40% for workers aged between 14 and 25 in 2014. Furthermore, in the same category, over 19% works less than 20 h per week [4]. Unemployment has long been found to be associated with detrimental effects on several health outcomes, especially through the engagement in riskier health-related lifestyles , following
BMC Public Health, 2019
Background: Flexible employment is increasing across Europe and recent studies show an association with poor mental health. The goal of the current study is to examine this association in the Italian population to assess the possible mediating role of financial strain. Methods: Data were obtained by two Italian cross-sectional studies (PASSI and HIS) aimed at monitoring the general population health status, health behaviours and determinants. Mental health status was assessed using alternatively two validated questionnaires (the PHQ-2 and the MCS-12 score) and Poisson regression models were performed to assess if precarious work was associated with poor mental health. A formal mediation analysis was conducted to evaluate if the association between precarious work and mental health was mediated by financial strain. Results: The analyses were performed on 31,948 subjects in PASSI and on 21,894 subjects in HIS. A nearly twofold risk of depression and poor mental health was found among precarious workers, compared to workers with a permanent contract, which was strongly mediated by financial strain. Conclusions: Even with the limitations of a cross-sectional design, this research supports that precarious employment contributes through financial strain to reduce the mental health related quality of life and to increase mental disorders such as symptoms of depression or dysthymia. This suggests that when stability in work cannot be guaranteed, it would be appropriate to intervene on the wages of precarious jobs and to provide social safety nets for ensuring adequate income.
European Journal of Public Health
Background Job loss is a well-established social determinant of health. Recent research has taken an ‘institutional turn’, asking whether unemployment support could buffer the health consequences of job loss. Here, we exploit a quasi-natural experiment based on the Fornero reforms in Italy, which increased wage replacement rates from 60% to 75% on 1 January 2013. Methods We employed difference-in-difference models using longitudinal data covering 202 incidents of job loss from the EU-Survey on Income and Living Conditions to quantify the impact of job loss on changes in self-reported health prior to and after the Fornero reforms (2011–14). Results Job loss pre-Fornero was associated with health declines −0.342 [95% confidence interval (CI): −0.588 to −0.096] but did not significantly influence health post-Fornero 0.031 (95% CI: −0.101 to 0.164). The difference-in-difference estimate was 0.373 (95% CI: 0.107–0.639), or a −0.51 standard deviation in self-reported health, consistent wi...
Is temporary employment damaging to health? A longitudinal study on Italian workers
Social Science & Medicine, 2015
Working conditions have changed dramatically over recent decades in all the countries of European Union: permanent full-time employment characterized by job security and a stable salary is replaced more and more by temporary work, apprenticeship contracts, casual jobs and part-time work. The consequences of these changes on the general well-being of workers and their health represent an increasingly important path of inquiry. We add to the debate by answering the question: are Italian workers on temporary contracts more likely to suffer from poor health than those with permanent jobs? Our analysis is based on a sample of men and women aged 16e64 coming from the Italian longitudinal survey 2007e2010 of the European Union Statistics on Income and Living Conditions. We use the method of inverse-probability-oftreatment weights to estimate the causal effect of temporary work on self-rated health, controlling for selection effects. Our major findings can be summarized as follows: firstly, we show a negative association between temporary employment and health that results from a statistical causal effect in the work-to-health direction, and does not trivially derive from a selection of healthier individuals in the group of people who find permanent jobs (selection effect). Secondly, we find that temporary employment becomes particularly negative for the individual's health when it is prolonged over time. Thirdly, whereas temporary employment does not entail significant adverse consequences for men, the link between temporary employment and health is strongly harmful for Italian women.
Unemployment insurance and deteriorating self-rated health in 23 European countries
Journal of Epidemiology & Community Health, 2014
Background The global financial crisis of 2008 is likely to have repercussions on public health in Europe, not least through escalating mass unemployment, fiscal austerity measures and inadequate social protection systems. The purpose of this study is to analyse the role of unemployment insurance for deteriorating self-rated health in the working age population at the onset of the fiscal crisis in Europe. Methods Multilevel logistic conditional change models linking institutional-level data on coverage and income replacement in unemployment insurance to individuallevel panel data on self-rated health in 23 European countries at two repeated occasions, 2006 and 2009. Results Unemployment insurance significantly reduces transitions into self-rated ill-health and, particularly, programme coverage is important in this respect. Unemployment insurance is also of relevance for the socioeconomic gradients of health at individual level, where programme coverage significantly reduces health risks attached to educational attainment. Conclusions Unemployment insurance mitigated adverse health effects both at individual and countrylevel during the financial crisis. Due to the centrality of programme coverage, reforms to unemployment insurance should focus on extending the number of insured people in the labour force.
Unemployment and self‐assessed health: evidence from panel data
Health Economics, 2007
We analyse the relationship between unemployment and self-assessed health using the European Community Household Panel (ECHP) for Finland over the period 1996-2001. Our results reveal that the event of becoming unemployed does not matter as such for self-assessed health. The health status of those that end up being unemployed is lower than that of the continually employed. Hence, persons who have poor health are being selected for the pool of the unemployed. This explains why, in a cross-section, unemployment is associated with poor self-assessed health. However, we are somewhat more likely to obtain the negative effects of unemployment on health when long-term unemployment is used as the measure of unemployment experience.
BMC public health, 2018
There is scant research that simultaneously analyzes the joint effects of long-term unemployment, poverty and public expenditure policies on poorer self-perceived health during the financial crisis. The aim of the study is to analyze the joint relationship between long-term unemployment, social deprivation, and regional social public expenditure on one side, and self-perceived health in Spain (2007-2011) on the other. Longitudinal data were extracted from the Survey on Living Conditions, 2007-2010 and 2008-2011 (9105 individuals and 36,420 observations), which were then used to estimate several random group effects in the constant multilevel logistic longitudinal models (level 1: year; level 2: individual; level 3: region). The dependent variable was self-perceived health. Individual independent interest variables were long and very long term unemployment, available income, severe material deprivation and regional variables were per capita expenditure on essential public services an...
Social Indicators Research, 2017
Labor market insecurities have been growing in Europe and previous research has illustrated that unemployment and insecure jobs negatively affect individuals' wellbeing and health. Although empirical evidence suggests that these effects vary substantially across different welfare states, we still know little about the moderating role of specific labor market policies. Taking a cross-national comparative perspective, this article investigates how passive and active labor market policies (PLMP, ALMP) as well as employment protection legislation (EPL) shape the experience of unemployment and insecure jobs. We complement micro data of round 1-6 (2002-2012) of the European Social Survey with time-varying macro indicators of PLMP, ALMP, and EPL. The data include about 89,000 individuals nested in 112 country-rounds and 26 countries respectively. We apply three-level random intercept models as well as pooled linear regression models including country fixed effects. The results show that labor market policies are important in shaping the experience of unemployment, but are less relevant for workers in insecure jobs. Specifically, higher unemployment benefit generosity buffers the negative effects of unemployment on well-being but not health. Moreover, we discuss different interpretations for the finding that higher ALMP expenditures are associated with more negative effects of unemployment on well-being and health. With respect to EPL it is found that in countries with high insider protection, deregulating the restrictions on the use of temporary employment increases the negative effects of unemployment on well-being and health.