Precarious employment, unemployment and their association with health-related outcomes in 35 European countries: a cross-sectional study

Though work and paid employment are generally beneficial, and unemployment is frequently harmful, precarious employment relations are also health damaging. This study compared the health status of workers in highly precarious employment with unemployed individuals in 35 European countries. We used data from the 6(th) European Working Conditions Survey (2015) (n = 33,938). The prevalence of precariousness was 58.99%. We fitted a multi-level generalized linear model (GLMM) to calculate the adjusted prevalence ratios (aPR) of health-related outcomes according to quartiles of precariousness and unemployment. We calculated the aPR of health-related outcomes in the highly precariously employed (quartile 4 of precariousness), with reference to unemployed individuals. We found significant associations of higher prevalence of bad health status, headache, skin and hearing problems, anxiety, fatigue, backache, upper and lower muscular pain and injuries among quartiles 3 and 4 of precariousness compared with those with no precarious employment. The confidence intervals of the aPR for most of health-related outcomes overlapped between the highest quartiles of precariousness and recent unemployment, indicating no significant differences among these groups. We conclude that unemployment and higher degrees of precariousness can be similarly health damaging. Therefore, we propose that employment conditions should be better monitored. This is an essential first step in order to document, and identify interventions to prevent, the health-damaging consequences of growing levels of precarious employment. This will be essential for achieving the 8th sustainable development goal of decent work and economic growth by 2030.