Evaluate the health risks and impact pathways of precarious employment in the context of globalization: A national longitudinal research from 2017 to 2023 in Japan.

BACKGROUND

Since the 1970s, neoliberalism has transformed the global economy, replacing full-time, long-term employment with flexible work arrangements, contributing to precarious employment (PE). PE has been linked to negative health outcomes, but research on the multiple dimensions of PE remains limited.

METHODS

This study employed a longitudinal cohort design using data from the Japanese Panel Study of Employment Dynamics (JPSED) from 2017 to 2023, focusing on individuals aged 16-65 who were employed but not on full-time permanent contracts. We developed a modified Employment Precariousness Scale (EPRES-JP) for evaluation. The entropy-based TOPSIS method with adjustable weight coefficients (Ea-TOPSIS) method was applied to calculate the Precarious Employment Index (PEI), and logistic regression analyzed its association with health outcomes, while Structural Equation Modeling (SEM) explored potential mediating pathways.

RESULTS

The study found that the "Rights" dimension (social insurance and leave access) had the highest average weight at 40.2 %, with the impact of COVID-19 (introduced in 2021) significantly contributing to the PEI. Higher PEI was associated with greater risks of headaches (OR = 1.11, 95 % CI [1.06, 1.16]), fatigue (OR = 1.09, 95 % CI [1.04, 1.14]), anxiety (OR = 1.12, 95 % CI [1.07, 1.17]), depression (OR = 1.18, 95 % CI [1.13,1.24]), loss of appetite (OR = 1.22, 95 % CI [1.16, 1.28]), and sleep disturbances (OR = 1.20, 95 % CI [1.15, 1.25]). SEM identified mediating pathways between PE, job and life satisfaction, and health outcomes.

CONCLUSION

These findings deepen our understanding of how PE affects worker health. Enhancing job characteristics and life satisfaction may mitigate the health risks of PE. Broader labor policies are essential to improve job security and worker well-being.