Over the last four decades there has been a transition away from the standard employment type of full-time, permanent work with entitlements (annual/sick leave, etc.) to less standard or more flexible terms of employment, with increased casualization of the workforce, fixed-term contracts and part-time work, low wages, limited workplace rights and protection and individual-level bargaining over employment conditions [1
]. The term precarious employment has increasingly been used to describe this less stable, and often detrimental, employment form [2
]. However, the definition of precarious employment is broader than the contractual features of precarious employment and also encompasses the social aspects of precarious employment relationships and, specifically, workplace power relationships, e.g., powerlessness to exercise workplace rights or helplessness against workplace authoritarianism [1
]. Precarious employment working arrangements may apply to all workers and not just those who work in less secure employment [5
Considerable work has been done that shows that precarious employment impacts adversely on the mental and physical health of exposed workers [6
], and on work-related injuries [9
]. Employment for women has been shown consistently to be more precarious than that of men [10
]. Similarly, precarious employment in migrant workers is higher than in native-born workers [11
]. However, little is known about the impact precarious employment has on the health of migrant women [13
] or if the impact differs from migrant male workers [1
]. The intersections of gender and class or gender and migration status, for example, produce an experience of work and its arrangements that might vary qualitatively and structurally between women and men and between migrants and native-born workers [14
]. In addition, measures of precarious employment have revealed more than one dimension related to that concept. They include vulnerability, temporariness and the ability to exercise workplace rights [4
]. It is unclear how the different dimensions of precarious employment adversely impact health, or if some dimensions are more health damaging than others [1
]. A review of studies found that the anticipation of losing a job or feeling that the job may be temporary were most closely associated with increases in risk factors for adverse health as well as actual adverse changes in health [15
External migration is a major global phenomenon involving the movement of people and families between countries. In 2017, there were an estimated 258 million external migrants worldwide. Of those, 164 million were estimated to be working [16
]. Australia’s mix of migrant intake has mirrored the country’s industrial and economic development. In the post-war period up until the 1970s, nearly six million European migrants arrived to build Australia’s manufacturing industries and infrastructure. These skilled, semi-skilled and unskilled workers obtained largely secure employment and migrated permanently. As the country started to transition in the mid-1970s from a manufacturing and industrial to a service-based economy, migrants with higher skill and educational levels were sought. Migrants from Southeast Asia began to arrive at this time, and it became increasingly difficult to come to Australia as an unskilled worker [17
]. Since this time, there has been restructuring and deregulation of the labour market, and Australian manufacturing has declined and has moved offshore. In the 1980s, new migrants largely entered precarious employment (casual and fixed-term contract work) and temporary migration was encouraged [18
]. The requirement for skilled workers increased further in the mid-1990s and is now the largest migration stream. Today, the majority of new migrants come from more than 180 countries and make up 29.7% of the Australian population and, at the latest census, make up 35% of the Australian workforce [19
]. Four of the top five countries contributing to the migrant workforce are China (2.7%), India (2.6%), New Zealand (2.2%) and the Philippines (1.2%) [20
]. Despite these large numbers, the prevalence of precarious employment or its health impacts among migrant workers is relatively unexplored, particularly with regard to differences between men and women. The aims of this present study were to investigate the two dimensions of precarious employment which have been suggested as the most important in terms of the impact on health, namely, perceptions of vulnerability and insecurity in current employment [15
]. We investigated (1) if the prevalence of vulnerability and insecurity differ by migration status and gender; (2) the impact of vulnerability and insecurity on the self-reported health of women compared with men and migrants compared with Caucasian Australians, and (3) the relative impact of vulnerability and insecurity on health.
For the survey of Australian-born workers, 1217 households had someone who met the criteria and, of these, 1062 consented to participate (response rate 87.3%). Of these, 1051 identified as Caucasian Australian. For the survey of migrant workers, 2051 households contained someone who was either born in New Zealand, India or the Philippines, currently working and aged over 18 years. Of this total, 1630 agreed to participate (response rate 79.5%). All missing values except occupational status were missing completely at random. There were 271 (10.1%) missing values for occupational status, all Australian-born. As the percentage missing was borderline for recommended imputation (10%) and as occupational status was not statistically significantly related to health, no imputation was conducted.
Men worked more hours than women, independent of migrant status and were more likely to be self-employed or work full time (Table 1
). More women born in New Zealand were recruited in comparison to men, and more men born in India were recruited in comparison to women. Twice as many men as women were employed as machinery operators or labourers, and New Zealanders had lived in Australia longer than the other migrant groups.
Overall, women were more statistically significantly likely to experience vulnerability at work than men (Table 2
). When the mean scale scores for vulnerability were compared between women and men, women had higher mean vulnerability than men (µ = 6.5 vs. µ = 5.5, t = 5.40 p
< 0.0001, data not shown). For insecurity, more women reported low insecurity at work than men, and more men reported moderate insecurity. When the mean scale scores for insecurity were compared between women and men, men had higher mean insecurity scores than women (men µ = 9.3 vs. women µ = 8.6 t = −4.160 p
< 0.0003, data not shown).
Among women, patterns of vulnerability and insecurity were similar across the country of birth groups. Among men, workers from India had a higher prevalence of high insecurity than workers from Australia, New Zealand or the Philippines. Patterns of vulnerability and insecurity were similar between men and women across the country of birth groups, except that fewer Australian-born women reported no vulnerability at work compared with Australian-born men.
Over women and men combined, workers born in the Philippines had a higher mean vulnerability score compared with other migrant workers (µ = 6.5 vs. µ = 5.8 t = −3.47 p < 0.0003, data not shown), whereas workers born in India had a higher mean insecurity score compared with other migrant workers (µ = 9.8 vs. µ = 8.9, t = −6.1 p < 0.0001, data not shown).
Increasingly poor health, both physical and mental, was linearly associated with vulnerability and job insecurity except for psychological distress, where the odds of reporting high to very high psychological distress was marginally higher for the moderate job insecurity group than for the high job insecurity group (Table 3
). Reporting high to very high psychological distress was six times as likely for those who also reported high vulnerability at work. Workers reporting high job insecurity were approximately three times more likely to report fair to poor health, health worse or much worse than last year and high to very high psychological distress than workers who reported low job insecurity. Similarly, workers in moderately insecure jobs were more likely to report adverse health outcomes compared with workers in jobs with low insecurity.
Health measures did not differ significantly between any of the foreign-born groups, but men were 24% less likely to report fair-to-poor health compared with women (Table 3
Using the health indicator score as a proxy measure of overall health and well-being, associations with vulnerability and well-being showed that workers born in Australia had statistically significant poorer health compared with workers born outside Australia, for all levels of vulnerability and job insecurity. Health did not differ significantly between any of the foreign-born groups (Table 4
Vulnerability had the highest impact on health (Coef.0.34 p < 0.0001) compared with insecurity (Coef.0.25 p < 0.0001), but there was no significant interaction between vulnerability and insecurity (Coef.0.01 p = 0.114) (data not shown).
As it is possible to feel both vulnerable and insecure, the combinations of vulnerability and insecurity were explored. The greatest impact on health was the combination of high vulnerability and high insecurity (Coef.2.37 p = 0.002), followed by high vulnerability and moderate insecurity (Coef.2.0 p = 0.007) (data not shown).
This study examining factors of precarious work showed that women were more likely to report vulnerability at work, whereas men were less likely to report working in jobs with low insecurity and more likely to report working in jobs with moderate insecurity than women. Men from India were more likely to report working in jobs with high insecurity compared with Australian-born men. The impact of vulnerability and job insecurity on health varied by country of birth, but not gender. Compared with workers born elsewhere, workers born in Australia showed a consistent trend toward poorer health when physical and mental health indictors were combined. In this study, vulnerability was more health damaging than insecurity.
The gender differences in our results generally concur with other work. We found that the prevalence of low/moderate insecurity was higher in men than women, but there was no difference by gender in the prevalence of high insecurity. Vulnerability was higher in women than men. Work from Spain examining employment precariousness reported a higher prevalence of precariousness in women than men (52.9% vs. 43%, p
< 0.001) [24
]. In Australia, precarious working conditions, measured as an index, have increased from 2009 for both men and women, but more rapidly for men than women; however, the prevalence remains higher in women [36
]. When looking at the separate components of precariousness, the pattern is not always the same. For example, a systematic review of the literature examining the distribution of employment conditions in women and men found a higher prevalence of high job insecurity in women than men [10
In our study, differences in the percentage reporting job insecurity existed between migrants and Australian-born workers. Males from the Philippines and India had a higher prevalence of insecurity than Australian-born males. This finding is similar to work from Spain that found that migrant workers had a higher prevalence of precariousness at work than native-born workers (77.1 vs. 45.2%, p
< 0.001), particularly among young, female immigrant workers (88.6%) [24
]. Similarly, a lower prevalence of US-born agricultural workers reported insecure work compared with foreign-born workers [37
A review of the literature examining the impact of employment insecurity on health over the period 1980–2006 found no difference in the impact of employment insecurity on either psychological or physical health by gender [38
]. However, a more recent review found moderate quality evidence of an adverse effect of employment insecurity (OR 1.52, 95% CI 1.35–1.70) on mental health [39
]. This supports findings from Spain, where population-attributable risks (PAR) for mental ill health were higher among females and immigrant workers compared with their counterparts. The PAR was 7.7 for non-manual Spanish and 14.7 for immigrant men, while for non-manual Spanish and immigrant women it was 20.0 and 34.3, respectively. The pattern was similar, but more marked, for manual workers [24
]. Our study found no difference in the impact of either vulnerability or insecurity on the overall health indicator (physical plus mental) health of women and men. However, the impact of vulnerability and insecurity on the overall health indicator did differ by migration status, with Australian-born workers reporting poorer self-reported health than workers born elsewhere.
In our study, the perception of high vulnerability at work was associated with higher psychological distress than the perception of high insecurity (OR 6.24 compared with 3.11, Table 3
). These results are in line with a study of the working population of Spain, aged 16–65, which found that vulnerability, as measured by the EPRES scale, correlated most strongly with perceived poorer health, particularly mental health (correlation coefficient −0.343, p
< 0.01). Furthermore, those authors found that personality characteristics which favour answering questions negatively did not influence their vulnerability items [4
]. However, our study showed that when physical health and mental health measures were combined to produce a proxy of overall health, the impact on health appeared to be greater on the Australian-born worker than the worker born overseas. This is not a finding that has been presented before to our knowledge, and it indicates that we might need to take a more wholistic approach to the impact of precariousness in the workplace, as has been proposed by Benach [1
A possible explanation for the greater health impact in our study of vulnerability than insecurity and for the differential health impact between workers born in Australia compared with workers born in India or the Philippines is that both India and the Philippines have large informal labour markets where precarious work conditions, such as unstable and insecure work practices, are the norm. Additionally, the formal labour market in these countries is undergoing a rapid process of informalisation, at the same time that the informal labour market is growing in size [40
]. The experience of these workers in their home countries may have been working in the informal labour market, thus making them more familiar with precarious working conditions and particularly insecurity. We did not ask about working conditions in the home country, so we are unable to assess this in this current study.
Finally, there appears to be a gap in the literature concerning the place of precariousness in stress related to the workplace. While there are some theoretical models of the role of stress in the workplace, they are almost exclusively based on the concept of job satisfaction focusing on concepts such as the level of demand and control within the workplace [41
]. Some recent work has examined the role of ethnicity in coping with stress in the workplace [42
]. However, the role of precariousness, which we would argue is as prevalent and as important a source of stress, has not been discussed in these works. There would appear to be a place for some investigation into how ethnicity with its concurrent cultural mores affects the perception of precarity and stress in the workplace. Our descriptive study suggests that some cultural mores may have an ameliorating role, at least in Australia.
As the study was a self-reported cross-sectional survey, no attribution of causality can be made. Telephone surveys can be influenced by a number of factors including, in the case of migrant workers, fear of consequences for participating [43
] and fear of being identified which might impact their work [44
]. However, the high participation rate (79.4%) suggests that few of the workers we contacted were in these categories. A further limitation of this study was the need to include two non-probability sampling strategies to achieve the required number of workers within each migrant group. Weighting the data to the census for workers from each migrant group helped to address any bias in population estimates and there was an unexpected bonus. The sample we used from the sample broker, who only provided mobile numbers, yielded more workers who were young, male and from lower socioeconomic levels. This supports previous research, which argues for the importance of using flexible methods when researching “hard-to-reach” populations [45
We only looked at two dimensions of precarious employment and there are more as identified by Vives [4
], and there may be other dimensions that impact negatively on health to a greater or lesser extent.
A strength of this study is that we collected quantitative individual-level data from workers across the population, rather than just in high-risk industries. This allowed us to include all job types allowing for the results to be generalised to the population, which is unusual in studies on migrant workers.