How do types of employment relate to health indicators? Findings from the Second European Survey on Working Conditions

Study objective-To investigate the associations of various types of employm ent with six self reported health indicators, taking into account the part played by demographic variables, individual working conditions and four eco logical indicators at the country level. Design-Cross sectional survey (structured interview) of a sample of the act ive population of 15 European countries aged 15 years or over. Main indepen dent variables were nine types of employment categorised as follows: small employers, full and part time permanent employees, full and part time fixed term employees, full and part time sole traders and full and part time tem porary contracts. Main outcome measures were three self reported health rel ated outcomes (job satisfaction, health related absenteeism, and stress) an d three self reported health problems (overall fatigue, backache, and muscu lar pains). Logistic regression and multilevel models were used in the anal yses. Setting-15 countries of the European Union. Participants-15 146 employed persons aged 15 or over. Main results-Precarious employment was consistently and positively associat ed with job dissatisfaction but negatively associated with absenteeism and stress (as compared with full time permanent workers). Fatigue, backache an d muscular pains also tended to be positively associated with precarious em ployment, particularly with full time precarious employment. Small employer s reported high percentages of stress and fatigue, but absenteeism was rela tively low. Sole traders generally reported high percentages of all outcome s, except for absenteeism, which was low. For each type of employment (exce pt temporary contracts), full time workers tended to report worse health ou tcomes than part time workers. Patterns were generally consistent across co untries. Associations persisted after adjustment for individual level worki ng conditions and were not modified by country level variables. Conclusions-This study is the first to examine the relations between variou s types of employment and six health related indicators for all 15 member s tates of the European Union. Suggestive patterns worthy of further explorat ion have been found. Standardised definitions of types of underemployment a nd health related outcomes, more potent epidemiological designs and the inc lusion of socioeconomic information (for example, social security systems, incapacity benefit schemes) at the regional level are proposed for inclusio n in further research.