Precarious employment and mental health across European welfare states: a gender perspective

Padrosa, Eva; Vanroelen, Christophe; Muntaner, Carles; Benach, Joan; Julià, Mireia

doi:10.1007/s00420-022-01839-7

Precarious employment and mental health across European welfare states: a gender perspective

Original Article
Published: 10 February 2022

Volume 95, pages 1463–1480, (2022)
Cite this article

International Archives of Occupational and Environmental Health Aims and scope Submit manuscript

1744 Accesses
15 Citations
7 Altmetric
Explore all metrics

Abstract

Objective

The aim of this article was to examine the relationship between precarious employment (PE), welfare states (WS) and mental health in Europe from a gender perspective.

Methods

Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, and categorized into quartiles. Countries were classified into Continental, Anglo-Saxon, Scandinavian, Southern and Central-Eastern WS. Mental health was assessed through the WHO-5 Well-Being Index and dichotomized into poor and good mental health. In a sample of 22,555 formal employees, we performed gender-stratified multi-level logistic regression models.

Results

Results showed greater prevalences of PE and poor mental health among women. However, the association between them was stronger among men. Cross-country differences were observed in multi-level regressions, but the interaction effect of WS was only significant among women. More precisely, Central-Eastern WS enhanced the likelihood of poor mental health among women in high precarious employment situations (quartiles 3 and 4).

Conclusions

These findings suggest the interaction between contextual and individual factors in the production of mental health inequalities, both within and across countries. They also call for the incorporation of gender-sensitive welfare policies if equitable and healthy labor markets are to be achieved in Europe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Flexible Working, Work–Life Balance, and Gender Equality: Introduction

Article Open access 26 November 2018

The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature

Article 15 November 2022

Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions

Article Open access 21 April 2020

Notes

Operationalization according to the wage levels defined by the Organisation for Economic Co-operation and Development (OECD, 2020b).

References

Alsos K, Nergaard K, Van Heuvel A (2019) Collective bargaining as a tool to ensure a living wage. Experiences from the Nordic countries. Transf Eur Rev Labour Res 25(3):351–365
Article Google Scholar
Arts W, Gelissen J (2010) Models of the welfare state. In: Leibfried S, Lewis J, Obinger H, Pierson C (eds) The Oxford handbook of the welfare state. Oxford University Press, Oxford
Google Scholar
Auer P, Cazes S (2003) Employment stability in an age of flexibility: evidence from industrialized countries. International Labour Organization, Geneva
Google Scholar
Bambra C, Eikemo TA (2009) Welfare state regimes, unemployment and health: a comparative study of the relationship between unemployment and self-reported health in 23 European countries. J Epidemiol Community Health 63(2):92–98
Article CAS Google Scholar
Bardasi E, Francesconi M (2004) The impact of atypical employment on individual wellbeing: evidence from a panel of British workers. Soc Sci Med 58:1671–1688
Article Google Scholar
Barnett R, Hyde J (2001) Women, men, work, and family: an expansionist theory. Am Psychol 56(10):781–796
Article CAS Google Scholar
Benach J, Vives A, Amable M, Vanroelen C, Tarafa G, Muntaner C (2014) Precarious employment: understanding an emerging social determinant of health. Annu Rev Public Health 35:229–253
Article CAS Google Scholar
Benach J, Vives A, Tarafa G, Delclos C, Muntaner C (2016) What should we know about precarious employment and health in 2025? Framing the agenda for the next decade of research. Int J Epidemiol 45(1):232–238
Article CAS Google Scholar
Bergqvist K, Yngwe M, Lundberg O (2013) Understanding the role of welfare state characteristics for health and inequalities—an analytical review. BMC Public Health 13(1):1–20
Article Google Scholar
Bodin T, Çağlayan Ç, Garde AH, Gnesi M, Jonsson J, Kiran S, Julià M (2020) Precarious employment in occupational health—an omega-net working group position paper. Scand J Work Environ Health 46(3):321–329
Article Google Scholar
Briggs A (1961) The welfare state in historical perspective. Eur J Sociol 2(2):221–258
Article Google Scholar
Campos-Serna J, Ronda-Pérez E, Artazcoz L, Moen BE, Benavides FG (2013) Gender inequalities in occupational health related to the unequal distribution of working and employment conditions: a systematic review. Int J Equity Health 12(1):1–18
Article Google Scholar
Cerami A, Vanhuysse P (2009) Post-communist welfare pathways: theorizing social policy transformations in Central and Eastern Europe. Palgrave Macmillan Ltd, London
Book Google Scholar
Christofides LN, Polycarpou A, Vrachimis K (2013) Gender wage gaps, “sticky floors” and “glass ceilings” in Europe. Labour Econ 21:86–102
Article Google Scholar
Chung H, Muntaner C (2006) Political and welfare state determinants of infant and child health indicators: an analysis of wealthy countries. Soc Sci Med 63(3):829–842
Article Google Scholar
Chung H, Muntaner C (2007) Welfare state matters: a typological multilevel analysis of wealthy countries. Health Policy 80(2):328–339
Article Google Scholar
Dahl E, Van der Wel KA (2013) Educational inequalities in health in European welfare states: a social expenditure approach. Soc Sci Med 81:60–69
Article Google Scholar
Daly M (2001) Globalization and the Bismarckian Welfare States. In: Skyes R, Prior B, Palier P (eds) Globalization and European Welfare States: Challenges and Change. Palgrave Macmillan Ltd, New York
Google Scholar
Daly M (2020) gender inequality and welfare states in Europe. Edward Elgard Publishing, Cheltenham
Book Google Scholar
De Moortel D, Vandenheede H, Vanroelen C (2014) Contemporary employment arrangements and mental well-being in men and women across Europe: a cross-sectional study. Int J Equity Health 13(1):90
Article Google Scholar
De Witte H, Pienaar J, De Cuyper N (2016) Review of 30 years of longitudinal studies on the association between job insecurity and health and well-being: is there causal evidence? Aust Psychol 51(1):18–31
Article Google Scholar
Eikemo TA, Bambra C (2008) The welfare state: a glossary for public health. J Epidemiol Community Health 62(1):3–6
Article CAS Google Scholar
Esping-Andersen G (1990) The three worlds of welfare capitalism. Princeton University Press, Princeton
Google Scholar
Eurofound (2020) European working conditions survey. Available at: https://www.eurofound.europa.eu/surveys/european-working-conditions-surveys-ewcs
Farina E, Green C, McVicar D (2020) Zero hour contracts and their growth. Br J Ind Relat 58(3):507–531
Article Google Scholar
Fenger H (2007) Welfare regimes in Central and Eastern Europe: incorporating post-communist countries in welfare regime typology. Contemp Issues Ideas Soc Sci 3(2):1–20
Google Scholar
Ferrera M (1999) The “Southern model” of welfare in social Europe. J Eur Soc Policy 6:17–37
Article Google Scholar
Fritzell J, Hvinden B, Kautto M, Kvist J, Uusitalo H (2005) Nordic welfare states in the European context. Routledge, London
Book Google Scholar
Gevaert J, Van Aerden K, De Moortel D, Vanroelen C (2020) Employment quality as a health determinant: empirical evidence for the waged and self-employed. Work Occup 48(2):146–183
Article Google Scholar
Hanson S, Pratt G (1991) Job search and the occupational segregation of women. Ann Assoc Am Geogr 81(2):229–253
Article Google Scholar
Heisig J, Schaeffer M (2019) Why You should always include a random slope for the lower-level variable involved in a cross-level interaction. Eur Sociol Rev 35(2):258–279
Article Google Scholar
Hox J, Moerbeek M, Van de Schoot R (2017) Multilevel analysis: techniques and applications, 3rd edn. Routledge, New York
Book Google Scholar
International Labour Organization (2018) Global Wage Report 2018/19 What lies behind gender pay gaps. International Labour Organization, Geneva
Google Scholar
Jonsson J, Vives A, Benach J, Kjellberg K, Selander J, Johansson G, Bodin T (2019) Measuring precarious employment in Sweden: translation, adaptation and psychometric properties of the Employment Precariousness Scale (EPRES). BMJ Open 9(9):e029577
Article Google Scholar
Julià M, Vives A, Tarafa G, Benach J (2017) Changing the way we understand precarious employment and health: precarisation affects the entire salaried population. Saf Sci 100:66–73
Article Google Scholar
Kalleberg A (2018) Precarious lives: job insecurity and well-being in rich democracies. Polity Press, Cambridge
Google Scholar
Kim IH, Muntaner C, Vahid Shahidi F, Vives A, Vanroelen C, Benach J (2012) Welfare states, flexible employment, and health: a critical review. Health Policy 104(2):99–127
Article Google Scholar
Koranyi I, Jonsson J, Rönnblad T, Stockfelt L, Bodin T (2018) Precarious employment and occupational accidents and injuries-a systematic review. Scand J Work Environ Health 44(4):341–350
Article Google Scholar
Korpi W (2016) The democratic class struggle. Routledge, London
Google Scholar
Korpi W, Ferrarini T, Englund S (2013) Women’s opportunities under different family policy constellations: gender, class and inequality tradeoffs in western countries re-examined. Soc Polit Int Stud Gend State Soc 20:1–40
Google Scholar
Kovačević J, Šehić D (2015) The pursuit of a remedy for gender inequality in wider Europe: comparison of policies and indices in the EU, Nordic Countries, and sout east Europe. Econ Ann 60(204):127–156
Article Google Scholar
Kreshpaj B, Orellana C, Burström B, Davis L, Hemmingsson T, Johansson G, Bodin T (2020) What is precarious employment? A systematic review of definitions and operationalizations from quantitative and qualitative studies. Scand J Work Environ Health 46(3):235–247
Article Google Scholar
Kuttner R (2018) Can democracy survive global capitalism? Norton, New York
Google Scholar
Lewis J (1992) Gender and the development of welfare regimes. Norton, New York
Book Google Scholar
Li C (2013) Little’s test of missing completely at random. Stand Genom Sci 13(4):795–809
Google Scholar
Lokar S (2000) The situation of women in Eastern Europe: five theses. Labour Force Eastern Eur 66:66–78
Google Scholar
Marmot M, Wilkinson R (2005) Social determinants of health. Oxford University Press, Oxford
Book Google Scholar
Menéndez M, Benach J, Muntaner C, Amable M, O’Campo P (2007) Is precarious employment more damaging to women’s health than men’s? Soc Sci Med 64(4):776–781
Article Google Scholar
Mensah A, Adjei N (2020) Work-life balance and self-reported health among working adults in Europe: a gender and welfare state regime comparative analysis. BMC Public Health 20:1052
Article Google Scholar
Muñoz-Bustillo R, Fernández-Macías E, Antón J, Esteve F (2009) Indicators of job quality in the European Union. European Parliament, Brussels
Google Scholar
Muntaner C (2016) Global precarious employment and health inequalities: working conditions, social class or precariat? Cad Saude Publ 32:e00162215
Google Scholar
Muntaner C, Chung H, Solar O, Santana V, Castedo A, Benach J, E N (2010) A macro-level model of employment relations and health inequalities. Int J Health Serv 40(2):215–221
Article Google Scholar
Muntaner C, Borrell C, Ng E, Chung H, Espelt A, Rodríguez-Sanz M, O’Campo P (2011) Politics, welfare regimes, and population health: controversies and evidence. Sociol Health Illn 33(6):946–964
Article Google Scholar
Naldini M (2004) The family in the Mediterranean welfare states. Routledge, New York
Book Google Scholar
Navarro V, Shi L (2001) The political context of social inequalities and health. Int J Health Serv 31(1):1–21
Article CAS Google Scholar
Navarro V, Muntaner C, Borrell C, Benach J, Quiroga Á, Rodríguez-Sanz M, Pasarín MI (2006) Politics and health outcomes. The Lancet 368(9540):1033–1037
Article Google Scholar
O’Campo P, Eaton WW, Muntaner C (2004) Labor market experience, work organization, gender inequalities and health status: results from a prospective analysis of US employed women. Soc Sci Med 58(3):585–594
Article Google Scholar
Padrosa E, Belvis F, Benach J, Julià M (2021a) Measuring precarious employment in the European working conditions survey: psychometric properties and construct validity in Spain. Qual Quant 55(2):543–562
Article Google Scholar
Padrosa E, Bolíbar M, Julià M, Benach J (2021b) Comparing precarious employment across countries: measurement invariance of the employment precariousness scale for Europe (EPRES-E). Soc Indic Res 154:893–915
Article Google Scholar
Pascall G, Manning N (2000) Gender and social policy: comparing welfare states in Central and Eastern Europe and the former Soviet Union. J Eur Soc Policy 10(3):240–266
Article Google Scholar
Piketty T (2015) About capital in the twenty-first century. Am Econ Rev 105(5):48–53
Article Google Scholar
Plomien A (2006) Women and the labor market in Poland: from socialism to capitalism. Globalization, uncertainty and women’s careers: an international comparison. Edward Elgar Publishing, Cheltenham
Google Scholar
Pollert A (2003) Women, work and equal opportunities in post-communist transition. Work Employ Soc 17(2):331–357
Article Google Scholar
Puig-Barrachina V, Vanroelen C, Vives A, Martínez J, Muntaner C, Levecque K, Louckx F (2014) Measuring employment precariousness in the European working conditions survey: the social distribution in Europe. Work 49(1):143–161
Article Google Scholar
Rodgers G (1989) Precarious work in Western Europe. In: Rodgers G, Rodgers J (eds) Precarious jobs in labour market regulation: the growth of atypical employment in Western Europe. International Institute for Labour Studies, Geneva, pp 1–16
Google Scholar
Rönnblad T, Grönholm E, Jonsson J, Koranyi I, Orellana C, Kreshpaj B, Bodin T (2019) Precarious employment and mental health: a systematic review and meta-analysis of longitudinal studies. Scand J Work Environ Health 45(5):429–443
Article Google Scholar
Rosenfield S, Mouzon D (2013) Gender and mental health. In: Aneshensel C, Phelan J, Bierman A (eds) Handbook of the sociology of mental health. Springer, Dordrecht
Google Scholar
Rubery J, Fagan C (1995) Gender segregation in societal context. Work Employ Soc 9(2):213–240
Article Google Scholar
Shahidi F, De Moortel D, Muntaner C, Davis O, Siddiqi A (2016a) Do flexicurity policies protect workers from the adverse health consequences of temporary employment? A cross-national comparative analysis. SSM-Popul Health 2:674–682
Article Google Scholar
Shahidi F, Siddiqi A, Muntaner C (2016b) Does social policy moderate the impact of unemployment on health? A multilevel analysis of 23 welfare states. Eur J Public Health 26(6):1017–1022
Article Google Scholar
StataCorp (2015) Stata statistical software: release 14. StataCorp LP, College Station
Google Scholar
Topp C, Østergaard S, Søndergaard S, Bech P (2015) The WHO-5 well-being index: a systematic review of the literature. Psychother Psychosom 84:167–176
Article Google Scholar
Utzet M, Valero E, Mosquera I, Martin U (2020) Employment precariousness and mental health—understanding a complex reality: a systematic review. Int J Occup Med Environ Health 33(5):569–598
Article Google Scholar
Valero E, Martin U, Bacigalupe A, Utzet M (2021) The impact of precarious jobs on mental health: a gender-sensitive literature review. Int Arch Occup Environ Health 94(4):577–589. https://doi.org/10.1007/s00420-020-01605-7
Article Google Scholar
Van Aerden K, Puig-Barrachina V, Bosmans K, Vanroelen C (2016) How does employment quality relate to health and job satisfaction in Europe? A typological approach. Soc Sci Med 158:132–140
Article Google Scholar
Virtanen M, Kivimäki M, Joensuu M, Virtanen P, Elovainio M, Vahtera J (2005) Temporary employment and health: a review. Int J Epidemiol 34(3):610–622
Article Google Scholar
Vives A, Amable M, Ferrer M, Moncada S, Llorens C, Muntaner C, Benach J (2010) The employment precariousness scale (EPRES): psychometric properties of a new tool for epidemiological studies among waged and salaried workers. Occup Environ Med 67(8):548–555
Article Google Scholar
Vives A, González F, Moncada S, Llorens C, Benach J (2015) Measuring precarious employment in times of crisis: the revised employment precariousness scale (EPRES) in Spain. Gac Sanit 29(5):379–382
Article Google Scholar
Vives A, González-López F, Solar O, Bernales-Baksai P, González MJ, Benach J (2017) Precarious employment in Chile: psychometric properties of the chilean version of Employment Precariousness Scale in private sector workers. Cad Saude Publ 33:e00156215
Google Scholar
Vives A, Benmarhnia T, González F, Benach J (2020) The importance of using a multi-dimensional scale to capture the various impacts of precarious employment on health: results from a national survey of Chilean workers. PLoS ONE 15(9):e0238401
Article CAS Google Scholar
Vosko L, MacDonald M, Campbell I (2009) Gender and the contours of precarious employment. Routledge, New York
Book Google Scholar
Weiner E (2010) Market dreams: gender, class, and capitalism in the Czech Republic. University of Michigan Press, Michigan
Google Scholar
White I, Royston P, Wood A (2011) Multiple imputation using chained equations: Issues and guidance for practice. Stat Med 30:377–399
Article Google Scholar
WHO Commission on Social Determinants of Health (2008) Closing the Gap in a Generation: Health Equity through Action on the Social Determinants of Health: Commission on Social Determinants of Health Final. Report World Health Organization, Geneva
Google Scholar
World Health Organization (1998) Wellbeing measures in primary health care/the depcare project. WHO Regional Office for Europe, Copenhagen
Google Scholar
Young M (2010) Gender differences in precarious work settings. Ind Relat 65(1):74–97
Google Scholar

Download references

Acknowledgements

The authors would like to thank Jessie Gevaert and Mireia Bolíbar for their helpful comments on earlier versions of the manuscript, as well as for their methodological advice.

Funding

The research leading to these results was supported by the Spanish Ministry of Science, Innovation and Universities under grant agreement Nº CSO2016-79103R (AEI/FEDER, UE), and by the ICREA Academia program, which financially supports the work of JB. Funders were not involved in the study design, collection, analysis and interpretation of data, in the writing of the manuscript, and in the decision to submit it for publication.

Author information

Authors and Affiliations

ESIMar (Mar Nursing School), Parc de Salut Mar, Universitat Pompeu Fabra-Affiliated, Mar Campus, 08003, Barcelona, Spain
Eva Padrosa & Mireia Julià
SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
Eva Padrosa, Christophe Vanroelen, Joan Benach & Mireia Julià
Research Group On Health Inequalities, Environment, and Employment Conditions Network (GREDS-EMCONET), Department of Political and Social Sciences, Universitat Pompeu Fabra, Barcelona, Spain
Eva Padrosa, Joan Benach & Mireia Julià
Interface Demography (ID), Department of Sociology, Vrije Universiteit Brussel, Barcelona, Spain
Christophe Vanroelen
Faculty of Nursing, University of Toronto, Toronto, Canada
Carles Muntaner
Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
Carles Muntaner
Transdisciplinary Research Group On Socioecological Transitions (GinTrans2), Autonomous University of Madrid, Madrid, Spain
Joan Benach

Authors

Eva Padrosa
View author publications
You can also search for this author in PubMed Google Scholar
Christophe Vanroelen
View author publications
You can also search for this author in PubMed Google Scholar
Carles Muntaner
View author publications
You can also search for this author in PubMed Google Scholar
Joan Benach
View author publications
You can also search for this author in PubMed Google Scholar
Mireia Julià
View author publications
You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by EP. The first draft of the manuscript was written by EP and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Eva Padrosa.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Appendices

Appendix

Appendix 1 Operationalization of the EPRES-E structure.

	Indicator	Operationalisation	Response options
Temporariness	Duration of current contract	Combination of: (a) what type of contract do you have; b) what is the duration of your current contract?	0. Permanent contract
			1. Temporary, > = 1 year
			2. Temporary, no exact duration
			3. Temporary, 6–11 months
			4. Temporary, < 6 months
	Tenure	How many years have you been in your company or organization?	0. More than 10 years
			1. 10–5 years
			2. 5–3 years
			3. 3–1 year
			4. Less than 1 year
Disempowerment	Trade unions	Does a trade union, works council or a similar committee representing employees exist at your organization?	0. Yes
			1. No
			2. Don’t know
	Meetings	Does a regular meeting in which employees can express their views about what is happening in the organization exist at your organization?	0. Yes
			1. No
			2. Don’t know
Vulnerability	Respect of boss	Your immediate boss respects you as a person	0. Strongly agree
			1. Tend to agree
			2. Neither agree nor disagree
			3. Tend to disagree
			4. Strongly disagree
	Fair treatment	You are treated fairly at your workplace	0. Always
			1. Most of the time
			2. Sometimes
			3. Rarely
			4. Never
Exercise of rights	Break when you need it	You can take a break when you wish	0. Always
			1. Most of the time
			2. Sometimes
			3. Rarely
			4. Never
	Hours off for personal matters	Would you say that for you arranging to take an hour or two off during working hours to take care of personal or family matters is…	0. Very easy
			1. Fairly easy
			2. Fairly difficult
			3. Very difficult
Uncertain working times	Schedule unpredictability	Do changes to your working time arrangements occur regularly? If yes, how long before are you informed about these changes?	0. No
			1. Yes, several weeks in advance
			2. Yes, several days in advance
			3. Yes, the day before
			4. Yes, the same day
	Work at short notice	How often have you been requested to come into work at short notice?	0. Never
			1. Less often
			2. Several times a month
			3. Several times a week
			4. Daily
	Working times regularity	Combination of: do you work (a) the same number of hours every day; b) the same number of days every week; c) the same number of hours every week; (d) fixed starting and finishing times?	0. Very high (yes on all)
			1. High (no on at least one)
			2. Medium (no on at least two)
			3. Low (no on at least three)
			4. Very low (no on all)
Wages	Net earnings per month	Net monthly earnings from your main paid job	0. High earnings (more than 1.5 of the median population)^{Footnote 1}
			1. Medium–high earnings (between the median and high earnings)
			2. Medium–low earnings (between the median and low earnings)
			3. Low earnings (less than 0.6 of the median population)
	Net earnings per hour	Combination of: (a) net monthly earnings from your main paid job; b) how many hours do you usually work per week in your main paid job?	0. High earnings (more than 1.5 of the median population)
			1. Medium–high earnings (between the median and high earnings)
			2. Medium–low earnings (between the median and low earnings)
			3. Low earnings (less than 0.6 of the median population)

^aItem discarded after further analysis.

Appendix 2 Characteristics of complete and incomplete cases (European Working Conditions Survey 2015, selected countries^a)

	Overall			Continental			Scandinavian			Anglo-Saxon			Southern			Central-Eastern
	C n = 18435	I n = 4120	χ ²	C n = 7092	I n = 1282	χ ²	C n = 3170	I n = 214	χ ²	C n = 1597	I n = 354	χ ²	C n = 3105	I n = 1199	χ ²	C n = 3471	I n = 1071	χ ²
Gender
Men	8737 (47.40)	1984 (48.16)	–	3445 (48.58)	632 (49.30)	–	1472 (46.45)	100 (46.73)	–	789 (49.44)	171 (48.31)	–	1555 (50.10)	584 (48.71)	–	1476 (42.52)	497 (46.41)	*
Women	9694 (52.60)	2136 (51.84)	–	3646 (51.42)	650 (50.70)		1697 (53.55)	114 (53.27)		807 (50.56)	183 (51.69)		1549 (49.90)	615 (51.29)		1995 (57.48)	574 (53.59)
Age
16–25	1543 (8.37)	358 (8.69)	–	606 (8.54)	124 (9.67)	–	288 (9.09)	45 (21.03)	*	159 (9.96)	36 (10.17)	–	229 (7.38)	71 (5.92)	–	261 (7.52)	82 (7.66)	–
26–35	4152 (22.52)	847 (20.56)		1674 (23.60)	266 (20.75)		614 (19.37)	28 (13.08)		367 (22.98)	71 (20.06)		694 (22.35)	253 (21.10)		803 (23.13)	229 (21.38)
36–45	4942 (26.81)	1146 (27.82)		1872 (26.40)	326 (25.43)		767 (24.20)	38 (17.76)		434 (27.18)	93 (26.27)		973 (1.34)	376 (31.36)		896 (25.81)	313 (29.23)
56–55	5153 (27.95)	1183 (28.71)		1966 (27.72)	384 (29.95)		902 (18.90)	47 (26.17)		429 (26.86)	97 (27.40)		836 (26.92)	366 (30.53)		1020 (29.39)	289 (26.98)
56–64	2645 (14.35)	586 (14.22)		974 (13.73)	182 (14.20)		599 (18.90)	56 (26.17)		208 (13.02)	57 (16.10)		373 (12.01)	133 (11.09)		491 (14.15)	158 (14.75)
Place of birth
Country of residence	16218 (88.55)	3685 (90.16)	*	5962 (84.14)	1094 (85.47)	–	2883 (91.00)	191 (89.25)	–	1344 (84.32)	288 (81.59)	–	2838 (91.43)	1118 (93.32)	*	3191 (94.86)	994 (95.39)	–
Other	2098 (11.45)	402 (9.84)	*	1124 (15.86)	186 (14.53)	–	285 (9.00)	23 (10.75)	–	250 (15.68)	65 (18.41)	–	266 (8.57)	80 (6.68)	*	173 (5.14)	48 (4.61)	–
Educational attainment
Low	2682 (14.58)	630 (15.44)	–	976 (13.79)	207 (16.30)	–	252 (7.96)	32 (14.95)	*	390 (24.62)	99 (28.61)	–	873 (28.15)	238 (19.97)	*	191 (5.51)	54 (5.10)	–
Medium	9107 (49.50)	2047 (50.17)		3830 (54.10)	658 (51.81)		1326 (41.91)	100 (46.73)		422 (26.64)	102 (29.48)		1352 (43.60)	528 (44.30)		2177 (62.76)	659 (62.29)
High	6608 (35.92)	1403 (34.39)		2273 (32.11)	405 (31.89)		1586 (50.13)	82 (38.32)		772 (48.74)	145 (41.91)		876 (28.25)	426 (35.74)		1101 (31.74)	345 (32.61)
Mental health
Good	15460 (83.86)	3434 (83.35)	–	5920 (83.47)	1095 (85.41)	–	2748 (86.69)	179 (83.64)	–	1254 (78.52)	287 (81.07)	–	2715 (87.44)	1015 (84.65)	*	2823 (81.33)	858 (80.11)	–
Fair	2975 (16.14)	686 (16.65)	–	1172 (16.53)	187 (14.59)	–	422 (13.31)	35 (6.36)	–	343 (21.48)	67 (18.93)	–	390 (12.56)	184 (15.35)	*	648 (18.67)	213 (19.89)	–

C Complete cases, I Incomplete cases. χ² Chi-squared test
*p value < 0.005
^aCountries included: Austria, Belgium, Croatia, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland and the UK

Appendix 3 Multilevel models of mental health, complete case analysis (European Working Conditions Survey 2015, selected countries^a)

	M0		M1		M2		M3		M4
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI	OR	95% CI
Men
Fixed effects
Intercept	0.14	(0.13–0.16)	0.04	(0.04–0.16)	0.04	(0.03–0.06)	0.03	(0.01–0.10)	0.03	(0.01–0.10)
EPRES-E
Q1	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Q2	–	–	1.39	(1.16–1.67)	1.39	(1.60–1.67)	1.39	(1.16–1.67)	1.41	(1.08–1.85)
Q3	–	–	1.94	(1.63–2.33)	1.94	(1.62–2.32)	1.94	(1.62–2.32)	1.77	(1.35–2.32)
Q4	–	–	3.20	(2.68–3.81)	3.16	(2.66–3.77)	3.17	(2.66–3.78)	3.03	(2.34–3.92)
Age	–	–	1.01	(1.01–1.02)	1.01	(1.01–1.02)	1.01	(1.01–1.02)	1.01	(1.01–1.02)
Place of birth
Country of residence	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Other	–	–	0.95	(0.80–1.13)	0.95	(0.80–1.13)	0.94	(0.79–1.12)	0.95	(0.80–1.13)
Educational attainment
Low	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Medium	–	–	1.03	(0.86–1.21)	1.02	(0.87–1.20)	1.02	(0.87–1.20)	1.01	(0.86–1.18)
High	–	–	1.10	(0.92–1.32)	1.10	(0.92–1.31)	1.10	(0.92–1.31)	1.10	(0.91–1.30)
Welfare state
Continental	–	–	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Scandinavian	–	–	–	–	0.79	(0.56–1.09)	0.82	(0.54–1.24)	0.68	(0.40–1.14)
Anglo-Saxon	–	–	–	–	1.29	(0.86–1.93)	1.41	(0.85–2.34)	1.44	(0.78–2.65)
Southern	–	–	–	–	0.76	(0.55–1.07)	0.78	(0.44–1.37)	0.98	(0.51–1.89)
Central-Eastern	–	–	–	–	1.02	(0.75–1.38)	1.16	(0.62–2.16)	0.81	(0.37–1.77)
EPRES-E*Welfare states
Q2*Scandinavian	–	–	–	–	–	–	–	–	1.11	(0.66–1.87)
Q2*Anglo-Saxon	–	–	–	–	–	–	–	–	0.94	(0.54–1.62)
Q2*Southern	–	–	–	–	–	–	–	–	0.69	(0.40–1.20)
Q2*Central-Eastern	–	–	–	–	–	–	–	–	1.31	(0.70–2.44)
Q3*Scandinavian	–	–	–	–	–	–	–	–	1.39	(0.83–2.34)
Q3*Anglo-Saxon	–	–	–	–	–	–	–	–	1.14	(0.67–1.93)
Q3*Southern	–	–	–	–	–	–	–	–	0.82	(0.48–1.38)
Q3*Central-Eastern	–	–	–	–	–	–	–	–	1.52	(0.85–2.73)
Q4*Scandinavian	–	–	–	–	–	–	–	–	1.39	(0.84–2.31)
Q4*Anglo-Saxon	–	–	–	–	–	–	–	–	0.87	(0.53–1.44)
Q4*Southern	–	–	–	–	–	–	–	–	0.75	(0.46–1.21)
Q4*Central-Eastern	–	–	–	–	–	–	–	–	1.54	(0.89–2.69)
Random effects
Intercept	0.07	(0.03–0.14)	0.07	(0.04–0.16)	0.05	(0.02–0.12)	–	–	–	–
EPRES-E	–	–	–	–	–	–	0.03	(0.02–0.11)	0.04	(0.02–0.10)
Covariance	–	–	–	–	–	–	–	–	0.04	(0.01–0.08)
Women
Fixed effects
Intercept	0.17	(0.15–0.19)	0.07	(0.05–0.09)	0.07	(0.05–0.10)	0.06	(0.03–0.12)	0.03	(0.01–0.09)
EPRES-E
Q1	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Q2	–	–	1.20	(1.02–1.42)	1.20	(1.04–1.41)	1.20	(1.02–1.41)	1.09	(0.84–1.47)
Q3	–	–	1.62	(1.38–1.90)	1.61	(1.51–1.89)	1.62	(1.38–1.90)	1.32	(1.03–1.68)
Q4	–	–	2.39	(2.04–2.80)	2.38	(2.51–2.79)	2.39	(2.04–2.80)	2.03	(1.61–2.56)
Age	–	–	1.01	(1.01–1.02)	1.01	(1.01–1.02)	1.01	(1.01–1.02)	1.01	(1.01–1.02)
Place of birth
Country of residence	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Other	–	–	0.95	(0.81–1.11)	0.95	(0.78–1.11)	0.94	(0.80–1.10)	0.94	(0.81–1.10)
Educational attainment
Low	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Medium	–	–	0.89	(0.77–1.04)	0.89	(0.73–1.03)	0.89	(0.77–1.04)	0.88	(0.76–1.03)
High	–	–	1.05	(0.90–1.23)	1.05	(0.89–1.22)	1.05	(0.90–1.23)	1.06	(0.90–1.23)
Welfare state
Continental	–	–	–	–	(ref)	(ref)	(ref)	(ref)	(ref)	(ref)
Scandinavian	–	–	–	–	0.91	(0.53–1.31)	0.79	(0.51–1.22)	0.70	(0.42–1.17)
Anglo-Saxon	–	–	–	–	1.17	(0.58–1.84)	1.58	(0.91–2.73)	1.32	(0.68–2.56)
Southern	–	–	–	–	0.86	(0.49–1.24)	1.12	(0.62–1.99)	0.91	(0.46–1.78)
Central-Eastern	–	–	–	–	1.09	(0.68–1.52)	1.94	(0.99–3.80)	1.18	(0.55–2.55)
EPRES-E*Welfare states
Q2*Scandinavian	–	–	–	–	–	–	–	–	1.07	(0.69–1.66)
Q2*Anglo-Saxon	–	–	–	–	–	–	–	–	1.07	(0.60–1.91)
Q2*Southern	–	–	–	–	–	–	–	–	1.27	(0.75–2.15)
Q2*Central-Eastern	–	–	–	–	–	–	–	–	1.45	(0.87–2.42)
Q3*Scandinavian	–	–	–	–	–	–	–	–	1.25	(0.81–1.91)
Q3*Anglo-Saxon	–	–	–	–	–	–	–	–	1.18	(0.69–2.02)
Q3*Southern	–	–	–	–	–	–	–	–	1.43	(0.87–2.33)
Q3*Central-Eastern	–	–	–	–	–	–	–	–	1.89	(1.16–3.05)
Q4*Scandinavian	–	–	–	–	–	–	–	–	1.10	(0.72–1.68)
Q4*Anglo-Saxon	–	–	–	–	–	–	–	–	1.34	(0.82–2.20)
Q4*Southern	–	–	–	–	–	–	–	–	1.15	(0.71–1.85)
Q4*Central-Eastern	–	–	–	–	–	–	–	–	1.79	(1.13–2.84)
Random effects
Intercept	0.07	(0.04–0.14)	0.08	(0.04–0.16)	0.07	(0.04–0.14)	–	–	–	–
EPRES-E	–	–	–	–	–	–	0.06	(0.03–0.12)	0.06	(0.03–0.12)
Covariance	–	–	–	–	–	–	–	–	0.06	(0.01–0.10)

M0: intercept-only. M1: individual-level variables. M2: M1 + country-level variable. M3: M2 + random slope for EPRES-E. M4: M3 + interaction term
Significant results (p < 0.05) are in bold
^aCountries included: Austria, Belgium, Croatia, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Lithuania, Luxembourg, the Netherlands, Norway, Poland, Portugal, Slovakia, Slovenia, Spain, Sweden, Switzerland and the UK

Rights and permissions

Reprints and permissions

About this article

Cite this article

Padrosa, E., Vanroelen, C., Muntaner, C. et al. Precarious employment and mental health across European welfare states: a gender perspective. Int Arch Occup Environ Health 95, 1463–1480 (2022). https://doi.org/10.1007/s00420-022-01839-7

Download citation

Received: 05 November 2021
Accepted: 22 January 2022
Published: 10 February 2022
Issue Date: September 2022
DOI: https://doi.org/10.1007/s00420-022-01839-7

Keywords

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Precarious employment and mental health across European welfare states: a gender perspective