Precarious employment: understanding an emerging social determinant of health

Annu Rev Public Health. 2014:35:229-53. doi: 10.1146/annurev-publhealth-032013-182500.


Employment precariousness is a social determinant that affects the health of workers, families, and communities. Its recent popularity has been spearheaded by three main developments: the surge in "flexible employment" and its associated erosion of workers' employment and working conditions since the mid-1970s; the growing interest in social determinants of health, including employment conditions; and the availability of new data and information systems. This article identifies the historical, economic, and political factors that link precarious employment to health and health equity; reviews concepts, models, instruments, and findings on precarious employment and health inequalities; summarizes the strengths and weaknesses of this literature; and highlights substantive and methodological challenges that need to be addressed. We identify two crucial future aims: to provide a compelling research program that expands our understanding of employment precariousness and to develop and evaluate policy programs that effectively put an end to its health-related impacts.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Economic Recession / statistics & numerical data
  • Employment / methods
  • Employment / psychology*
  • Employment / statistics & numerical data*
  • Epidemiologic Research Design
  • Epidemiologic Studies*
  • Global Health
  • Health Services / statistics & numerical data
  • Health Status
  • Health Status Disparities*
  • Humans
  • Mental Health / statistics & numerical data
  • Politics
  • Public Assistance / statistics & numerical data
  • Social Determinants of Health / statistics & numerical data*