Precarious employment trajectories and health: combining qualitative and quantitative approaches based on a patient cohort to study the association at the population level
Résumé
While the reference to workplace risk factors prevail within the field of occupational health, the major changes in work and employment observed over the last 40 years question the mechanisms through which both work and employment contribute to the shaping of social inequalities in health over the life course. Among these trends, the development of non-standard forms of employment and the substantive part of unemployment, particularly along women working life, invite us to consider precarity of occupational trajectories as a potential determinant of ill health in adulthood and older age.
Based on a qualitative survey conducted among working-class cancer patients, we have built a quantitative classification of employment trajectories according to the accumulation of hazardous working conditions (here, carcinogenic exposures), together with poor employment conditions (job instability, career discontinuity, low-skill jobs, versatility). Based on multiple correspondance analysis followed by hierachical ascending classification, this allowed us to build a typology reflecting some dimensions of precarization of occupational trajectories as observed in France over the last decades. We then applied the same typology to a representatitve sample of the French population aged 40-74 based on the SIP (Santé itinéraire professionnel) national survey which collected extensive information on occupational career and health events over the life course.
The classification showed that women were over-represented among highly precarious trajectories and those who started to work after the 1970’s. Based on the three items of the Mini European Health Module, we found that people with precarious job trajectories more often reported less than good self-perceived health, currently experiencing longstanding illness or health problem, and activity limitation due to health problems. The trend was similar among men and women. We now seek to integrate a gender and historical perspective to further the analysis, while taking into account working conditions as a potential mediating pathway.