ALLIANCE ON CONTINGENT EMPLOYMENT

WORK ORGANIZATION AND HEALTH

For work organization and health stream publications, go to publications

Canadians are facing major changes in the organization of their work. At the same time, our knowledge of the ways in which work makes people healthy - or sick - is transforming. The physical demands of jobs and work environments are increasingly cited as important factors in predicting workplace injuries and illnesses. Researchers are realizing, moreover, that work design, the nature of social interactions in the workplace, and the structure of organizations have significant impacts on the health of workers. The multiple and varied models of work organization confronted by contingent workers necessitates a new approach to occupational health and safety.

The research of this stream involves developing and testing new dimensions of employment uncertainty, exploring the experiences of workers in precarious employment across various sectors; comparing the quality of life of workers in precarious employment with the prototypical full-time permanent job in industry; and examining the impacts of "employment strain" on workers in precarious employment in devising quality of work life indicators; and obtaining clinical health measures for a subset of respondents.

Work Organization and Workers in Precarious Employment

In understanding work related health outcomes, research over the last ten years has placed work organization on a par with exposure to dangerous substances and bio-mechanical risks. Work organization is a complex set of practices that shape the physical and social organization of workplaces. Together, these practices define how people interact with their physical environment and each other. Work organization creates many of the health risks that lead to ill health and injury among workers.

A major breakthrough in our understanding of the relationship between work organization and health evolved from the work of Karasek and Theorell in the 1970s and the 1980s. They developed what has come to be known as the "job strain" model. Subsequent work by Hall and Johnson (1980) expanded the matrix to include a third dimension of social support.

Job strain is defined as the balance between psychological demands of a job (Is work excessive? Are there conflicting demands? Is there time for work? Is it too fast or too hard?) and decision-making power (Do workers have the freedom to make their own decisions? Can they choose how to perform work? Do they have a say on the job? Do they take part in decisions?).

Research based on this model has linked work organization with hypertension, musculoskeletal injuries, migraines and psychological distress. Researchers using the "job strain" model have shown that health problems in general, and specifically high blood pressure and cardiovascular disease, are more common where jobs combine high psychological demands but low decision-making power. Heart disease, for example, is more common amongst over-worked cashiers and line workers than amongst over-worked executives.

To date, research on the job strain model has focused on conventional workplaces. This Community University Research Alliance represents the first attempt to test this model with a large group of workers in precarious employment. These workers face a number of unique work organization characteristics that may contribute to what researchers in this stream have labelled "employment strain":

• Their relationship to their employer is often tenuous.
• They frequently hold multiple jobs involving more than one workplace.
• The instability of contingent work makes them vulnerable to demands for increased workloads.

Researchers in this stream are addressing questions about the quality of life and health impacts of precarious employment through a large-scale survey. Is all precarious employment unhealthy? What are the measurable dimensions of precariousness in the context of work organization and health, and which dimensions have the most adverse health consequences? Does the nature and impact of precariousness differ by sector?