Michael Quinlan University of NSW, University of Sydney & Middlesex University How precarious employment damages health: Evidence from Australia (Vulnerable.

Michael Quinlan University of NSW, University of Michael Quinlan University of NSW, University of Sydney & Middlesex UniversitySydney & Middlesex University

How precarious employment How precarious employment damages health: Evidence from damages health: Evidence from

AustraliaAustralia(Vulnerable workers, precarious work: a global (Vulnerable workers, precarious work: a global

perspective symposium)perspective symposium)

Paper presented to 64Paper presented to 64thth LERA Annual Meeting, Chicago LERA Annual Meeting, Chicago 8 January 20118 January 2011

ContentsContents

Changes to work and OHS effects of Changes to work and OHS effects of

thisthis

How to explain this – four modelsHow to explain this – four models

Explaining the PDR modelExplaining the PDR model

Evidence testing PDR risk factorsEvidence testing PDR risk factors

Testing the model itself – preliminary Testing the model itself – preliminary

resultsresults

Conclusion and referencesConclusion and references

Changes to Work Organisation and Changes to Work Organisation and its health and safety effectsits health and safety effects

Over past 30 years significant changes to Over past 30 years significant changes to work & labour markets including work & labour markets including widespread business restructuring, widespread business restructuring, downsizing & outsourcing, growth of downsizing & outsourcing, growth of temporary and insecure work (and temporary and insecure work (and precarious workforces including precarious workforces including increasingly global contingent labour)increasingly global contingent labour)Matching this shift is mounting evidence Matching this shift is mounting evidence that the changes are having substantial that the changes are having substantial adverse effect on occupational health and adverse effect on occupational health and safety (eg global reviews of downsizing, safety (eg global reviews of downsizing, subcontracting and temporary work – see subcontracting and temporary work – see references)references)

Attempts to explain adverse OHS Attempts to explain adverse OHS effects of precarious employmenteffects of precarious employment

Karasek’s demand/control or job strain Karasek’s demand/control or job strain model (too task focused)model (too task focused)

Siegrist’s effort/reward modelSiegrist’s effort/reward model

Lewchuk’s employment strain model Lewchuk’s employment strain model (includes job search and social support)(includes job search and social support)

Sydney Uni Work Health Team (M. Quinlan, Sydney Uni Work Health Team (M. Quinlan, P Bohle & M. McNamara) PDR model P Bohle & M. McNamara) PDR model (pressure, disorganisation & regulation)(pressure, disorganisation & regulation)

PDR model: Risk factors associated PDR model: Risk factors associated with Insecure and contingent workwith Insecure and contingent work

Effort/Reward Effort/Reward PressuresPressures

DisorganizationDisorganization Regulatory Regulatory FailureFailure

Spill-over Spill-over EffectsEffects

Insecure jobs (fear of losing

job)

Short tenure, inexperience

Poor knowledge of legal rights,

obligations

Extra tasks, workload shifting

Contingent, irregular payment

Poor induction, training &

supervision

Limited access to OHS, workers comp rights

Eroded pay, security,

entitlements

Long or irregular work

hours

Ineffective procedures &

communication

Fractured or disputed legal

obligations

Eroded work quality,

public health

Multiple jobs(may work for

several agencies)

Ineffective OHSMS /

inability to organise

Non-compliance & regulator oversight (stretched resources)

Work-life conflict

Methods

Stratified sample of injured workers• Investigated workers’ compensation claims in Victoria; 198

agency & direct hire matched by occupation & year of injury (1994/95–2000/01)

• Statements from injured workers, witnesses, employers & host supervisors, medical reports

Focus groups and survey of agency workers• 147 surveyed, mostly blue collar• 5 Focus groups in Melbourne & regional Victoria• Mostly blue collar, plus call centres, health sector

Example 1:Underhill study of agency Example 1:Underhill study of agency workers (Rel Ind 66:3 2011)workers (Rel Ind 66:3 2011)

• High levels of employment & income insecurity• Irregular hours (27% of injured workers) & irregular

income (Eg. storeperson – average weekly wage A$276 but ranged from A$105 - $621 over 15 weeks)

• 45% never/rarely had continuity of placements • 32% different hourly wage dependent upon host

• Interchangeable - easily & quickly replaced• Worker asking for 2 days sick leave told he would

be replaced by another worker

Example 1: Explaining the risk - economic Example 1: Explaining the risk - economic and reward pressuresand reward pressures

Work with injuryI kept working and put up with the pain which was worse when I stopped and I

didn’t mention it to anyone at the time as I was concerned my job would be terminated…I needed the money and didn’t want to attract attention by wearing a brace.” (process worker)

Accept work intensificationWe’ve had labour hire guys pass out, working hard…was stifling hot up there

(3rd level, warehouse) …they were under the impression they wouldn’t get hours, so they went flogging themselves then they passed out (storeperson, distribution, focus group)

Perform more hazardous tasks The permanent staff here always get priority on the better shifts…certain jobs are

regarded as easier than others, and the permanent and host casuals get priority on those ahead of the agency… (storeperson, distribution, focus group).

Example 1: Contributing to workplace Example 1: Contributing to workplace risk - economic pressuresrisk - economic pressures

Characteristics of agency workforce and placement Younger workers (more than double direct hire but

older workers injured earlier in a placement too) Lack of familiarity with workplace Inexperienced, inadequate training or

underqualified Poor person-job match Poor communication Undermining of OHS management system

Example 1: Explaining the risk - Example 1: Explaining the risk - disorganisationdisorganisation

When I started my only training with the pump was being shown the on/off switch and the reversing procedure…

Each driver is responsible for the ongoing cleanliness on a daily basis of any fork he is using. While permanent employees of the company use the same forklift each day, casuals can swap and change from one fork to another during the course of the day depending on the type of work being undertaken… (claims investigator).

Example 1: Disorganisation Example 1: Disorganisation examplesexamples

Most examples provided are also examples of lack of compliance

Lack of, poor standard of trainingPlacements involving high risk tasksFailure to respond to OHS issues Dismissal for raising issuesUnderpinned by:

Vulnerability to dismissal – weak employment protectionLarge number of small agencies & ability to avoid prosecutions

Example 1: Regulatory failure - culture Example 1: Regulatory failure - culture of non-complianceof non-compliance

Based on convergent interviews with 30 temporary agency homecare workers (some self-employed) in two regions of South Australia working in

Aged careDisability careTroubled youth

Example 2: Agency workers in Example 2: Agency workers in homecarehomecare

Employment and income irregular (eg if elderly person hospitalised) , unpaid overtime & vulnerable (if try to impose rules lose job)

You might not have work for two or three months. So you You might not have work for two or three months. So you think, I might as well just do this because then there won't be think, I might as well just do this because then there won't be much work. It sort of goes off and on… There's what they call much work. It sort of goes off and on… There's what they call ‘the quiet times’ and that's usually around like Christmas, ‘the quiet times’ and that's usually around like Christmas, January. And then it sort of starts picking up.January. And then it sort of starts picking up. (Adelaide, female (Adelaide, female #1)#1)

You don’t always get in to a place at nine o’clock and walk out You don’t always get in to a place at nine o’clock and walk out the door at 10:30, on an hour and a half job for instance. the door at 10:30, on an hour and a half job for instance. Because you potentially need to meet other needs than just Because you potentially need to meet other needs than just what’s written on the sheet in terms of what you’re doing as a what’s written on the sheet in terms of what you’re doing as a support work… You have to attend to the person’s emotional support work… You have to attend to the person’s emotional needs as well…needs as well… (Adelaide, male #4) (Adelaide, male #4)

‘‘As far as conditions go, there are no conditions. We have no As far as conditions go, there are no conditions. We have no holiday pay. We have no sick pay. We have no superannuation. holiday pay. We have no sick pay. We have no superannuation. We have no insurance. All those things we have to provide We have no insurance. All those things we have to provide ourselves’ourselves’ (Barossa, female #6) (Barossa, female #6)

Example 2: Economic and reward Example 2: Economic and reward pressurespressures

Identified problems with risk assessment, management systems & rules (some impractical eg mobile numbers), training (amount & quality), poor design etc

We were put at risk… our safety was at risk. We would be put We were put at risk… our safety was at risk. We would be put in motel rooms with violent children that couldn’t be placed in in motel rooms with violent children that couldn’t be placed in foster care, and we had no training… Basically, they gave us no foster care, and we had no training… Basically, they gave us no formal training.formal training. (Adelaide, female #2) (Adelaide, female #2)

You can pick up the kid at any given time when they phone You can pick up the kid at any given time when they phone you… and they’ll fail to give you some information which could you… and they’ll fail to give you some information which could be, you know – the child has sexualised behaviours, the child be, you know – the child has sexualised behaviours, the child needs medication, the child this and that… And there’s no risk needs medication, the child this and that… And there’s no risk assessment. It’s, pick the ball up and run with it and hopefully assessment. It’s, pick the ball up and run with it and hopefully you don’t fall over. you don’t fall over. (Adelaide, male #3)(Adelaide, male #3)

Probably the most risky place to work in people’s homes is Probably the most risky place to work in people’s homes is usually the bathroom: slippery floors, dealing with unsteady usually the bathroom: slippery floors, dealing with unsteady clients, dealing with taps that aren’t set up for people or shower clients, dealing with taps that aren’t set up for people or shower heads that aren’t set up for people with a disability.heads that aren’t set up for people with a disability. (Barossa, (Barossa, female #3)female #3)

Example 2: DisorganisationExample 2: Disorganisation

OHS regulators only beginning to address homecare, (limited guidance material, inspection & enforcement) & low unionisation, industry fragmented

No workers’ compensation whatsoever. If you hurt No workers’ compensation whatsoever. If you hurt yourself, it’s your responsibility. You need to have yourself, it’s your responsibility. You need to have income insurance as a self-employed contractor, income insurance as a self-employed contractor, otherwise you get nothing… But as an employee, otherwise you get nothing… But as an employee, there’s workers compensation.there’s workers compensation. (Adelaide, female #4) (Adelaide, female #4)

If the agency moved in and tried to change everything If the agency moved in and tried to change everything to suit the contractor, [the client would] either drop out to suit the contractor, [the client would] either drop out of the service or go and find somebody else. So it's all of the service or go and find somebody else. So it's all pretty low key… Yes, they were turning a blind eye... pretty low key… Yes, they were turning a blind eye... Really, people are screaming out just to get a bit of Really, people are screaming out just to get a bit of respite.respite. (Barossa, male #2) (Barossa, male #2)

Example 2: Regulatory failureExample 2: Regulatory failure

Representative population sample conducted in 2009 by phone using phase 1 of PDR model (phase 2 used in second survey undertaken in 2011)

Phase 2 PDR model has better measures of disorganisation and regulatory failure

841 in paid employment (subdivided into temporary employed, ongoing employed & self employed)

Predictive efficacies of PDR and ERI models in relation to work-life conflict & health(SF12), were compared, controlling for demographic variables and working hours

Example 3: Survey of 1541 older Example 3: Survey of 1541 older Australians (45-65 years)Australians (45-65 years)

Significant differences between 3 employment groups in terms of health & work-life conflict (but also independent measure of precariousness) PDR & ERI both predictive & independentWhen mental health was predicted by the elements of PDR, ERI and employment status, the significant predictors in the final model were: gender *, working hours*, reward pressure**, financial pressure***, and work-life conflict***(R²=.16).When work-life conflict was predicted by the elements of PDR, ERI and employment status, the significant predictors in the final model were: age**, gender*, working hours***, reward pressure***, financial pressure***, and ERI*** (R²=.30).

* p< .05, ** p<.01, *** p<.001* p< .05, ** p<.01, *** p<.001

Example 3: Survey of 1541 older Example 3: Survey of 1541 older workers (45-65 years): Findingsworkers (45-65 years): Findings

Overall conclusionOverall conclusionSubstantial research links precarious employment to poor OHS outcomes but still trying to understand how this occursModel building in early stagesBoth Lewchuk model and PDR (defining precariousness?) suggest not just employment status but relationship of this to other factors (eg interaction with living conditions & spill-over effects)PDR model is multi-factorial (but related) and evidence to support this approachPDR model appears to have elements of ERI but operates independentlyNeed further refinement, international collaborative studies and constructive engagement re model developmentAlso need to use multiple research methods (not just surveys, cohort studies or longitudinal panel data). Qualitative data useful too

Some referencesSome referencesQuinlan, M. & Bohle, P. (2008) Under pressure, out of control or home Quinlan, M. & Bohle, P. (2008) Under pressure, out of control or home alone? Reviewing research and policy debates on the OHS effects of alone? Reviewing research and policy debates on the OHS effects of outsourcing and home-based work, outsourcing and home-based work, International Journal of Health International Journal of Health ServicesServices, 38(3): 489-525. , 38(3): 489-525.

Lewchuk, W., Clarke, M. & de Wolff, A. (2008). ‘Working without Lewchuk, W., Clarke, M. & de Wolff, A. (2008). ‘Working without commitments: precarious employment and health’, commitments: precarious employment and health’, Work, employment & Work, employment & societysociety, 22(3): 387-406., 22(3): 387-406.

Quinlan, M. & Bohle, P. (2009), Over-stretched and Unreciprocated Quinlan, M. & Bohle, P. (2009), Over-stretched and Unreciprocated Commitment: Reviewing research on the OHS effects of downsizing and Commitment: Reviewing research on the OHS effects of downsizing and job insecurity job insecurity International Journal of Health ServicesInternational Journal of Health Services 39(1): 1-44. 39(1): 1-44. Bohle, P., Finn, J., Quinlan, M. & Rawlings-Way, O. (2009) Bohle, P., Finn, J., Quinlan, M. & Rawlings-Way, O. (2009) A Report on A Report on the Occupational Health and Safety of Homecare Contract Workers in the Occupational Health and Safety of Homecare Contract Workers in Adelaide and the Barossa Region. Adelaide and the Barossa Region. A report prepared for The South A report prepared for The South Australian Office of the Employee Ombudsman. University of Sydney.Australian Office of the Employee Ombudsman. University of Sydney.Underhill, E. and Quinlan, M. (2011) HUnderhill, E. and Quinlan, M. (2011) How precarious employment affects ow precarious employment affects health and safety at work: the case of temporary agency workers. health and safety at work: the case of temporary agency workers. Relations IndustriellesRelations Industrielles 66(3):397-421. 66(3):397-421.