The quality of employment (trajectories) and the mental health and mortality of women and men: Evidence from Belgium and the UK

Increasing attention is now paid to the quality of jobs and employment as work-
related health determinants. Employment precariousness has been linked to
adverse health outcomes, and could contribute to the reproduction of health
inequalities. However, individuals’ relation to the labour market should be
rather understood in terms of ‘careers’ than as ‘jobs’ at discrete moments
in time. Careers, or employment trajectories, are dynamic, and can involve
multiple jobs, spells of employment over time, and for those in more ‘precarious’
trajectories, can result in an accumulation of employment-related risk factors
for health and wellbeing, with possible gender dierences. More longitudinal
studies are therefore needed to situate low employment quality and employment
precariousness within men’s and women’s working lives, and in relation to their
mental health and mortality over a longer follow-up period.
Against this backdrop, this PhD thesis examines the links between the quality
of employment (trajectories) and the mortality and mental health outcomes
of women and men in Belgium and the United Kingdom (UK). The thesis
is composed of four empirical papers and draws on secondary administrative
and survey datasets: the 2001 Belgian census linked to a mortality follow-
up, social security data derived from the Belgian Crossroads Bank for Social
Security, and the UK Household Longitudinal Study (Understanding Society).
The papers apply a variety of quantitative statistical techniques, including
Multichannel Sequence Analysis and Latent Class Analysis, to derive types of
employment arrangements and trajectories in multiple dimensions, as well as
survival and regression analyses, to investigate associated mortality and mental
health outcomes.
Overall, findings from this thesis underline the importance of the quality of
employment as work-related mortality and mental health determinants in both
the UK and Belgium. The thesis highlights the urgent need to consider not
only the quality of employment, but the quality of employment trajectories
from a mental health perspective. Women’s and men’s quality of employment
and their labour market paths can dier quite significantly, as can the mortality
and mental health implications of their employment situation. Finally, in the
UK, low employment quality is shown to be associated with reduced mental
wellbeing more so than with mental ill-health. This points to the importance
of considering multiple dimensions of mental health. Overall, policies wishing
to alleviate labour market and health inequalities should improve the quality
of employment of those in the most precarious jobs on a sustainable basis.