Table 2.
| Main findings for studies examining gender differences | |||||
|---|---|---|---|---|---|
| Author, country | Statistical methods | Health measures | Findings | ||
| General health | Mental health | Mortality | |||
| Fiori et al.,26 Italy | Linear regression models | Mental Health Inventory (derived from the SF-36) | – |
Males who reported having the worst mental health were those in atypical employment (B = 2.763), self-employed (B = 2.317), and employed under a fixed-term contract (B = 1.684). Among more educated men, those in a less secure position (Fixed-term: B = 3.789; Atypical: B = 4.498) had a statistically significant higher risk of poor mental health than men in permanent employment. Females who had a fixed-term contract had poorer mental health (B = 2.547), among highly educated women those in fixed-term employment were at a greater risk of poor mental health (B = 2.547). |
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| Julià et al.,28 Spain | Poisson regression models/adjusted prevalence rate ratios. Adjusted for age, social class, education status, place of birth, company tenure, and job insecurity. | Mental health inventory (derived from the SF-36) | – | Overall, temporary workers had poorer mental health than permanent workers. However, the association with poor mental health was unexpectedly stronger in permanent workers with high precariousness (aOR = 2.97, 95% CI = 2.25–3.92 in males, aOR = 2.50, 1.70–3.67 in females) than in temporary workers (aOR = 2.17, 95% CI = 1.59–2.96 in males, aOR = 1.81, 95% CI = 1.17–2.78 in females). | – |
| Kachi et al.,35 Japan | Cox proportional hazard ratio (HR) models | K-6 self-rated scale (6 questions, ⩾14 used as cut-off to define Serious Psychological Distress) | – | Exposure to precarious employment in males was associated with a higher risk of serious psychological distress (adjusted HR = 1.79; 95% CI = 1.28–2.51) and was more pronounced in males who were continually employed in precarious arrangements (adjusted HR = 2.32; 95% CI = 1.59–3.40)). In females, there were no statistically significant observations between serious psychological distress and exposure to precarious employment (adjusted HR = 0.96; 95% CI = 0.72–1.29). | – |
| Khlat et al.,38 France | Cox survival regression/adjusted hazard ratios (HR) | Death (all-cause, non-violent causes, cardiovascular disease, cancer, violent causes) | – | – | In males, compared to permanent workers, temporary workers had higher all-cause mortality (adjusted HR = 2.21; 95% CI = 1.16–4.24), non-violent mortality (adjusted HR = 2.22; 95% CI = 1.12–4.40), in particular cardiovascular mortality (adjusted HR = 3.56; 95% CI = 1.02–12.44). There was no significant difference for all-cause mortality observed in females (adjusted HR = 1.28; 95% CI = 0.45–3.62). |
| Kim et al.,36 South Korea | Multivariate logistic regression | Centers for Epidemiologic Studies Depression Scale (11-question version) | – | In both males and females, continual precarious employment showed no association with new-onset of depressive symptoms (Males: aOR = 1.59; 95% CI = 0.90–2.81; Females: aOR = 1.50; 95% CI = 0.69–3.25). In females, new-onset depressive symptoms were higher in any employment transitions that included precarious employment (permanent-precarious: aOR = 2.88; 95% CI = 1.24–6.66; precarious-permanent: aOR = 2.57; 95% CI = 1.20–5.52). These observations were not statistically significant in males (permanent-precarious: aOR = 1.19; 95% CI = 0.57–2.50; precarious-permanent: aOR = 0.76; 95% CI = 0.39–1.46). |
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| Minelli et al.,29 Italy | Fixed effects ordered logit model | SALUT (5-point Likert scale. Ranging from 1–‘very poor’ to 5–‘excellent’. | Self-reported health scores were lower in male temporary workers (compared to permanent employees) aged 15–40 years, but not females. Male first-job seekers were also observed to have lower self-reported health scores. | – | – |
| Niedhammer et al.,37 France | Hazard ratios (adjusted for SES, age, lifestyle factors, work conditions, social support) | Premature mortality (death before the age of 70 years), all-cause mortality, total mortality. | – | – | In temporary workers, premature mortality was adjusted HR = 1.80 (95% CI = 1.24–2.63) times higher than in permanent employees. This observation was far more pronounced in males (adjusted HR = 2.23; 95% CI = 1.42–3.51) than females (adjusted HR = 1.11; 95% CI = 0.56–2.20). |
| Pirani and Salvini,31 Italy | Marginal structural model (adjusted for age, marital status, area of residence, education, financial situation, occupation, pre-existing condition) | Poor self-rated health combined of ‘very poor’, ‘poor’ and ‘fair’ responses. (WHO suggested question ‘How is your health in general?’). | In females, compared to permanent employment, poor self-rated health greater in temporary contracts (aOR = 4.95; 95% CI = 2.10–11.69). This observation was present in transitions from permanent–temporary (aOR = 5.56; 95% CI = 1.86–16.61) and consistently temporary (aOR = 4.28; 95% CI = 1.83–10.02). In males, none of these observations were statistically significant. Poor SRH in temporary employment compared to permanent (aOR = 2.06; 95% CI = 0.76–5.57). | – | – |
| Richardson et al.,34 Australia | Random effects panel model | Mental Health Inventory (derived from the SF-36). | – | This study found almost no evidence that flexible employment harms mental health. Among the employed, only males educated to diploma level employed either fixed-term full-time (coefficient: −2.479) or part-time (coefficient: −0.928) has lower mental health scores. | – |
| Samuelsson et al.,30 Sweden | Multiple linear regression | GHQ–six-item version. | One significant interaction was observed; gender moderated the association between temporary employment and poor SRH. Stratified analyses (by gender) indicated that temporary employment was significantly associated in males (β = 0.11, p < .05) but not females (β = −0.05, NS). | – | – |
| Sidorchuk et al.,27 Sweden | Crude and adjusted odds ratios (aOR). Adjusted for socioeconomic position, disposable family income, and survey year. | GHQ-12. Below 3 good mental health, ⩾3 poor mental health |
– | When compared to permanently employed counterparts, the odds of experiencing psychological distress was higher in males (aOR = 1.35; 95% CI = 1.15–1.59) than females (aOR = 1.17; 95% CI = 1.05–1.31). | – |
| Sousa et al.,25 Spain | Prevalences, crude and adjusted odds ratios (aOR) | Poor self-rated health combined of ‘very poor’, ‘poor’ and ‘fair’ responses. GHQ-12 (Mental Health). Below 3 good mental health, ⩾3 poor mental health |
In males, poor self-rated health was not strongly influenced by contract arrangements. Compared to Spanish born, permanent workers, females at highest risks of poor self-rated health are foreign-born workers who have been in Spain >3 years with no employment contract (aOR = 4.63; 95% CI = 1.95–10.97) or temporary contract (aOR = 2.36; 95% CI = 1.13–4.91). |
Compared to Spanish born, permanent workers, male foreign-born workers on temporary contracts who have lived in Spain for less than 3 years were at the highest risk of poor mental health (aOR = 1.96; 95% CI = 1.13–3.38). Compared to Spanish born, permanent workers, females at highest risks of poor mental health are foreign-born workers who have been in Spain >3 years with no employment contract (aOR = 1.93; 95% CI = 0.95–3.92). |
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SF-36: Short Form-36 (SF-36) health questionnaire; B: unstandardised coefficient; aOR: adjusted odds ratio; CI: confidence interval; HR: hazard ratio; K6: shortened Kessler Psychological Distress scale; WHO: World Health Organization; SRH: self-rated health; GHQ: General Health Questionnaire; β: standardised beta values; SES: socioeconomic status.