Employment arrangement, job stress, and health-related quality of life.

Objective: We aimed to understand the characteristics of U.S. workers in non-standard employment arrangements, and to assess associations between job stress and Health-related Quality of Life (HRQL) by employment arrangement.

Background: As employers struggle to stay in business under increasing economic pressures, they may rely more on non-standard employment arrangements, thereby increasing the pool of contingent workers. Worker exposure to job stress may vary by employment arrangement. Excessive exposure to stressors at work is considered to be a potential health hazard, and may adversely affect health and HRQL.

Methods: We used the Quality of Worklife (QWL) module which supplemented the General Social Survey (GSS) in 2002, 2006, 2010, and 2014. GSS is a biannual, nationally representative cross-sectional survey of U.S. households that yields a representative sample of the civilian, non-institutionalized, English-speaking, U.S. adult population. The QWL module assesses an array of psychosocial working conditions and quality of work life topics among GSS respondents. We used pooled QWL responses from 2002 to 2014 by only those who reported being employed at the time of the survey. After adjusting for sampling probabilities, including subsampling for non-respondents and correcting for the number of adults in the household, 6005 respondents were included in our analyses. We grouped respondents according to their employment arrangement, including: (i) independent contractors (contractor), (ii) on call workers (on call), (iii) workers paid by a temporary agency (temporary), (iv) workers who work for a contractor (under contract), or (v) workers in standard employment arrangements (standard). Respondents were further grouped into those who were stressed and those who were not stressed at work. Descriptive population prevalence rates were calculated by employment arrangement for select demographic and organizational characteristics, psychosocial working conditions, work-family balance, and health and well-being outcomes. We also assessed the effect of employment arrangement on job stress, and whether job stress was associated with the number of reported unhealthy days and days with activity limitations. These two health and well-being outcomes capture aspects of worker HRQL.

Results: Our results underscored the importance of employment arrangement in understanding job stress and associated worker health and well-being outcomes. Between 2002 and 2014, the prevalence of workers in non-standard employment arrangements increased from 19% to 21%; however, the observed trend did not monotonically increase during that period. Compared with workers in standard arrangements, independent contractors and on call workers were significantly less likely to report experiencing job stress. For workers in standard arrangements and for contractors, we observed significant association between perceived job stress and reported unhealthy days. We observed a similar association for reported days with activity limitations, for workers in standard and temporary arrangements.

Conclusion: The major contribution of our study was to highlight the differences in job stress and HRQL by employment arrangement. Our results demonstrated the importance of studying each of these employment arrangements separately and in depth. Furthermore, employment arrangement was an important predictor of job stress, and compared with non-stressed workers, stressed workers across all employment arrangements reported more unhealthy days and more days with activity limitations.