Is Nonstandard Employment Hazardous to Workers' Health Status? A Focus on Special Employment in South Korea

Purpose: Workers in special employment relationship (WSERs) are workers in nonstandard employment arrangements who lack worker protection accorded in standard employment arrangements. This study aimed to describe self-rated health (SRH) and depressive symptoms (DS) among Korean WSERs in comparison to regular wage workers (RWW) and identify associations between working conditions and those outcomes. Methods: In this study, secondary data analysis using the 5th Korean Working Conditions Survey was used. The sample totaled 29,120, including 1,538 WSERs and 27,564 RWWs. Sociodemographic and work-related characteristics were employed as explanatory variables and SRH and DS as dependent variables. Using multiple logistic regression, the determinants of fair/poor SRH and DS were identified. Results: The prevalence rates for fair/poor SRH and DS in WSERs were 25.2% and 28.3%, respectively, and 20.7% and 25.0% in RWWs, respectively. Compared to RWWs, WSERs had 31% (aOR=1.31, 95% CI=1.14~1.49) and 20% (aOR=1.20, 95% CI=1.06~1.36) higher odds of SRH and DS, respectively. Some factors, such as a lack of rest guarantee and sickness presenteeism, had a larger influence in the WSER than in the RWW group. Conclusion: Compared to RWWs, WSERs reported having poorer working conditions and were more likely to report poor general and mental health. Therefore, in Korea, public health policymakers should consider measures to protect the working conditions and health of WSERs, a growing segment of the working population. The study produced new epidemiological evidence regarding the relationships between employment arrangements and health.