Precarious employment and health: Expanding the Boundaries of Research

The historical deterioration of employment and working conditions in wealthy nations is captured by the concept of precarious employment (PE), which has spurred scholarly and policy interest. A decade after identifying key research gaps, persistent and emerging challenges remain. Although a clear and standardized definition of PE as a social determinant of health already exists, many scholars still struggle to define and operationalize it effectively, obscuring its roots in power relations and social mechanisms. Evidence confirms it as a critical, unequally distributed social determinant of health, disproportionately affecting workers by class, gender, race, and migration status. Yet the structural mechanisms underlying these inequities-such as occupational segregation-remain insufficiently theorized and empirically studied, particularly in low- and middle-income countries (LMICs) where PE often overlaps with informal employment. Intersectional frameworks illustrate how interconnected systems of oppression shape health outcomes, particularly through the syndemic entanglement of precarious work, housing insecurity, and other forms of social precariousness. These dynamics demand broader conceptual and empirical approaches. Spain's recent PRESME Report represents an important step forward, offering a strategic transdisciplinary framework for implementing intersectoral labor and public health policies. Understanding how PE harms health is essential for advancing health equity and guiding evidence-based policy.