The Role of Work Arrangements in the Future of Work

The National Institute for Occupational Safety and Health (NIOSH) Future of Work Initiative hosted a webinar to address the role of work arrangements in the future of work. Among the changes anticipated in the Future of Work is an increasing prevalence of nonstandard work arrangements, such as contingent, platform-based, seasonal, on-call, or other “nonstandard” work. There are no commonly accepted definitions for traditional or for nonstandard (also referred to as alternative) work arrangements. This lack of consistency affects the ability of researchers to collect accurate data. Without accurate data, researchers are unable to correctly assess the prevalence of different work arrangements and the relationship between work arrangements and worker well-being. Therefore, it is important to understand the factors influencing work arrangements.

Work Arrangements in the Future of Work

To provide a clearer classification of work arrangements, a two-tiered approach can be used. The first tier is a legal approach to classifying employed, co-employed, and nonemployee workers. The second tier involves important characteristics of all work arrangements that vary by arrangement. These characteristics include pay level and security, benefits, job security, and work schedule.

Recent frameworks and initiatives have aligned this two-tiered approach to work arrangements with job quality elements. Two examples of this work include the NIOSH Healthy Work Design and Well-being (HWD) Program, and the Good Jobs Principles identified by the Department of Labor and Commerce and their partners. Partially overlapping efforts by government, academic, nonprofit, and other organizations are underway to better understand and improve the quality of jobs. These efforts include developing work design conceptual frameworks that specify job quality elements as well as their determinants and outcomes. Typologies may consider factors such as permanence of the arrangement, the relationship between worker and firm, underutilization of labor, increased oversight of work with reduced responsibility for workers, and changes in the quality of work. Understanding the cumulative impact of these changes on worker well-being is important beyond individual work condition.

The challenges of the changing work landscape result from economic uncertainty and the demands of the modern economy. These challenges impact workers’ physical and mental health, as they may struggle with illness or loss of income due to a lack of health insurance or retirement benefits. In the past, workplaces typically provided these benefits for most Americans.^10-11 Another issue is that workers in non-traditional arrangements often have multiple jobs, leading to more time spent commuting, and unpredictable schedules that can affect their and their families’ well-being. ^10,12-13 There is evidence suggesting that the type of work arrangement can impact health^8,14-18. This is partially but not completely due to impacts on health benefits. ^19-21

Changes in employment structure can negatively affect health when:

• there is a big difference between what is expected of us and what we can actually control or achieve, leading to stress-related symptoms and diseases. ²²
• economic insecurity reduces the ability to prioritize one’s health and impacts access to quality healthcare when needed.²³
• there is diffusion of responsibility for workers’ health in alternative work arrangements. Workers tend to take less responsibility or feel less obligated to help or take action when others are present because they assume someone else will step in and do it instead.

Challenges and Next Steps

In the 20^th century, laws and regulations were established to protect workers in traditional jobs where they were formally hired for permanent positions. However, similar protections have not been fully developed for alternative and contingent employment in the same comprehensive manner. ⁹

There are limited data available to analyze different work arrangements and their impact on health. This is due to the separation of statistical agencies focused on labor market and health information, resulting in a lack of comprehensive data. The collection of data on working conditions is done through supplements to surveys rather than a single integrated survey, and some supplements are not regularly administered.²⁴ Efforts have been made to fill these data gaps, but they still have limitations and do not include health measures. Many studies focus on specific working conditions and health outcomes, but few assess comprehensive types of work organization and overall health status. Additionally, most studies are cross-sectional, making it difficult to determine the causal relationship between poor working conditions and poor health.

Further research on the elements of work arrangements is necessary to understand their effects on worker well-being. Research priorities should include:

• Building the evidence base regarding which job elements matter more for which workers.
• Improving data collection to better distinguish among the employed, co-employed, and non-employed.
• Aggregating job quality to the family level to consider earnings, benefits, schedules, and working conditions of multiple workers.
• Assessing the effects of job quality over the span of a working life, considering all jobs held at the same time, the sequence of jobs, and periods of unemployment.
• Collecting data to build the evidence base supporting the case for good job creation as a good investment.

Please view the NIOSH webinar: The Role of Work Arrangements in the Future of Work.

For more information, see other blogs on the Future of Work and Occupational Safety and Health.

Rene Pana-Cryan, PhD, is the NIOSH chief economist and director of the NIOSH Economic Research and Support Office, and co-manager of the Healthy Work Design and Well-Being Cross-Sector Program.

Tapas Ray, PhD, is an economist in the NIOSH Economic Research and Support Office and co-assistant coordinator of the Healthy Work Design and Well-Being Cross-Sector Program.

Edward Yelin, PhD, is the Edward A Dickson Emeritus Professor of Medicine and Health Policy at UCSF.

Molly Leshner, MPH, serves as a Health Communication Specialist and Health Scientist in the Division of Science Integration at NIOSH.

References

1. Tamers SL, Streit J, Pana-Cryan R, et al. Envisioning the future of work to safeguard the safety, health, and well-being of the workforce: A perspective from the CDC’s National Institute for Occupational Safety and Health. Am J Ind Med. 2020;63(12): 1065-1084. https://doi.org/10.1002/ajim.23183
2. Ray TK, Kenigsberg TA, Pana-Cryan R. Employment arrangement, job stress, and health-related quality of life. Safety Science 2017;100(Pt A): 46-56. https://doi.org/10.1016/j.ssci.2017.05.003
3. Howard, J. Nonstandard work arrangements and worker health and safety. Am J Ind Med. 2017;60(1): 1-10. https://doi.org/10.1002/ajim.22669
4. Pana-Cryan R, Howard J, Bushnell T. Nonstandard work arrangements. In: Tetrick LE, Fisher GG, Ford MT, Quick JC, eds. Handbook of Occupational Health Psychology. 3rd ed. American Psychological Association; 2023. https://www.apa.org/pubs/books/handbook-occupational-health-psychology

5. Bhattacharya A, Ray T. Precarious work, job stress, and health-related quality of life. Am Journal Ind Med. 2021;64(4): 310-319. https://doi.org/10.1002/ajim.23223
6. Ray TK, Pana-Cryan R. (2021). Work flexibility and work-related well-being. Int J Environ Research Public Health. 2021;18(6): 3254. https://doi.org/10.3390/ijerph18063254
7. Weil D. Understanding the present and future of work in the fissured workplace context. RSF. 2019;5(5):147-165.
8. Goh J, Pfeffer J, Zenios S. Exposure to harmful workplace practices could account for inequality in life spans across different demographic groups. Health Affairs. 2015;34(10):1761-1768.
9. Cummings KJ, Kreiss K. Contingent workers and contingent health: risks of a modern economy. JAMA. 2008;299(4):448-450.
10. Harvard School of Public Health, National Public Radio, Robert Wood Johnson Foundation. Workplace and Health. 2016.
11. Bureau of Labor Statistics. Employee Benefits in the United States—March 2016. July 22, 2016. 2016. USDL-16-1493.
12. Benach J, Vives A, Tarafa G, Delclos C, Muntaner C. What should we know about precarious employment and health in 2025? Framing the agenda for the next decade of research. Int J Epidemiol. 2016;45(1):232-238.
13. Schneider D, Harknett K. Consequences of routine work-schedule instability for worker health and well-being. Am Sociological Rev. 2019;84(1):82-114.
14. De Moortel D, Vandenheede H, Vanroelen C. Contemporary employment arrangements and mental well-being in men and women across Europe: a cross-sectional study. Int J Equity in Health. 2014;13(1):1-14.
15. Bosmans K, Hardonk S, De Cuyper N, Vanroelen C. Explaining the relation between precarious employment and mental well-being. A qualitative study among temporary agency workers. Work (Reading, Mass.). 2015;53(2):249-264.
16. Van Aerden K, Puig-Barrachina V, Bosmans K, Vanroelen C. How does employment quality relate to health and job satisfaction in Europe? A typological approach. Soc Sci Med. 2016;158:132-140.
17. Grzywacz J, Dooley D. “Good jobs” to “bad jobs”: replicated evidence of an employment continuum from two large surveys. Soc Sci Med. 2003;56(8):1749-1760.
18. Dube A, Kaplan, E. Does outsourcing reduce wages in the low-wage service occupations? Evidence from janitors and guards. Ind Labor Relat Rev. 2010;62(2).
19. Asfaw A, Pana-Cryan R, Rosa R. Paid sick leave and nonfatal occupational injuries. Am J Public Health. 2012;102(9):e59-e64.
20. Asfaw A. Disparities in access to health insurance and workers’ compensation benefit between non-contingent and contingent farm workers in US agriculture. J Health Dispar Res Pract. 2014;7(3):6.
21. DeRigne L, Stoddard-Dare P, Quinn L. Workers without paid sick leave less likely to take time off for illness or injury compared to those with paid sick leave. Health Affairs. 2016;35(3):520-527.
22. Choi BK, Schnall P, Landsbergis P, et al. Recommendations for individual participant data meta-analyses on work stressors and health outcomes: comments on IPD-Work Consortium papers. Scand J Work Environ Health. 2015;41(3):299-311.
23. Yelin E, Trupin L, Yazdany J. A prospective study of the impact of current poverty, history of poverty, and exiting poverty on accumulation of disease damage in SLE. Arthritis Rheumatol. 2017;69(8).
24. Bernhardt A, Thomason S. What do we know about gig work in california? An analysis of independent contracting. UC Berkeley Center for Labor Research and Education; 2017.