Association of Precarious Employment with Unmet Healthcare Needs and Health Checkup Participation.

Abstract

Introduction: Precarious employment (PE) has emerged as a public health concern. This study explored the association between PE and unmet healthcare needs and participation in health checkups.

Methods: This study analyzed data from a nationally representative sample of 12,215 wage workers, comprising a total of 65,405 observations, obtained from the Korean Welfare Panel Study (2008-2022). PE was characterized by insecure employment, inadequate wages, and lack of worker rights, and categorized into quartiles: lowest, low, high, and highest. The study focused on two outcomes: unmet healthcare needs due to financial constraints and non-participation in health checkups over the past year. Robust Poisson regression models were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CIs) under the framework of generalized estimating equations.

Results: Of the respondents, 0.7% reported unmet healthcare needs, while 44.2% did not attend health checkups. Compared with workers in the lowest PE quartile, those in the high and highest PE quartiles had a 5.83-fold (95% CI: 2.73-12.45) and 12.53-fold (95% CI: 5.88-26.70) increase in the prevalence of experiencing unmet healthcare needs, respectively. Similarly, compared to the lowest PE quartile, those in the high and highest PE quartiles had a 2.38-fold (95% CI: 2.26-2.51) and 2.92-fold (95% CI: 2.77-3.08) increase in the prevalence of non-participation in health checkups, respectively.

Conclusion: PE is associated with unmet healthcare needs and non-participation in health checkups. This study underscores the need for policies that improve healthcare access for workers in precarious conditions.