The centrality of work to health and well-being is unarguable. In industrialised societies, work consumes the greatest active time in adult life, is the most reliable source of continuous access to adequate income, and provides access to a host of key psychosocial dimensions such as identity, self-esteem and social networks. In Australia and New Zealand, as in other developed countries, the relationship between socioeconomic status (SES) and health has been identified: lower socioeconomic status is consistently associated with poorer health outcomes (National Advisory Committee on Health and Disability 1998; Turrell and Mathers 2000). Given that occupation is a key dimension of SES, at least part of the impact of SES on health is likely to be a reflection of differences in working conditions (Marmot, Siegrist et al. 1999). Moreover, the absence of employment is clearly detrimental to both physical and mental health (Bartley, Ferrie et al. 1999). The significant relationship between work and health overall, well beyond traditional occupational health concerns, is therefore widely accepted.
Worldwide, working life is undergoing major changes. Modern established market economies are increasingly characterised by demands for vastly greater labour market flexibility. They have been marked by rising participation by women, as well as increases in long-term unemployment, in temporary employment and in irregular employment contracts. New Zealand and Australia are similar in this regard: rapid and dramatic changes have occurred over recent years in the organisation of labour, of work and of the work environment. The question is what is the impact on health of the sorts of radical changes in working life that are taking place in modern economies? The present paper takes up this issue. Specifically, the aims of the paper are to:
• provide an overview of what we know about the changes that have taken place in working life in New Zealand and Australia;
• consider the mechanisms by which such changes may exert their influence on health; and
• highlight some key areas where gaps in knowledge are critically undermining our ability to identify important adverse health outcomes due to working life and targets for their prevention.
Changes in structure and conditions of employment
It has been observed that the Australian and New Zealand labour markets share many similar characteristics: participation rates, gender distribution, wage structures and unemployment rates are all comparable (Brosnan and Walsh 1998).