Chapter 3

Health and wellbeing impacts

3.1
This chapter presents evidence received on the detrimental impacts of insecure work on individuals and their relationships, families, and society.
3.2
It looks at impacts on physical health, mental health, wellbeing and relationships, in addition to considering the relationship between job security and levels of alcohol and drug abuse, and the risk and incidence of suicide, depression, and suicidal ideation.
3.3
The chapter then addresses proposals for reducing the mental and emotional harms created by insecure work, and their impacts on physical health and wellbeing, and social and economic inclusion.
3.4
The chapter concludes with the committee's views and recommendations.

Job insecurity has powerful negative impacts

3.5
A number of submitters gave expert testimony as to the harms associated with insecure work.
3.6
Emeritus Professor Michael Quinlan FASSA, from the Industrial Relations Research Group at the University of NSW, and Dr Elsa Underhill from Deakin University, submitted that there is over 25 years' worth of research and evidence on the association between insecure work and occupational health and safety (OHS)—including many Australian studies. The findings of this research are remarkably consistent—that the effects of insecure work 'are pervasive and overwhelmingly negative'.1 The same conclusion has been reached by a number of international bodies, including the World Health Organisation in its 2007 report, Employment Conditions and Health Inequalities.2
3.7
According to Professor Quinlan and Dr Underhill, the major 'negative health and safety outcomes' associated with insecure work arrangements, compared with full-time permanent jobs, are:
(1)
Higher incidence/frequency of injuries, including fatalities
(2)
Poorer physical and mental health (including susceptibility to bullying and drug use); and
(3)
Poor knowledge of and access to regulatory employment rights and less willingness to raise OHS concerns.3
3.8
In a combined submission, Professor Tony LaMontagne from the Institute for Health Transformation at Deakin University, and Dr Tania King and Ms Yamna Taouk from the Melbourne School of Population and Global Health, described job security and unemployment as 'powerful determinants of socioeconomic, health and wellbeing outcomes'.4
3.9
The authors pointed out that the impacts of unemployment are more easilyrecognised than the impacts of insecure employment. This is evident in the way that social and economic supports—such as the JobSeeker payment—have been put in place to assist the unemployed. However, despite its 'powerful' negative impacts on individuals, relationships, families and society, job insecurity tends to be 'a socially invisible phenomenon', and there are 'very few policy responses or institutionalised supports' in place to address it.5
3.10
Professor LaMontagne, Dr King and Ms Taouk argued it is possible the adverse 'health burden' linked to job insecurity may even exceed that linked to unemployment—it certainly impacts a greater proportion of workers
(15–25 per cent, as opposed to 4–5 per cent). The authors concluded that the health and wellbeing impacts of job insecurity warrant 'at least commensurate policy and practice attention'.6
3.11
To better understand who is impacted by job insecurity, and how, Professor LaMontagne, Dr King and Ms Taouk drew together research from numerous experts in Australia and around the world. They presented evidence from two large working population data studies which demonstrated that:
males report 'slightly higher levels' of job insecurity compared to females;
casual and labour hire workers report the highest levels of job insecurity;
the 'lowest skilled workers' report 'the highest levels of insecurity';
non-Australian-born workers report higher insecurity than Australian-born workers;
there was 'a sharp increase in job insecurity' in 2008, during the Global Financial Crisis (GFC); and
job insecurity 'exposure also varies over time within persons'.7
3.12
The Australian Medical Association (AMA) submitted that job insecurity is 'a significant stressor' associated with 'a range of negative health outcomes', and that insecure work 'further exacerbates existing levels of social and economic disadvantage'. The AMA added that improving job security 'can lead to improvements in health equity'.8
3.13
Key health effects of insecure work, according to the AMA, are:
stress and anxiety resulting from uncertainty about future work;
an increased likelihood of psychological distress and psychiatric morbidity;
a higher risk of coronary heart disease;
higher incidences of high cholesterol and hypertension; and
feeling unable to report injuries or accidents suffered in the workplace.9
3.14
The AMA pointed out that rates of insecure work in Australia are 'higher' for those cohorts that are already socially and economically disadvantaged, 'including women, young people, Aboriginal and Torres Strait Islander peoples, migrants and people with a disability'—meaning 'disadvantage is both a predictor of insecure work and exacerbated by insecure work'.10
3.15
Dr Antonio Di Dio from the AMA told the committee that the impacts of insecure work on a person's health is 'a cradle-to-grave kind of situation' and leads to higher incidence of physical and mental disease:
… for the majority … who simply have no option but to accept casualised work on a long-term basis, they have a far higher incidence of presentations with generalised and specific anxiety disorders, with mild to moderate to progressive depression, but also risk factors for physical disease. The biggest killer in this country, which is cardiovascular disease, whether it's in the form of heart attacks, strokes, or diabetes related vascular disease. There is objective evidence—and also lots of anecdotal evidence—that people who have more casualised work have higher rates and incidents of all of those illnesses.11
3.16
A key concern among submitters was the link between job insecurity and suicide—especially for men. According to Suicide Prevention Australia, global research looking at suicide rates, population, and economic data, has found the rate of suicide for unemployed people is 'nine times that of the general population'.12
3.17
MATES in Construction—an organisation established to help prevent and respond to suicide in the construction industry—submitted that the construction sector has 'one of the highest occupational suicide rates in the country',13 and this is 'linked to job insecurity'. In a sector characterised by 'multilevel contracting arrangements', few workers have secure fulltime jobs. Most workers are employed through tiered subcontracting arrangements, 'having to start the search for the next job as each new job is started'.14

Box 3.1:   'Chris'—insecure work and COVID-related disruptions

'… I was out of work till November starting yet another casual position that lasted till Easter 2021.
I was off again till May and another casual position that finished early July.
I had just got word that the metro was about to start when the NSW government decided to wait till there where 30 or more [COVID-19] infections before locking down. This as you know led to 27 new infections a day.
So I once again find myself unemployed. I have run through all my savings and have not had any assistance from the government.
The most annoying thing is I was just about to start the metro project that I'd been waiting so long for.
The way COVID has been handled in this county and the roll out of much needed vaccinations has been a total failure.
This is just one experience. I know so many others in Australia are struggling with no pay or under pay and the tragedy of the people who've lost lives and loved ones.'15
3.18
According to MATES in Construction, job insecurity is a 'contributing factor' in many of the deaths in the sector each year, with more than 50 per cent of calls to the MATES 24/7 Helpline concerning workers' 'lack of job security':
This is consistent with research which has shown that job insecurity leads to an increase [in] the risk of occupational stress that may be involved in suicide. Where a prevalence of non-permanent positions which impact on job security, have also been suggested as contributing factors for suicide within the construction industry.16
3.19
Stresses associated with the COVID-19 pandemic have exacerbated the situation, according to MATES in Construction; with lockdowns leading to further job insecurity, as well as the impacts of travel-related stress and testing regimes.17
3.20
MATES in Construction was concerned that specific factors relating to the composition of the construction workforce may make it especially vulnerable to a heightened suicide risk 'during and after COVID-19':
These are gender; lack of help seeking; younger workforce; low socioeconomic position. In addition, there are what is termed contextual drivers. These are gaps in social security protection due to the informal and insecure nature of some construction work; high workforce mobility; limited job control; unemployment; masculine norms. These factors can contribute to a risky environment for mental health or suicidality, especially in the face of a pandemic and its social and economic consequences.18
3.21
These fears appeared to be founded, as MATES in Construction saw call rates 'go up through COVID', with an increase of over 40 per cent recorded by September 2021. National Chief Executive Officer, Mr Chris Lockwood observed that 'being employed actually added stress' early on in the pandemic, as construction workers felt anxious about going to work and risking the health and safety of their families: 'We are expecting some of the real impacts to still be coming down the track in terms of how it is going to impact on the individuals working in the industry.'19
3.22
Professor Quinlan and Dr Underhill were also concerned about the potential immediate and long-term impacts of the pandemic on those in insecure work, saying lessons could be learned from 'previous business cycle downturns/crashes like the [Global Financial Crisis] GFC'. Health impacts from the GFC were 'significant and long-term in both rich and poor countries', the authors submitted, 'compounding existing health inequities' and increasing suicides—particularly amongst 'lower class occupations':
Given the pandemic far outweighed even the GFC in scale it is logical to presume its effects will be even more profound. Even as the Australian economy bounces back it is unlikely to be a return to the prior economy and labour market. The uncertainty the pandemic created is likely to affect business employment decisions for years and may well include an even greater preference for insecure work arrangements, with consequent negative outcomes for OHS.20

Box 3.2:   'Gary'—over-worked and needs a break

'… Positions are not being filled. Either contractors or overtime is used to cover job shortages. This is destroying family life and causing burn out due to workers being unable to have a proper break/ holiday due to being locked down.
I have already had two years' worth of holidays restricted to my home. I need to recharge by getting to go to a beach etc. Current situations are leading to family break downs and mental health issues.'21

Impacts on physical health

3.23
Professor LaMontagne, Dr King and Ms Taouk focussed on perceived job insecurity, which is 'the subjectively perceived threat of job loss and the worries related to that threat'. While there can be some variance in perception between different people in the same environment, 'there is also evidence that subjective perceptions reflect objective reality'.22
3.24
Professor LaMontagne explained that insecure work 'is harmful to physical health', increasing cardiovascular disease, coronary heart disease, hypertension, and other conditions.23
3.25
Reporting on a recent study conducted in Europe, Professor LaMontagne said being in insecure work increases the risk of coronary heart disease by '1.3 times or 30 per cent', meaning 'five per cent of coronary heart disease in the working population' can be attributed to insecure work. (See Figure 3.1.) The study was based on data across 35 European countries where around 17 per cent of the working population were assessed as being in insecure jobs—a figure Professor LaMontagne said is 'comparable with Australia'.24

Figure 3.1:  Job insecurity-related increase in risk of coronary heart disease (CHD) and depression

Professor Tony LaMontagne, Dr Tania King and Ms Yamna Taouk, Submission 81.1, p. 1.
3.26
Compounding this, the AMA submitted that people in insecure work earn less than those in secure jobs, are less likely to be able to afford medical care, and less likely to take time off work to seek medical treatment, and are more likely to suffer from chronic illnesses.25
3.27
In October 2021, the Australian Council of Trade Unions (ACTU) reported employee survey results indicating that:
67 per cent of injured or sick workers in insecure jobs have not taken time off work 'because they feared it would negatively impact their job';
60 per cent have not taken time off 'because they had no paid leave available'; and
only a quarter (25 per cent) 'felt that they had adequate support to return to work after an injury', compared with 61 per cent of permanent employees.26

Box 3.3:   'Cathy'—complex health needs and insecure work

'… I have not had a break for over 10 years. I have to be constantly available for work, the alternative is not being able to pay my rent. I face homeless and hunger.
I have lived with incredible stress and this has significantly impacted on my mental as well as physical health. I cannot afford proper treatment or medication, and, as public patient believe I experience discrimination—in some cases, not all.
I have a $45 000 HECS and student loan debt I will never be able to repay, let alone use those skills.
To ask for support, I have to focus on my deficits which have become my reality. Being an intelligent, competent, energetic, positive person is not really possible.
Supposedly I work for myself—I cannot work in a standard environment. I have been working for a large NGO on and off for 10 years, on a relatively regular basis since 2015/16. I have no contract, no agreed hours. I make myself available but I am often too stressed to work.
I can no longer focus properly, I have inadequately treated eye disease, and a host of issues including exhaustion and fatigue. I can't afford to see the specialists who might be able to come to a diagnosis and therefore effective treatment, and appointments for anyone, including GPs are weeks and months apart.
I am over 55 and female. I read that I belong to a demographic which is the fastest growing homeless group in Australia. I actually don't feel like an Australian or as if I am a part of your community given the horrible experiences I have been through and the consequences.
I don't think I will be able to survive for much longer. I took out what little superannuation I had last year and have mostly spent that now on upgrading my work equipment, specialist visits, recommended dietary supplements, home furnishings and food.
I don't believe my work has any longevity or myself because I can't concentrate or focus properly, and I am very depressed. There is no way out of this.
I very much hope that this enquiry will also consider those people who are under and unemployed, rather than creating further exclusion and division.'27

Impacts on mental health

3.28
Experts told the committee that 'exposure to insecurity' is connected with a number of 'adverse health outcomes in the mental health area'. Professor LaMontagne listed 'depression, anxiety, burnout, suicidal thoughts, suicidal behaviours and some evidence coming around now of suicide mortality'.28
3.29
Suicide Prevention Australia submitted that:
Conditions at work can have a profound effect on mental health and wellbeing. A national survey of over 10,000 Australians in 2019 highlighted that more than half the Australian workforce reported experiencing an issue with mental ill health, with two in five of these saying their workplace either caused or exacerbated the condition. The estimated costs of workplace­related mental illness and injury are estimated to be at least $15.8 billion to $17.4 billion per year.29
3.30
Professor LaMontagne, Dr King and Ms Taouk referred to a range of research sources which have determined that perceived job insecurity induces:
… a physiological stress response, resulting in a range of reversible behavioural and health effects in the short term (e.g., drug use, tension, increased blood pressure) as well as more enduring and serious physical and mental health and wellbeing outcomes in the longer term (e.g., depression, anxiety, cardiovascular disease, and suicide) …30
3.31
Suicide Prevention Australia referred to recent Australian studies on male suicide rates which found that 'periods of unemployment and underemployment'—especially underemployment in insecure forms of work—are 'strongly correlated with an increase in the suicide rate'. Also that the risk of suicide is 'at its highest in the first five years of unemployment'.31
3.32
According to Suicide Prevention Australia's Director of Policy and Government Relations, Mr Matthew McLean, research has demonstrated that 'regular, stable and predictable income' is a protective factor against mental illness, along with 'access to paid leave and the certainty that comes with'. Mr McLean said:
… if you're employed in an arrangement that doesn't have either that certainty in size or regularity of income or those safety net measures of leave, workers compensation or superannuation, the absence of those might create risk for mental ill-health and could create risk for suicide.32
3.33
MATES in Construction said rates of suicide amongst workers in the construction industry in Australia are 71 per cent higher 'than amongst other employed men', with mining workers 'at risk' due to shift work, working in remote locations, and 'higher than average mental stress and alcohol consumption'.33
3.34
The issue of job security has 'significant broader [psychological] impacts', leads to distress requiring 'the support of a Case Manager', and contributes to 'relationship breakdown'. MATES in Construction Case Management data from 2020–21 demonstrated that over half of 'workers in distress' are impacted by relationship breakdown and '1 in 6 is at risk of suicide'.34
3.35
Specific features of insecure work that were found to lead to distress among these construction workers were 'excessive job stress' caused by insecurity, and 'low job control'. Recognising that work can be 'detrimental to mental health', 'as well as being positive', MATES in Construction worked with Beyond Blue and industry leaders to develop a 'Blueprint for the industry' that could address detrimental impacts:
And importantly it identified that one of the 5 key pillars the industry could use to address issues such as job insecurity and to deliver on the promise of better mental health and suicide prevention was to focus on 'Promoting work's positive impact on Mental Health'.35
3.36
MATES in Construction provided anecdotal evidence of cases where addressing job insecurity had led to direct improvements in mental health. Mr Lockwood said:
One of the simplest stories that might play out … is we direct them to try and resolve things within their workplace. When they are able to achieve some sort of resolution, that gives them more comfort in terms of their ongoing security. … If they are able to get comfort through whatever form around a more-secure job, then that can be one of the chinks that allow them to step forward to address the other issues they might be dealing with at the time.36
3.37
Academic research has also found this correlation. Professor LaMontagne pointed to the European study which measured the correlation between insecure work and heart disease, saying it also estimated 'the proportion of depression in the working population that is attributable to job insecurity' (see Figure 3.1, previous section):
With depression, it is 1.6 times higher, which is a 60 per cent elevated risk of depression for people in insecure jobs. What that translates to is … nine per cent of prevalent depression in the working population being attributable to job insecurity.37
3.38
Basing research on data from HILDA—the Household Income and Labour Dynamics in Australia—study, Professor LaMontagne looked at the same cohort of people over 15 years, across multiple surveys, to see if there was a correlation between changes in the level of job security, and mental health of individuals. Professor LaMontagne identified 'probably the strongest causal inference study of job insecurity and mental health published internationally to date', finding that:38
… improvements in job security across the Australian working population were associated with corresponding improvements in mental health, as well as deteriorating job security being associated with increases in depressive symptoms. There was also a strong dose-response relationship observed, with greater changes in job security predicting greater changes in mental health, both for better and for worse.39

Impacts of the pandemic

3.39
Inquiry participants were concerned that the pandemic was likely to increase the suicide risk associated with insecure work. Suicide Prevention Australia appeared before the committee in September 2021. The available data did not show an increase in rates of death by suicide during the pandemic at that point. However, it showed an increase in other indicators of psychological distress, including 'presentations to hospital for people experiencing self-harm episodes',40 and record levels of calls to Lifeline for assistance:41
The facts are that there hasn't been an increase in suicide yet. However, there has been an increase in distress in the community ... So it's fair to say that, although we have contained the situation during the pandemic, the bigger risks will emerge as we start to roll back the protective factors that we've put in for the community during the pandemic.42
3.40
The Chief Executive Officer of Suicide Prevention Australia, Ms Nieves Murray, suggested people in certain industries that have been particularly affected by job losses and increasingly insecure work, like tourism and the arts, will face a 'significant increase in distress' and a 'higher risk of suicide' if the 'protective factors' and social and financial supports put in place by governments during the pandemic are removed too quickly.43
3.41
Mr McLean reported that, in a recent community sector survey for 2021 World Suicide Prevention Day, when organisations were asked to identify 'the greatest risk to suicide rates over the next 12 months', 74 per cent identified 'unemployment and job security'; 88 per cent identified 'social isolation'; and 56 per cent identified 'housing access and affordability' as a 'key risk'.44

Box 3.4:   'Dave'—self-funded retiree impacted by the pandemic

'… Because of my age I was ordered to stay home for my own safety. As a consequence I have no income, and assets I can't sell. My wife is keeping me housed and fed.
Private borrowings from family members are paying my unavoidable business expenses. That debt is growing at about $1 500 a month.
Everybody needs a secure income or access to good social security. I have financially survived this pandemic only because I have a good family.
If I had been single I would have been destitute. This is third world social security.'45

Impacts on social wellbeing and relationships

3.42
Insecure work impacts peoples' social connectedness and relationships.
3.43
Suicide Prevention Australia expressed strong concerns about the emergence of an increasingly fractured and casualised workforce, where gig work is becoming more dominant, along with short-term contracting and temporary roles. These 'flexible' models 'have the potential to further isolate individuals' suffering from loneliness, and exacerbate existing gaps in social connection, by failing to provide 'regular colleagues or fixed workplaces':
A recent poll of young adults showed that over 50% of freelancers surveyed feared a lack of connection to a company's internal culture would leave them feeling like outsiders. Consultations with our stakeholders mirrored these concerns, identifying that a lack of social connection in the workforce can lead to increased loneliness, high work demands can result in fractured relationships within families and lack of access to support systems in the community, and financial uncertainty causing difficulty in planning for the future.46
3.44
Professor LaMontagne, Dr King and Ms Taouk submitted evidence showing that insecure work makes it hard for workers 'to plan, spend, study, and engage in society'. Job insecurity also 'places workers at risk of exploitation' and 'threatens' their 'economic security, self-esteem, social and familial relations, and other fundamental human needs'.47
3.45
The authors cited research showing causal links between job insecurity and social and economic outcomes, such as 'relationship breakdown' due to 'worsening finances'.48
3.46
Suicide Prevention Australia told the committee that job insecurity often results in 'economic hardship, which then leads to relationship breakdown', creating 'causal linkages' which 'accumulate' and can become 'the tipping point' that leads to suicide.49
3.47
The Western Australian Council of Social Service (WACOSS) submitted that insecure workers often struggle to afford adequate housing, access credit for home loans or secure a rental, and are at increased risk of homelessness and longterm (even intergenerational) poverty:
An emerging body of international research suggests that housing is associated with many aspects of social and economic life, including personal and family wellbeing, mental and physical health, economic participation, social connectedness, community functioning, sustainable cities and social cohesion.50
3.48
Along with facing housing insecurity, income insecurity, and a lack of social connection, insecure workers may be denied 'dignity in retirement', according to WACOSS. Already disadvantaged insecure workers were further disadvantaged by a Government policy measure which allowed 'temporary early access to superannuation' during the pandemic, resulting in almost three million Australians 'accessing their super savings to meet short-term financial needs during the COVID crisis'. According to WACOSS, this will 'clearly' impact their superannuation balance and 'their ability to secure a dignified retirement':
Australians who have worked throughout their adult lives, paid their taxes and contributed to their communities have a right to expect as citizens they will be granted dignity in retirement. Insecure work is undermining the capacity of Australian workers to provide for their retirement years. If current circumstances continue, we risk seeing many of today’s young workers and working families facing poverty and financial hardship in retirement.51

Box 3.5:   'Sabrina'—a plea for families

'Please get every especially family committed person a permanent employment. Due to casual temporary employment there is so much of insecurity whether the contract is going to be extended or not, no paid leave, we cannot enjoy any benefits as an employee, and very hard to get a mortgage grant being a casual temporary contract employment.
Cannot enjoy any public holiday as it's no pay, very sad. So much of trauma and stress to maintain a family without a [permanent] job. Please provide permanent jobs. Thank you.'52
3.49
Research also indicates that precariously-employed workers are significantly more likely than permanently-employed workers 'to report unwanted sexual advances' at work—at the following rates:
casuals, 7 times more likely;
fixed-term contract workers, 11 times more likely; and
'own-account self-employed workers', 4 times more likely.53

Reducing the impacts of insecure work

3.50
Inquiry participants made a number of suggestions for reducing the impacts of insecure work on physical and mental health, wellbeing and social connection.
3.51
MATES in Construction talked about the importance of 'providing a mentally healthy and safe work environment', which is just as critical as delivering a physically safe work environment. Mr Lockwood was asked if it was important for workers to 'be able to take a day of paid leave to spend time with their family, sort out personal issues or just rest'—noting that, for casual and contracted workers, this is often impossible. MATES in Construction agreed that access to paid leave has a role to play in addressing mental health issues in construction and similar industries.54
3.52
Professor LaMontagne explained that work health and safety (WHS) authorities have not traditionally engaged with the issue of job insecurity, despite the fact that it is 'a job stressor' with genuine health impacts. This may be because these authorities see job security as 'an employment condition as opposed to a working condition', and thus, not in their remit. However, Professor LaMontagne argued job security and insecure work 'should be within the domain of [WHS] regulatory authorities'.55
3.53
Professor LaMontagne, Dr King and Ms Taouk submitted that 'policy and practice interventions' designed to improve job security would in fact have 'multiple benefits', increasing broader population health, while also 'meeting regulatory and ethical mandates for work to be psychologically safe, and in increasing employment sustainability'.56
3.54
The authors noted that because job insecurity is 'a recognised and welldocumented work-related hazard to health', it could be addressed through existing health and safety regulatory frameworks:
Job security can be improved and its impacts mitigated through complementary policy and practice interventions, ranging from international and national labour market policy to workplace and workerlevel interventions … In order to reduce the problem at its source, it is critical that interventions are directed to reducing job insecurity (socalled 'primary prevention') as much as, or more than, targeting job insecurity-associated ill-health …57
3.55
MATES in Construction highlighted the success of its program, which is evidence-based, industry owned and funded, and delivers 'specific services to the male dominated construction, energy and mining industries'. The program delivers 'tailored training and support, onsite, where it is needed most' and is 'backed up by a 24/7 helpline and Case management services'. According to MATES in Constriction, to date the program has assisted over 200 000 workers, with over 20 000 trained volunteers in workplaces across Australia. According to peer reviewed, published evidence, the program has delivered 'a reduction in suicides', including 'an eight percent reduction in the Qld construction industry suicide rate, five years after the introduction of the MATES Program'.58
3.56
As well as addressing the root causes of insecure work, Professor Quinlan and Dr Underhill recommended that Government provide more support for effective industry programs aimed at preventing suicide amongst insecure workers, such as the MATES program:
The program is not about counselling but about training workplaces and the workforce to recognise and deal with suicide ideation—to provide a self-support network where workers themselves are heavily involved. It receives considerable support from the industry and is group focused. The program has spread to other industries like mining with analogous schemes in road transport. … There is clear potential for the scheme to extend to other industries where insecure work and suicide are a problem but this would require more government support.59
3.57
Ms Murray from Suicide Prevention Australia talked about the need to also focus government investments and policies for suicide prevention on 'other areas of our community and society'—not just mental health—'if we're going to make a difference in the prevention of suicide or the reduction of suicide rates'. Ms Murray said investing in job security, housing affordability and support for families in 'challenging times' would have an 'equal', or perhaps 'more significant', impact on suicide rates by providing a 'safety net' for people at risk of suicide: 'Mental health is just one lens'.60
3.58
The AMA said the health impacts of insecure work are largely caused by 'prolonged anxiety about losing income, and the repercussions that this will have for workers' standards of living and ability to support their families'. The AMA suggested governments can reduce this anxiety by implementing policies that 'encourage secure working arrangements', on one hand, and providing an 'adequate social safety net', on the other hand:
The AMA’s Social Determinants of Health Position Statement calls on the Australian Government to: ensure that all individuals have access to means that support adequate standards of living, regardless of their participation in paid employment, and invest in measures that support retraining and re-employment for those who are affected by underemployment or unemployment.61
3.59
Suicide Prevention Australia noted that entitlements built into the Fair Work Act 2009 (paid leave, protection from unfair dismissal, and so on) 'often function as the protective factors that prevent risk or support those vulnerable to suicide'. However, those entitlements are not available to most gig workers and many other insecure workers. While there is currently 'limited evidence available on the rate of suicide or self-harm among gig economy workers', Suicide Prevention Australia recommended that the Australian Government should:
commission research into the rate of suicides among gig workers in Australia and overseas; and
work with industry to fund an online peer support platform for gig workers and to develop toolkits to help gig companies to support better workplace mental health.62

Committee view

3.60
Empirical evidence shows that insecure work has strong detrimental impacts on the physical and mental health of individuals, and often negatively impacts family life, social connectedness, and personal relationships.
3.61
Insecurity in work—whether actual, perceived, or both—affects every aspect of a person's life; from their self-esteem and self-worth, to their decisions around family planning, education, home ownership and retirement.
3.62
Insecure work impacts work health and safety, both for individuals and in workplaces, including construction sites, hospitals, mines and on our roads—sometimes with tragic consequences.
3.63
Insecure work makes people sick and reduces our productivity. It impacts children's ability to learn and to thrive; hampers low-income earners trying to save for a dignified retirement; and increases the Medicare burden on taxpayers.
3.64
Even more critically, insecure work can lead to depression, to hopelessness, and, in severe cases, to suicide.
3.65
Secure, ongoing work and a reliable and predictable income are 'protective factors' against physical health problems, like heart disease and hypertension, as well as depression and suicidal ideation. Participation in a stable workplace can also increase a person's social connectedness and decrease their isolation.
3.66
Governments must address the source problem of insecure work, as well as funding and supporting proven evidence-based programs that are helping people right now—like MATES in Construction.

Recommendation 3

3.67
The committee recommends that the Australian Government reviews the Model WHS Laws and associated Regulations to provide a greater emphasis on supporting workers' psychological safety in the workplace, and include 'job insecurity' as a workplace hazard in the appropriate laws and regulations.

Recommendation 4

3.68
The committee recommends that the Australian Government provides ongoing support and funding to MATES in Construction, and similar evidence-based, industry-focused suicide prevention and mental health and well-being programs—especially in industries where non-standard work arrangements are common, and those heavily-impacted by the pandemic, such as health, aged and disability care, hospitality, retail, the arts and tourism.

Recommendation 5

3.69
The committee recommends that the Australian Government commits to providing an adequate financial and social safety net for all, including by:
ensuring that the JobSeeker payment is sufficient to help unemployed Australians focus on upskilling or obtaining employment;
ensuring that the industries and cohorts most impacted by COVID-19 receive financial and other supports to rebuild and recover; and
by focussing government funding and policy efforts towards initiatives that address the impacts of the pandemic on mental health and wellbeing.

  • 1
    Professor Michael Quinlan & Dr Elsa Underhill (Professor Quinlan & Dr Underhill), Submission 2, p. 4.
  • 2
    See: World Health Organisation Employment Conditions Knowledge Network, Employment, Conditions and Health Inequalities, Geneva: 2007, www.who.int/social_determinants/resources/articles/ emconet_who_report.pdf (accessed 15 December 2021).
  • 3
    Professor Quinlan & Dr Underhill, Submission 2, p. 5.
  • 4
    Professor Tony LaMontagne, Dr Tania King and Ms Yamna Taouk (LaMontagne, King and Taouk), Submission 81, p. 2.
  • 5
    LaMontagne, King and Taouk, Submission 81, p. 5.
  • 6
    LaMontagne, King and Taouk, Submission 81, p. 6.
  • 7
    LaMontagne, King and Taouk, Submission 81, p. 3.
  • 8
    Australian Medical Association (AMA), Submission 36, p. 1.
  • 9
    AMA, Submission 36, p. 1.
  • 10
    AMA, Submission 36, p. 2.
  • 11
    Dr Antonio Di Dio, Board Member, AMA, Proof Committee Hansard, 16 September 2021, p. 49.
  • 12
    Suicide Prevention Australia, Submission 181, p. 3.
  • 13
    MATES in Construction, Submission 80, p. 5.
  • 14
    MATES in Construction, Submission 80, pp. 1–2.
  • 15
    Chris, Submission 141, [p. 1]. Emphasis added.
  • 16
    MATES in Construction, Submission 80, p. 3.
  • 17
    MATES in Construction, Submission 80, p. 6.
  • 18
    MATES in Construction, Submission 80, p. 6.
  • 19
    Mr Chris Lockwood, National Chief Executive Officer, MATES in Construction, Proof Committee Hansard, 16 September 2021, p. 23. Emphasis added.
  • 20
    Professor Quinlan & Dr Underhill, Submission 2, p. 13.
  • 21
    Gary, Submission 164, [p. 1].
  • 22
    LaMontagne, King and Taouk, Submission 81, p. 2.
  • 23
    Professor Anthony (Tony) Daniel LaMontagne, Professor of Work, Health and Wellbeing, Institute for Health Transformation, Deakin University, Proof Committee Hansard, 16 September 2021, p. 2.
  • 24
    Professor LaMontagne, Deakin University, Proof Committee Hansard, 16 September 2021, p. 1.
  • 25
    AMA, Submission 36, p. 2.
  • 26
    Australian Council of Trade Unions (ACTU), Media release: Insecure work is a massive work health and safety risk, 13 October 2021, www.actu.org.au/actu-media/media-releases/2021/insecure-work-is-a-massive-work-health-and-safety-risk (accessed 10 January 2022).
  • 27
    Cathy, Submission 147, [p. 1].
  • 28
    Professor LaMontagne, Deakin University, Proof Committee Hansard, 16 September 2021, p. 1.
  • 29
    Suicide Prevention Australia, Submission 181, p. 5.
  • 30
    LaMontagne, King and Taouk, Submission 81, p. 3.
  • 31
    Suicide Prevention Australia, Submission 181, p. 5.
  • 32
    Mr Matthew McLean, Director of Policy and Government Relations, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 43.
  • 33
    MATES in Construction, Submission 80, p. 1.
  • 34
    MATES in Construction, Submission 80, p. 3.
  • 35
    MATES in Construction, Submission 80, p. 4.
  • 36
    Mr Lockwood, MATES in Construction, Proof Committee Hansard, 16 September 2021, p. 25.
  • 37
    Professor LaMontagne, Deakin University, Proof Committee Hansard, 16 September 2021, p. 1.
  • 38
    Professor LaMontagne, Deakin University, Proof Committee Hansard, 16 September 2021, p. 2.
  • 39
    LaMontagne, King and Taouk, Submission 81, p. 5.
  • 40
    Ms Nieves Murray, Chief Executive Officer, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 42.
  • 41
    Mr McLean, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 43.
  • 42
    Ms Murray, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 42.
  • 43
    Ms Murray, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 43.
  • 44
    Mr McLean, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, pp. 43–44.
  • 45
    Dave, Submission 140.1, [p. 1].
  • 46
    Suicide Prevention Australia, Submission 181, p. 5.
  • 47
    LaMontagne, King and Taouk, Submission 81, p. 3.
  • 48
    LaMontagne, King and Taouk, Submission 81, p. 3.
  • 49
    Ms Murray, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 44.
  • 50
    Western Australian Council of Social Service (WACOSS), Submission 118, pp. 17–18.
  • 51
    WACOSS, Submission 118, pp. 19–20.
  • 52
    Sabrina, Submission 187, [p. 1].
  • 53
    LaMontagne, King and Taouk, Submission 81, pp. 3–4.
  • 54
    Mr Lockwood, MATES in Construction, Proof Committee Hansard, 16 September 2021, p. 24.
  • 55
    Professor LaMontagne, Deakin University, Proof Committee Hansard, 16 September 2021, p. 2.
  • 56
    LaMontagne, King and Taouk, Submission 81, p. 5.
  • 57
    LaMontagne, King and Taouk, Submission 81, p. 6.
  • 58
    MATES in Construction, Submission 80, p. 1.
  • 59
    Professor Quinlan & Dr Underhill, Submission 2, p. 27.
  • 60
    Ms Murray, Suicide Prevention Australia, Proof Committee Hansard, 16 September 2021, p. 45.
  • 61
    AMA, Submission 36, p. 3.
  • 62
    Suicide Prevention Australia, Submission 181, pp. 8–9.

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