Work Arrangements and Health: Evidence from a National Longitudinal Study In China

Background and Purpose

Precarious employment has become increasingly prevalent in China, often characterized by nonstandard work schedules and limited social protections. Drawing on the social determinants of health framework, prior research suggests that nonstandard work arrangements are associated with adverse health outcomes and widening social inequalities in developed economies; however, evidence from the Chinese context remains limited due to data at hand. This study adds to the body of scholarship on how work as a social determinant may weigh heavily on health behaviors and outcomes.

Methods

We use nationally representative panel data of the China Family Panel Studies (CFPS) to examine how multiple dimensions of nonstandard work arrangements in the survey year 2020, including night shifts, weekend work, on-call schedules, no fixed working hours, and overtime and part-time work, are associated with sleep, self-reported health, smoking, and drinking in the survey year 2022 among adult workers aged 16–65 (N = 7,595). We use multiple imputation (20 datasets) to address missing data. We conduct multivariate regression models with either the ordinary least squares (OLS) for continuous outcomes or logistic regression for binary outcomes, with robust standard errors and controlling for sociodemographic characteristics and access to employment benefits.

Results

Regression estimates show that weekly night shifts are significantly associated with shorter sleep hours (b = –0.20, p < .001), on-call requirements are linked to higher likelihood of smoking (b = 0.21, p = .002) and frequent drinking (b = 0.20, p = .010), and no fixed working hours is associated with increased risks of poor health (b = 0.25, p = .002). We further examine the dosage effect and find that exposure to multiple nonstandard work conditions is significantly associated with shorter sleep duration (b = –0.05, p = .002), higher likelihood of smoking (b = 0.09, p = .005), and more frequent drinking (b = 0.09, p = .014).

Predicted marginal effects further illustrate that individuals exposed to the worst work scenarios, including multiple nonstandard arrangements, disadvantaged working hours (part-time and overtime), and no insurance benefits, experience shorter sleep (7.22 hours vs. 7.35 hours for their counterparts) and higher risks of poor health (0.18 vs. 0.12 for their counterparts), smoking (0.37 vs. 0.27 for their counterparts) and drinking (0.18 vs. 0.12 for their counterparts). Health risks increase progressively with each additional nonstandard work condition, indicating a dose–response relationship between cumulative exposure and adverse health behaviors and outcomes.

Conclusions and Implications

This study highlights the detrimental and cumulative role of nonstandard work arrangements in shaping health behaviors and outcomes. These findings underscore the importance of labor policies that promote stable and predictable work schedules and workplace practices to mitigate the health consequences of nonstandard work arrangements that become increasingly prevalent among the workforce.