Low quality jobs linked with increased ‘deaths of despair’

Canadian research suggests rising incidence of suicide, drug poisoning, and alcohol-attributable mortality (SDAM) is in part to due to increasing insecure, precarious work.

“Deaths have risen against the backdrop of some pretty significant changes in the social and economic fabric in everyday life,” explains Dr. Faraz Vahid Shahidi, Institute for Work and Health (IWH) scientist and lead author of research published earlier this year in the Journal of American Epidemiology. “And the most commonly cited socio-economic shifts were growing income inequality, shrinking social safety net and deteriorating labour market conditions.”

Precarity a deadly work hazard
The study revealed lower-quality employment in general, and precarious employment in particular is associated with the highest rates of early death from SDAM compared to rates seen in workers in stable higher-quality employment. More specifically, precarious workers are approximately three times as likely to die from drug poisoning and twice as likely to die from alcohol-related causes and suicide.

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“It is well understood that some jobs don’t allow people to meet their basic needs in life, which can in turn affect their health,” says Shahidi. “That’s why we knew we would pick up on some kind of signal. What we didn’t realize was just how strong of a signal we would pick up.”

As noted by the IWH researchers, previous studies linked lower rates of labour force participation to higher rates of suicide and substance use-related harms. “Having a job does protect against despair,” explained Shahidi during an April 22, 2025, webinar offering insight to the study. “But not all jobs are created equal. Some forms of employment are insecure and unrewarding.”

This study sought to better understand how ‘quality of employment’, and not just ‘being employed’ is related to SDAM—sometimes referred to as ‘deaths of despair’. Employment quality was measured in terms of employment stability, hours and wages.

IWH researchers examined deaths rates of a cohort of almost three million Canadian workers aged 18 to 64 between 2006 and 2019. The workers were sorted into groups based on declining job quality, including:

Standard employment – secure employment including full-time hours, stable year-round employment and high earnings.
Portfolio employment – demanding employment including hours exceeding 49 each week, relatively stable year-round employment and high earnings.
Intermittent employment – unstable employment with modest income.
Marginal employment – underemployed or working outside field or qualifications, limited hours and below average earnings.
Precarious employment – insecure, low-wage jobs.

In addition to finding workers employed precariously faced the most significant risks of early death from SDAM, the evidence also suggests as job quality declined, deaths of despair rates increased. The evidence also indicates differing impacts based on gender and age.

Impact on women and men differ
Canadian women employed precariously, for instance, had 3.6 times the risk of death from drug poisoning, 2.4 times the risk of suicide and 1.8 times the risk of an alcohol attributable death compared to those in standard employment. Men holding the lowest quality jobs were 2.7 times more likely to die by drug poisoning, 1.7 times for suicide and 2.2 times from an alcohol attributable death.

The researchers speculated gendered stressors might be to blame for the higher rates among women in the case of suicide and drug poisoning mortality. Specifically, they cite the double burden of paid and unpaid work that women disproportionately bear, along with sexual and gender discrimination in the workplace that may be more prevalent in precarious employment.

Impact on older workers
Precarious employment was also strongly associated with deaths of despair among older compared to younger workers. These findings suggest the negative health impacts of precarious employment are cumulative over time.

Impact on next steps for healthier work
The findings also suggest the need to broaden occupational health and safety strategies to consider and address job quality as an occupational mental health hazard.

Under the Occupational Health and Safety Act (OSHA) employers have a general duty to take every precaution reasonable in the protection of a worker including their mental health [s.25(2)(h]. Fortunately, many work-related hazards that contribute to mental injuries and illnesses can be identified and eliminated. To date, some attention has been paid to psychosocial hazards such harassment, long hours of work and excessive job demands.

The researchers conclude efforts must go further still. “Our study findings have important policy implications as they provide evidence that underscores the importance of creating and promoting high-quality employment for supporting mental health and well-being in the working population. These include jobs that offer adequate hours, stability, and earnings to fulfill the financial and psychological needs of workers.”

Mental health training: Key to unlocking workplace well-being
Workers Health & Safety Centre (WHSC) supports workers, their representatives, supervisors and employers in public and private sectors in all industries with training designed to:

identify mental health hazards,
encourage discussion on preventative and protective measures for safer and healthier work and,
provide the tools to identify signs of mental health impacts.

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Low quality jobs linked with increased ‘deaths of despair’

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