Association of Precarious Employment With Unmet Healthcare Needs and Health Checkup Participation

Abstract

Introduction: Precarious employment has emerged as a public health concern. This study explored the association between precarious employment 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). Precarious employment 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 nonparticipation in health checkups over the past year. Robust Poisson regression models were used to calculate prevalence ratios and 95% 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 precarious employment quartile, those in the high and highest precarious employment 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 precarious employment quartile, those in the high and highest precarious employment 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 nonparticipation in health checkups, respectively. Conclusions: Precarious employment is associated with unmet healthcare needs and nonparticipation in health checkups. This study underscores the need for policies that improve healthcare access for workers in precarious conditions. (c) 2025 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.