Torn between safeguarding economic stability and health: A first empirical exploration of the employment-health dilemma

The employment–health dilemma is a theoretical framework to analyze the experiences of workers who face a combination of economic and health threats. It arises when workers in health-threatening jobs have few attractive job prospects and feel trapped in the dilemma of accepting/keeping a health-threatening job or quitting/rejecting that job and possibly incurring unemployment. This study provides a first qualitative exploration of this dilemma. As the corona crisis facilitated the emergence of economic and health threats in support staff in the healthcare industry (e.g., cleaners), we interviewed 45 of them regarding their experiences during the pandemic. More than half of the interviewees who met our inclusion criteria reported experiencing an employment–health dilemma, accompanied by mostly negative emotions and rumination. These interviewees encountered threats that severely restricted their courses of action. Moreover, the results of the qualitative content analysis supported the assumption that economic and health threats have antecedents at the societal, organizational, and individual level. Highlighting the interplay between precarious employment and hazardous work, this study supports the consideration of societal aspects that shape employment and health. We discuss the generalizability of our findings beyond this specific work context and time.