Impact of the COVID-19 pandemic on employment and inequalities: a systematic review of international evidence and critical appraisal of statistical methods

Author:

Abugamza A1ORCID,Kaskirbayeva D2,Charlwood A3,Nikolova S4,Martin A5

Affiliation:

1. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, UK; Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Saudi Arabia

2. KAZGUU University, Kazakhstan

3. Leeds University Business School, University of Leeds, UK

4. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, UK; Real World Methods and Evidence Generation, IQVIA, UK

5. Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, UK

Abstract

Aims: To assess the impact of the COVID-19 pandemic on individual labour market outcomes and how these vary over time and between different groups of individuals. Methods: Searches were conducted using Medline, Scopus and EconLit. Grey literature searches used Google Scholar and Econpapers. Study quality was assessed using the risk of bias in non-randomised studies of exposure tool (ROBINS-E), accompanied by a directed acyclic graph (DAG) to identify relevant mediators, moderators and confounders. Results: A total of 85 studies (77 peer-reviewed articles, 8 working papers) were included. The ROBINS-E showed that the overall risk of bias varied between studies from low ( n = 14), moderate ( n = 56) to serious ( n = 15). Studies also varied in terms of outcome measures, study designs and the academic disciplines of researchers. Generally, studies using data collected before and during the pandemic showed large negative effects on employment, working hours and income. Studies that assessed moderators (e.g. by industry, occupation, age, gender, race and country of birth) indicated the pandemic has likely worsened pre-existing disparities in health and work. Generally, women, less educated, non-whites and young workers were affected the most, perhaps due to their jobs involving high levels of personal contact (e.g. hospitality, sales and entertainment) and being less amenable to remote working. The DAG highlighted methodological challenges in drawing robust inferences about COVID-19’s impact on employment, including the lack of an unexposed control group. Conclusions: The COVID-19 health crisis caused unanticipated and unprecedented changes to employment opportunities around the world, with potential long-term health consequences. Further research should investigate the longer-term impact of COVID-19, with greater attention given to low- and middle-income countries. Our study provides guidance on the design and critical appraisal of future studies.

Funder

Deanship of Scientific Research, Princess Nourah Bint Abdulrahman University

Publisher

SAGE Publications

Reference38 articles.

1. Waddell G, Burton A. Is Work Good for Your Health and Well-Being? An Independent Review. Available online at: https://www.gov.uk/government/publications/is-work-good-for-your-health-and-well-being (2006, last accessed 15 May 2022)

2. Health effects of employment: a systematic review of prospective studies

3. Employment as a Social Determinant of Health: A Systematic Review of Longitudinal Studies Exploring the Relationship Between Employment Status and Physical Health

4. Work Health and Disability: Improving Lives. Available online at: https://www.gov.uk/government/consultations/work-health-and-disability-improving-lives (2022, last accessed 15 May 2022)

5. Australian Bureau of Statistics. Employment and Unemployment: An International Perspective. Available online at: www.abs.gov.au/articles/employment-and-unemployment-international-perspective (2022, last accessed 24 March 2022)

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