Precarious work as a social determinant affecting Black people's health access and health outcomes during health emergencies: Informing health equity efforts in pandemic recovery and pandemic preparedness

The COVID-19 pandemic has had widespread and unequal effects. For those who are precariously employed, effects have included reduced work hours and lost incomes. This includes workers in employment that is insecure, low-waged, with little or no benefits, and/or non-unionized. Precarious work is an important yet underexamined determinant negatively affecting the physical and mental health of workers, with potential long-term effects. Occupational hazards, limited access to social and health benefits (including sick days), low incomes, and social isolation are among factors contributing to poor health outcomes. Racialized, women, and immigrant workers are more likely to be employed precariously creating a critical health equity concern. A significant proportion of workers vital to the Canadian economy and health system are employed precariously, including 38 percent of workers in British Columbia. There is a need to understand how the pandemic affected precarious work as a determinant of health. This research will specifically examine how precarious work affected the health of Black people in British Columbia since the start of the COVID-19 pandemic. The Black population faces higher levels of unemployment and precarious work attributable to historical and ongoing barriers. Using interviews to learn from lived experiences and personal circumstances, it will examine how factors such as race, gender, and immigration status uniquely contribute to experiences of workers. The study will inform a broader understanding of the impacts of precarious work on the health of marginalized groups. Outcomes will inform pandemic recovery efforts to build back better by extending opportunities to achieve health equity while preparing for future health crises.