Previous reports showed that age and socioeconomic factors mediated health-related unemployment. However, those studies had limitations controlling for confounding factors. This study examines age and socioeconomic factors contributing to health-related unemployment using propensity score matching (PSM) to control for various confounding variables.

Data were obtained from the Korean National Health and Nutrition Examination Survey (KNHANES) from 2015–2017. We applied a 1:1 PSM to align health factors, and examined the association between health-related unemployment and age or socioeconomic factors through conditional logistic regression. The health-related unemployment group was compared with the employment group.

Among the 9,917 participants (5,817 women, 4,100 men), 1,182 (853 women, 329 men) were in the health-related unemployment group. Total 911 pairs (629 women pairs and 282 men pairs) were retained after PSM for health factors. The results of conditional logistic regression showed that older age, low individual and household income levels, low education level, receipt of the Basic Livelihood Security Program benefits and longest-held job characteristics were linked to health-related unemployment, despite having similar health levels.

Older age and low socioeconomic status can increase the risk of health-related unemployment, highlighting the presence of age discrimination and socioeconomic inequality. These findings underscore the importance of proactive management strategies aimed at addressing these disparities, which are crucial for reducing the heightened risk of health-related unemployment.

Job insecurity and emotional labor are poor job-related factors that are known to cause sleep disturbances in customer service workers. This study investigates the combined effect of emotional labor and job insecurity on sleep disturbance.

This study used data from the Fifth Korean Working Condition Survey and included 15,147 paid workers who serve customers below 65 years. We re-classified into 6 groups based on whether the degree of emotional labor increased (Rarely/Sometimes/Always) or whether job insecurity (No/Yes) was present. We performed propensity score matching for several covariates and calculated odds ratio (OR) and 95% confidence intervals (CIs) for sleep disturbance by logistic regression models using only matched subjects.

Workers exposed to emotional labor and job insecurity had significantly higher risk for 3 dimensions of sleep disturbance (difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue) (OR [95% CI]: 1.44 [1.22–1.69], 1.18 [0.99–1.40], 1.52 [1.30–1.79] for emotional labor; and 2.00 [1.75–2.29], 2.20 [1.91–2.53], 1.67 [1.45–1.92] for job insecurity). Compared to those who were exposed to both emotional labor rarely and without job insecurity, when workers had both poor job factors, the OR (95% CI) for sleep disturbance for difficulty falling asleep, waking up repeatedly during the sleep, and waking up with feeling of fatigue were 3.05 (2.42–3.86), 2.89 (2.26–3.69), and 2.60 (2.06–3.29), respectively. The relative excess risk due to Interaction of job insecurity and emotional labor was significant only for difficulty falling asleep, but not the other 2 sleep disturbance dimensions.

Customer service workers suffered from severe sleep disturbances according to the existing degree of emotional labor and job insecurity. The combined effect of both could have an additive influence on serious sleep disturbance among customer service workers.