diff --git a/scoping_review.qmd b/scoping_review.qmd index 80e6790..e9c24d6 100644 --- a/scoping_review.qmd +++ b/scoping_review.qmd @@ -130,6 +130,17 @@ Section 3 will then introduce the method applied in the scoping review of this s Section 4 will synthesize findings on a variety of intervention found in the literature, organized by general policy area of intervention pursued. Section 5 will then provide a brief discussion on these findings from the perspective of individual inequalities, the interventions found to reduce them, and resulting policy implications, before Section 6 briefly concludes. +# The world of work + +The policy areas and their respective focus perspectives are based in the conceptual understanding of the world of work, following the definition of work being activities performed by persons of any sex and age producing goods or providing services for "economic units [which] can be allocated mutually exclusively to one of the following sectors:" the formal sector, the informal sector, or the community and household own-use sector [@ILO2023c, 6]. +This is the broader understanding of work which specifically separates itself from a more narrow conception of those in employment who are engaging in "production for pay or profit", whether for the informal or the formal market economy [see especially @ILO2023c, Point 18ff]. +The key differentiations for these concepts are founded on an understanding of the production of goods or provision of services, as well as the distinctions between use by others for ultimate own-use and that of working for pay and/or profit – that is, as part of a market transaction in exchange for remuneration or in the form of profits derived from the goods or services. + +Whether these services or goods are produced in what is defined as the informal economy, the formal economy or under informal employment outside the informal sector is, for the general encapsulation of no importance – they occur in the world of work. +Here, conceptually, it should be captured under one of the five mutually exclusive forms of work [@ILO2023, p. 4, Point 7c] to be understood as: own-use production work, performing "any activity to produce goods or provide services for own final use" [@ILO2013, p.5]; employment work comprising those performing work for others in exchange for pay or profit introduced above; unpaid trainee work, performing "any unpaid activity to produce goods or provide services […] to acquire workplace experience or skills" [@ILO2013, p.7]; and volunteer work, that being "any unpaid, non-compulsory activity to produce goods or provide services for others" [@ILO2013, p.8]. + +Any activity falling under work as defined above on the one hand, but not under any of these forms of work on the other, is instead designated as other work activities in the following considerations. The key concepts between these categories come down to a varying intensity of participation, the distinction of working for pay and/or profit mentioned above, whether it is for ultimate own-use or the use by others, and its compulsory nature. + The ILO has a policy approach to reducing inequalities in the world of work segmented into five major focus areas: employment creation, access to education, labour rights protection, formalization, gender equality and diversity, and social protection. Each of these areas in turn rests on a variety of more specific emphases which further describe the potential implemented policy measures. An exemplary typology of general policy area, related specified policy focus and related focus if any can be found in @tbl-policy-areas. @@ -176,112 +187,6 @@ An exemplary typology of general policy area, related specified policy focus and Source: Authors' elaboration based on ILO [-@ILO2022b]. -## Existing reviews - -Aside from the general typology by the ILO introduced above, there are a variety of differing approaches to the interplay of inequalities and outcomes, -outlined in the following section. - - -In a multi-disciplinary systematic review of the association between a person's income, their employment and poverty in an urban environment, Perez et al. [-@Perez2022] find that employment plays a significant role in the poverty of urban residents, with primary barriers identified as lack of access to public transport, geographical segregation, labour informality and inadequate human capital. -Many of their investigated barriers can be mapped onto channels of inequality: -gender inequality's impact, through traditional gender roles and lack of empowerment, a lack of childcare possibilities, or unequal proportions of domestic work; -spatial inequality, through residential segregation or discrimination, lack of access to transportation, and a limited access to work; -as well as pre-existing inequalities, here defined as the inter-generational persistence of poverty, larger household sizes, and its possible negative impacts on human capital. -They also identify potential policy interventions to be applied to counteract these inequalities: -credit programs, institutional support for childcare, guaranteed minimum income/universal basic income or the provision of living wages, commuting subsidies, and housing mobility programs. - - -Zeinali et al. [-@Zeinali2021], in undertaking a systematic review of female leadership in the health-sector in low- and middle-income countries, take an intersectional approach and focus on the main barriers at the intersection of gender and social identity. -Here, they find that the main barriers limiting women's access to career development resources can be reduced access to mentorship and sponsorship opportunities, as well as a reduced recognition, respect, and impression of value at work for women in leadership positions. -The main channels of inequalities entrenching these barriers identified were the increased likelihood for women to take on the 'dual burdens' of professional work and childcare or domestic work, as well as biased views of the effectiveness of men's over women's leadership styles. - - -Looking strictly at the impact of basic income interventions on labour market, health, educational, housing and other outcomes, Pinto et al. [-@Pinto2021] find that, while workforce participation is the primary outcome in most studies, the evaluations have shifted over time to include a wider array of outcomes, perhaps reflecting an understanding of lower health and social care spending offsetting some of the basic income investments. -Most of the studies investigating basic income perspectives focus on advanced economies such as the US. - - -Finlay [-@Finlay2021] looks at the effects of female women's reproductive health on female labour force participation, especially career advancement, job quality and hours worked, to find a variety of responses differing between low-income, middle-income and high-income countries. -The main findings are that in low-income countries because of the prevalence of informal work, women are forced to adopt individual strategies of balancing child rearing and labour force participation through job type selection, reliance on other women in the household for child care, or birth spacing. -In middle-income countries, women have to juggle child rearing and labour force participation with an overall income inequality; here, early childbearing or lone motherhood especially can perpetuate poverty. -In high-income countries, social protection policies can assist in balancing child rearing and work but many underlying issues of gender inequality remain. -Throughout all countries, childbearing significantly interrupts career advancement. - - -Chaudhuri et al. [-@Chaudhuri2021] conduct a systematic review to look at coping strategies and the effects of food insecurity, often through poverty, on social and health outcomes for women and children. -They find that one of the primary non-food coping strategies for women is to look for outdoor employment, mostly farm work, which can in turn lead to what the authors argue as *time* poverty when their time for childcare or personal nutrition is now cut short. -This in turn can, in combination with food-based coping strategies such as food rationing (in size or frequency), nutritional switches or food sharing, lead to negative health outcomes for children including disrupted socio-cognitive development as well as coping through dropping out of school, thereby furthering the rift of pre-existing inequalities. - - -Chang et al. [-@Chang2021] use a qualitative systematic review to look at the linkages of breast-feeding and returning to paid employment for women and identify multiple barriers provided through inequalities discouraging continued breast-feeding after return to employment --- an experience often experienced as physically and emotionally difficult and potentially providing a barrier to full labour force participation. -Aside from individual motivation and support from employers, colleagues, and family members, women highlighted the importance of having workplace legislation in place to facilitate breast-feeding during employment, as well as access to convenient child care. -The review concludes indicating remaining gender and employment inequalities in accessing and receiving the support needed: gender role expectations viewing women as responsible for domestic work or childcare, with shorter maternity leave further discouraging breast-feeding especially of women not in managerial roles. - - -Undertaking a systematic review to find the effects of brain tumours in individuals on their labour market outcomes, Silvaggi [-@Silvaggi2020] find an impact of neuropsychological functioning on work productivity, issues for their process of returning to work, and often an exit from employment (job loss) for long-term survivors of brain tumours -While the channels are primarily viewed as stemming from the high short-term mortality and depressive symptoms or cognitive deficits, environmental barriers are identified as one channel as well, with the review ending in the policy recommendation of increased vocational rehabilitation for affected persons. - - -De Paz-Banez et al. [-@dePaz-Banez2020] use a systematic review of empirical studies to look at the effects of universal basic income on labour supply to find that, with no evidence of significant reductions in labour supply, instead the labour supply would increase globally among adults, men, women, young and old. -The insignificant reductions they found they assumed functional, since they were in the categories of: children, elderly, sick, people with disabilities, women with young children, young people continuing their studies and were offset by the otherwise increased supply. - - -Looking at the impact of gender on the employment outcomes for young disabled adults, Lindsay et al. [-@Lindsay2018] find that while youth with disabilities are half as likely to be employed, gender inequalities may play a compounding role with men being more likely to be in employment than women, working longer hours and having higher wages. -The identified channels here are different social supports, gender role expectations, as well as women's lower job expectations and overprotection from parents or guardians discouraging their independence. - - -Kumari [-@Kumari2018] looks at the relationship of both economic growth and gender disparity on the labour supply in investigating their effects on female work participation. - -They see a U-shaped participation rate and some evidence of cross-sector gender pay disparity which is affected by demographic factors such as migration, marriage, child care and fertility, as well as economic factors such as per capita income, unemployment, infrastructure and the prevalence of non-farm jobs. -Ultimately, they argue that the labour supply inequalities are based on inequality between the sexes and, while regulatory measures such as adequate family and childcare policies, tax regimes and the presence of subsidized healthcare help, changes to the female labour force participation fundamentally require the replacement of such a traditional value system itself. - - -While undertaking a systematic review concerning the effects of adopting technology on employment in LICs or LMICs, Ugur and Mitra [-@Ugur2017] find when adoption favours product innovation positive effects are somewhat likely. -They also find, however, that existing income inequalities can make the possible positive effects of its adoption more ambiguous and may in turn widen the rift of demand for skilled versus unskilled labour. -Lastly, policies favouring green transition technologies may in turn reduce income inequality, providing another possible linkage. - - -Lettieri and Diez Villoria [-@Lettieri2017] find that hiding mental illness is one of the primary strategies for improved employment outcomes in a meta-review looking at barriers to labour market inclusion for people mental disabilities. -This act of concealment of identity and self-stigmatization can seem necessary, they argue, due to the channels of workplace prejudices, perceiving them missing skills, as dangerous or unpredictable, or seeing the act of their hiring as charity due to expectations of lower productivity; but also due to discriminatory hiring practices and pre-existing inequalities leading to them being lower-skilled individuals due to prior discrimination, cultural and social barriers to training and work inclusion. -Here, relevant policies include interventions of supported employment (removing an environmental barrier), cognitive behavioural or computer-assisted therapies (cognitive barrier) or vocational rehabilitation programmes (human capital). - - -Taukobong et al. [-@Taukobong2016] review various dimensions of female empowerment and their effects on a variety of health and development outcomes, including the access and use of financial services for the poor. -They find that, aside from gender inequalities being both highly contextual and intersectional, especially the channels of control over one's income, assets, resources, having decision-making power and individual education affected these outcomes across all dimensions, reflecting their position as channels of gender inequality. -Additionally, personal mobility, safety and equitable interpersonal relationships are associated with some health and family planning outcomes. -Ultimately, the review shows that due to the contextual nature, interventions need to identify the variations of inequality at their start, see where inequalities exist, overlap and work as barriers for an effective implementation. - - -Ruhindwa et al. [-@Ruhindwa2016] review a variety of barriers to adequate workforce inclusion for people with disabilities, proposing an inclusive approach in which the individual is given space to take ownership of the solutions addressing challenges experienced in the employment sector. -Similarly, they view hiring discrimination and workplace stigmatization as the largest channels through which inequalities of disability manifest themselves. -They see especially employment support practices, with focus on enabling this, as relevant policy strategies, as well as national campaigns to ease disclosing one's disability in the labour market. - - -In looking at the various dimensions affecting the labour market outcomes of supported employment interventions for people with disabilities, Kirsh [-@Kirsh2016] finds that most literature still only regards the overall efficacy of the interventions without taking into account compounding intersectional characteristics. -They find that generally men are more likely to find employment through the intervention, possibly resting on current programmes focus on manual labour, as well as younger people generally finding better employment. -This highlights the intersectional nature of inequalities between disability, gender and age. -One relevant policy they see is that of vocational rehabilitation. - - -Hastbacka et al. [-@Hastbacka2016] undertake a scoping review to find the linkages between societal participation and people with disabilities, looking at specific interventions for the identity of participants, types of participation analysed, and channels of effect. -They see most literature focusing on labour market participation and viewing disabled people as coherent group instead of intersectional. -The main channels of inequality providing barriers they identify are financial factors, attitudes of discrimination, health issues and unemployment, while the main driving mechanisms identified are legislation and disability policies, as well as support from people in close contact with disabled people and attitudes in society and the hiring process. - - -In a systematic review looking at the effectiveness of workplace accommodations on employment and return to work, Nevala et al. [-@Nevala2015] find few studies with rigorous design leading to conclusive evidence. -They do find moderate evidence that employment in disability can be increased through workplace accommodations such as vocational counselling or guidance, education, self-advocacy, positive perception and help by others. -There is also low evidence for return to work being increased by education, work aids and techniques and cooperation between employers and other professionals (such as occupational health care, or service providers). - -## The world of work - -The policy areas and their respective focus perspectives are based in the conceptual understanding of the world of work, following the definition of work being activities performed by persons of any sex and age producing goods or providing services for "economic units [which] can be allocated mutually exclusively to one of the following sectors:" the formal sector, the informal sector, or the community and household own-use sector [@ILO2023c, 6]. -This is the broader understanding of work which specifically separates itself from a more narrow conception of those in employment who are engaging in "production for pay or profit", whether for the informal or the formal market economy [see especially @ILO2023c, Point 18ff]. -The key differentiations for these concepts are founded on an understanding of the production of goods or provision of services, as well as the distinctions between use by others for ultimate own-use and that of working for pay and/or profit – that is, as part of a market transaction in exchange for remuneration or in the form of profits derived from the goods or services. - -Whether these services or goods are produced in what is defined as the informal economy, the formal economy or under informal employment outside the informal sector is, for the general encapsulation of no importance – they occur in the world of work. -Here, conceptually, it should be captured under one of the five mutually exclusive forms of work [@ILO2023, p. 4, Point 7c] to be understood as: own-use production work, performing "any activity to produce goods or provide services for own final use" [@ILO2013, p.5]; employment work comprising those performing work for others in exchange for pay or profit introduced above; unpaid trainee work, performing "any unpaid activity to produce goods or provide services […] to acquire workplace experience or skills" [@ILO2013, p.7]; and volunteer work, that being "any unpaid, non-compulsory activity to produce goods or provide services for others" [@ILO2013, p.8]. - -Any activity falling under work as defined above on the one hand, but not under any of these forms of work on the other, is instead designated as other work activities in the following considerations. The key concepts between these categories come down to a varying intensity of participation, the distinction of working for pay and/or profit mentioned above, whether it is for ultimate own-use or the use by others, and its compulsory nature. - ## Inequalities in the world of work Inequalities in the world of work have to be fundamentally conceptualized along two axes: On the one hand, vertical inequality captures the "income inequality between all households in a country" [@ILO2021]. @@ -341,6 +246,87 @@ Addressing these inequalities, in turn, is just as important to reducing inequal For pre-existing inequalities, it will be especially important to understand the often delayed and more opaque nature of the roots of many outcomes, with channel being more difficult to identify and clearly label – especially in an intersectional context. These five dimensions of inequalities --- income inequality, gender inequality, socio-demographic inequality, spatial inequality and pre-existing inequalities --- will thus provide the categorical anchors along which the reviewed studies will be analysed for their policy effects, each with a slightly different focus in linkages between inequality, policy and outcome. +## Existing reviews: alternative approaches + +Aside from the general typology by the ILO introduced above, there are a variety of differing approaches to the interplay of inequalities and outcomes, +outlined in the following section. + + +Chaudhuri et al. [-@Chaudhuri2021] conduct a systematic review to look at coping strategies and the effects of food insecurity, often through poverty, on social and health outcomes for women and children. +They find that one of the primary non-food coping strategies for women is to look for outdoor employment, mostly farm work, which can in turn lead to what the authors argue as *time* poverty when their time for childcare or personal nutrition is now cut short. +This in turn can, in combination with food-based coping strategies such as food rationing (in size or frequency), nutritional switches or food sharing, lead to negative health outcomes for children including disrupted socio-cognitive development as well as coping through dropping out of school, thereby furthering the rift of pre-existing inequalities. + + +Finlay [-@Finlay2021] looks at the effects of female women's reproductive health on female labour force participation, especially career advancement, job quality and hours worked, to find a variety of responses differing between low-income, middle-income and high-income countries. +The main findings are that in low-income countries because of the prevalence of informal work, women are forced to adopt individual strategies of balancing child rearing and labour force participation through job type selection, reliance on other women in the household for child care, or birth spacing. +In middle-income countries, women have to juggle child rearing and labour force participation with an overall income inequality; here, early childbearing or lone motherhood especially can perpetuate poverty. +In high-income countries, social protection policies can assist in balancing child rearing and work but many underlying issues of gender inequality remain. +Throughout all countries, childbearing significantly interrupts career advancement. + + +Chang et al. [-@Chang2021] use a qualitative systematic review to look at the linkages of breast-feeding and returning to paid employment for women and identify multiple barriers provided through inequalities discouraging continued breast-feeding after return to employment --- an experience often experienced as physically and emotionally difficult and potentially providing a barrier to full labour force participation. +Aside from individual motivation and support from employers, colleagues, and family members, women highlighted the importance of having workplace legislation in place to facilitate breast-feeding during employment, as well as access to convenient child care. +The review concludes indicating remaining gender and employment inequalities in accessing and receiving the support needed: gender role expectations viewing women as responsible for domestic work or childcare, with shorter maternity leave further discouraging breast-feeding especially of women not in managerial roles. + + +Looking strictly at the impact of basic income interventions on labour market, health, educational, housing and other outcomes, Pinto et al. [-@Pinto2021] find that, while workforce participation is the primary outcome in most studies, the evaluations have shifted over time to include a wider array of outcomes, perhaps reflecting an understanding of lower health and social care spending offsetting some of the basic income investments. +Most of the studies investigating basic income perspectives focus on advanced economies such as the US. + + +Undertaking a systematic review to find the effects of brain tumours in individuals on their labour market outcomes, Silvaggi [-@Silvaggi2020] find an impact of neuropsychological functioning on work productivity, issues for their process of returning to work, and often an exit from employment (job loss) for long-term survivors of brain tumours +While the channels are primarily viewed as stemming from the high short-term mortality and depressive symptoms or cognitive deficits, environmental barriers are identified as one channel as well, with the review ending in the policy recommendation of increased vocational rehabilitation for affected persons. + + +De Paz-Banez et al. [-@dePaz-Banez2020] use a systematic review of empirical studies to look at the effects of universal basic income on labour supply to find that, with no evidence of significant reductions in labour supply, instead the labour supply would increase globally among adults, men, women, young and old. +The insignificant reductions they found they assumed functional, since they were in the categories of: children, elderly, sick, people with disabilities, women with young children, young people continuing their studies and were offset by the otherwise increased supply. + + +Looking at the impact of gender on the employment outcomes for young disabled adults, Lindsay et al. [-@Lindsay2018] find that while youth with disabilities are half as likely to be employed, gender inequalities may play a compounding role with men being more likely to be in employment than women, working longer hours and having higher wages. +The identified channels here are different social supports, gender role expectations, as well as women's lower job expectations and overprotection from parents or guardians discouraging their independence. + + +Kumari [-@Kumari2018] looks at the relationship of both economic growth and gender disparity on the labour supply in investigating their effects on female work participation. + +They see a U-shaped participation rate and some evidence of cross-sector gender pay disparity which is affected by demographic factors such as migration, marriage, child care and fertility, as well as economic factors such as per capita income, unemployment, infrastructure and the prevalence of non-farm jobs. +Ultimately, they argue that the labour supply inequalities are based on inequality between the sexes and, while regulatory measures such as adequate family and childcare policies, tax regimes and the presence of subsidized healthcare help, changes to the female labour force participation fundamentally require the replacement of such a traditional value system itself. + + +While undertaking a systematic review concerning the effects of adopting technology on employment in LICs or LMICs, Ugur and Mitra [-@Ugur2017] find when adoption favours product innovation positive effects are somewhat likely. +They also find, however, that existing income inequalities can make the possible positive effects of its adoption more ambiguous and may in turn widen the rift of demand for skilled versus unskilled labour. +Lastly, policies favouring green transition technologies may in turn reduce income inequality, providing another possible linkage. + + +Lettieri and Diez Villoria [-@Lettieri2017] find that hiding mental illness is one of the primary strategies for improved employment outcomes in a meta-review looking at barriers to labour market inclusion for people mental disabilities. +This act of concealment of identity and self-stigmatization can seem necessary, they argue, due to the channels of workplace prejudices, perceiving them missing skills, as dangerous or unpredictable, or seeing the act of their hiring as charity due to expectations of lower productivity; but also due to discriminatory hiring practices and pre-existing inequalities leading to them being lower-skilled individuals due to prior discrimination, cultural and social barriers to training and work inclusion. +Here, relevant policies include interventions of supported employment (removing an environmental barrier), cognitive behavioural or computer-assisted therapies (cognitive barrier) or vocational rehabilitation programmes (human capital). + + +Taukobong et al. [-@Taukobong2016] review various dimensions of female empowerment and their effects on a variety of health and development outcomes, including the access and use of financial services for the poor. +They find that, aside from gender inequalities being both highly contextual and intersectional, especially the channels of control over one's income, assets, resources, having decision-making power and individual education affected these outcomes across all dimensions, reflecting their position as channels of gender inequality. +Additionally, personal mobility, safety and equitable interpersonal relationships are associated with some health and family planning outcomes. +Ultimately, the review shows that due to the contextual nature, interventions need to identify the variations of inequality at their start, see where inequalities exist, overlap and work as barriers for an effective implementation. + + +Ruhindwa et al. [-@Ruhindwa2016] review a variety of barriers to adequate workforce inclusion for people with disabilities, proposing an inclusive approach in which the individual is given space to take ownership of the solutions addressing challenges experienced in the employment sector. +Similarly, they view hiring discrimination and workplace stigmatization as the largest channels through which inequalities of disability manifest themselves. +They see especially employment support practices, with focus on enabling this, as relevant policy strategies, as well as national campaigns to ease disclosing one's disability in the labour market. + + +In looking at the various dimensions affecting the labour market outcomes of supported employment interventions for people with disabilities, Kirsh [-@Kirsh2016] finds that most literature still only regards the overall efficacy of the interventions without taking into account compounding intersectional characteristics. +They find that generally men are more likely to find employment through the intervention, possibly resting on current programmes focus on manual labour, as well as younger people generally finding better employment. +This highlights the intersectional nature of inequalities between disability, gender and age. +One relevant policy they see is that of vocational rehabilitation. + + +Hastbacka et al. [-@Hastbacka2016] undertake a scoping review to find the linkages between societal participation and people with disabilities, looking at specific interventions for the identity of participants, types of participation analysed, and channels of effect. +They see most literature focusing on labour market participation and viewing disabled people as coherent group instead of intersectional. +The main channels of inequality providing barriers they identify are financial factors, attitudes of discrimination, health issues and unemployment, while the main driving mechanisms identified are legislation and disability policies, as well as support from people in close contact with disabled people and attitudes in society and the hiring process. + + +In a systematic review looking at the effectiveness of workplace accommodations on employment and return to work, Nevala et al. [-@Nevala2015] find few studies with rigorous design leading to conclusive evidence. +They do find moderate evidence that employment in disability can be increased through workplace accommodations such as vocational counselling or guidance, education, self-advocacy, positive perception and help by others. +There is also low evidence for return to work being increased by education, work aids and techniques and cooperation between employers and other professionals (such as occupational health care, or service providers). + # Methodology and data {{++ TODO: besides scoping, introduce systematic review considerations applicable: Cochrane, PRISMA ++}}