Unemployed and underemployed women are a marginalized population who not only disproportionately suffer from the disparity of job insecurity and lack of income, but also suffer from the intersecting disparity of gender inequity. Gender inequity influences health through unfair distributions of work, unequal access to economic resources and employment opportunities, amongst many other routes (Commission on the Social Determinants of Health, 2008). Women are typically employed in underpaid, more insecure and informal occupations. Another example of gender inequity is women’s limited participation in the paid workforce due to the unequal burden of childcare and household work. Family-friendly policies, which includes provisions for quality childcare facilities, flexible work hours, parental leave for both men and women, as well as programmes to change gender-biased attitudes towards childcare and household work are critical in ensuring equal employment opportunities are available for both men and women, thus alleviating the burden of gender inequity.

Job security is a crucial social determinant of health, especially for marginalized populations such as women, who are affected by the intersection of multiple health inequities. Job insecurity, characterized by precarious work arrangements, such as part-time or temporary work, as well as a lack of employment protection and benefits, is often associated with adverse health outcomes (Mikkonen & Raphael, 2010). According to a prospective cohort study conducted by Ferrie, Shipley, Stansfeld, & Marmot (2002), participants who faced job insecurity had significantly higher psychological morbidity and higher blood pressure compared to individuals who were securely employed. This effect was especially pronounced for women. Moreover, this study also found that the percentage of participants receiving prescription medication treatments for high blood pressure and cholesterol was significantly higher amongst individuals who suffered from job insecurity (96 women and 207 men) compared to those who those who had secure employment (12 women and 68 men). A longitudinal study also found that chronic job insecurity was associated with high levels of psychological stress (Dekker & Schaufeli, 1995). Research has also demonstrated that the disparity of job insecurity disproportionately affects women. Women represent 75% of permanent part-time workers, 62% temporary part-time workers but only 40% of full-time workers. In 2009, Statistics Canada reported that approximately 7 out of 10 women work part -time in Canada. Therefore, job insecurity, which disproportionately affects women, often leads to increased morbidity, poor physical and psychological health outcomes.

Employment and income are amongst the most important social determinants of health. Unemployment often leads to chronic stress and anxiety, which is associated with unhealthy coping behaviours, such as smoking and alcohol consumption. Furthermore, unemployment can drastically reduce self-esteem, an essential component of psychological well-being. Moreover, income is essential to health and well-being, as it determines living conditions, a prerequisite for health. A Canadian study shows that the death rates for those living in the most deprived neighbourhoods were 28% higher than the death rates for those living in the least deprived neighbourhoods (Mikkonen & Raphael, 2010). Not only are mortality rates significantly higher for those with lower income, studies have also shown that morbidity from chronic, non-communicable diseases, such as adult-onset diabetes and heart attacks, are much more commonly diagnosed in Canadians with lower income compared to those with medium to higher income. Therefore, it is vital to assist unemployed and underemployed women with employment training to increase their income as unemployment and low-income are strongly associated with chronic stress, unhealthy coping mechanisms, significantly higher morbidity and mortality rates.

Low income often leaves individuals in poor housing conditions and unhealthy built environments, which are associated with significantly higher rates of respiratory infections and chronic stress (Martin, Platt & Hunt, 1987). A systematic review of scientific literature conducted by Lovasi, Hutson, Guerra, and Neckerman (2009) found that populations with lower socioeconomic status tend to live in neighbourhoods with less supermarkets, recreation facilities as well as higher rates of traffic and other crimes, which were contributors to their significantly higher rates of obesity compared to populations with higher socioeconomic status. A lack of income also prevents individuals from being able to afford healthy and nutritious foods. According to Drewnowski and Specter (2004), foods high in fat, added sugars and refined grains are often available at a lower cost compared to highly nutritious choices such as fresh fruits or vegetables. Nutritious foods are essential to good health and can be costlier compared to junk food and unhealthy, highly processed foods with high saturated fats. Therefore, low income can lead to negative health outcomes through inability to afford proper housing and food insecurity.

Psychological well-being is also impacted by low income. Suicide rates have been reported to be twice as high amongst lowest income neighbourhoods compared to the wealthiest neighbourhoods. Furthermore, low income predisposes people to social deprivation due to inability to afford and participate in cultural, recreational and educational activities which are essential to building strong social networks that facilitate good health and well-being (Mikkonen & Raphael, 2010). Therefore, income is a fundamental prerequisite to health, as it facilitates psychological and social well-being through social networks and decreased chronic stress.

In conclusion, the burden of physical and psychological morbidity is significantly increased for unemployed and underemployed women due to the interplay of gender inequity, job insecurity and low income. Thus, in order to improve the health and well-being for women and children, who often rely on their mothers to play the important role of shaping their health and education outcomes, it is crucial to critically evaluate these intersecting inequities together to fully understand the health inequities for unemployed and underemployed women.