This study addresses the scarcity of research on health developments in the heterogeneous group of self-employed workers. It aims at understanding typical health progressions in this group and associations with demographic factors, work characteristics, and self-employment decisions. We investigate health profiles based on mental health problems, self-rated health, and work satisfaction, as well as transitions between them in relation to work effort, reward, overcommitment, demographic characteristics, and entrance and exit into self-employment. Using latent transition analysis, we analyzed data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including data from 593 participants. We identified four distinct, stable health profiles, revealing associations with work effort, reward, overcommitment, and self-employment decisions. No meaningful relations existed for demographic characteristics. Overall, the findings offer a comprehensive perspective on the health dynamics of self-employed individuals, their associations with work characteristics and decisions to enter and exit self-employment.

The self-employed are a relatively small, but important group of workers. They contribute to society and its economy through growth, innovation, and job-creation. Self-employed work is characterised by working for oneself; it is associated with high levels of autonomy, but also uncertainty about income, high demands, and sometimes lack of social context at work. This may lead to strenuous work situations and thus impaired health, which over time can affect work negatively, in a reciprocal relationship where health and work affect each other. Despite the importance of self-employed workers, health and the unique circumstances of self-employed work are still understudied. Further, while they are a diverse group, this heterogeneity has seldom been considered in earlier research. 

This thesis investigates health in terms of wellbeing, illbeing, and self-rated health in relationship to work and demographic characteristics, entrance into, and exit out of self-employment, thereby taking the heterogeneity of self-employed workers into account. The thesis comprises three studies based on survey data to: compare mental illbeing in self-employed workers, organisationally-employed workers, and those combining the two types of work (Study I); study the health of workers engaging in self-employment over time (Study II); and compare wellbeing and its relationship to experiences of work in self-employed and organisationally-employed workers (Study III). In all studies, advanced statistical methods using the Bayesian approach were applied to accurately model the complexity of the longitudinal or multilevel data.

In Study I, we found that illbeing in self-employed, organisationally-employed workers and combinators does not substantially differ. In Study II we demonstrate that workers engaging in self-employment belong to four distinct health profiles, which they also mostly maintain over time. Furthermore, entrance into and exit out of self-employed work, and work characteristics, but not demographic characteristics, are related to these health profiles of the self-employed. Lastly, in Study III, we found that experience of self-determination and meaning during the performance of work tasks have stronger associations with wellbeing than employment type (self-employed or organisationally employed).

In summary, this thesis shows that there are few substantial differences in illbeing between organisationally-employed workers, self-employed workers, and combinators. Further, and perhaps explaining some of these results, there is variation in the health of self-employed workers, both between different individuals, and over time, indicating that heterogeneity among self-employed workers is substantial. Lastly, also further explaining why health differences between workers of different employment forms are small, differences in wellbeing between self-employed and employed workers can be explained by the tasks that these workers perform during the day, beyond that of their employment form.

This thesis shows the importance of taking aspects of health, time, heterogeneity of workers, and assessment of these into account to gain more in-depth understanding of the interrelations between health and self-employed work.  

Purpose: Using COR theory to study developments of health and other key resources in self-employed workers in Sweden over 6 years, this study: (1) explored whether the heterogenous group of self-employed workers contained subgroups with different health trajectories, (2) investigated whether these were more typical for certain individuals (with respect to age, gender, sector, education, employment status), and (3) compared the different health trajectories regarding resource development in mental well-being, business resources, employment status, work ability. Method: The study used data from the Swedish longitudinal occupational survey of health (SLOSH) and included participants working as self-employed or combiner (N = 2642). Result: Five trajectories were identified with latent class growth curve model analysis (LCGM). Two health trajectories with (1) very good, respective (2) good stable health (together comprising 78.5% of the participants), (3) one with moderate stable health (14.8%), (4) one with a U-shaped form (1.9%), and (5) one with low, slightly increasing health (4.7%). The first two trajectories flourish: they maintained or increased in all key resources and were more likely to remain self-employed. Trajectories three and five consist of those who fight to maintain or increase their resources. Workers in the U-shaped health trajectory show signs of fight and flight after loss in health and other key resources. Conclusions: Studying subgroups with different resource developments over time was suitable to understand heterogeneity in self-employed workers. It also helped to identify vulnerable groups that may benefit from interventions to preserve their resources.

Research goals and motivation: Self-employed workers contribute significantly to our society in terms of economic productivity, job opportunity and innovation. Thus, it is in the interest of our society to support and encourage self employment. It is well documented that self-employed workers – on average – experience higher levels of wellbeing, and less mental health problems than employed workers do. However, self-employed workers are a highly heterogeneous group when it comes to who they are, how they work, and their health status. Thus, averages are not sufficient to inform researchers, policymakers and companies on how to understand the mental health and wellbeing of this group of workers. 

Workers enter and exit self employment all the time as business opportunities occur, need of an income arises, innovations are created, and businesses fail. However, little is known about the mechanisms behind these career transitions beyond economic factors. Is the decision to start a business related to wellbeing, and how? How many self-employed workers are thriving over time, both when it comes to wellbeing and their business? Who is struggling and experiencing mental health problems, and is this related to exiting self employment? Questions like these currently go unanswered. 

Theoretical background: This study is mainly exploratory, but mental health problems, wellbeing and how it develops and how it relates to entering and exiting self employment can be related work environment. The effort-reward imbalance model (ERI) has proven to be a good framework to understand health developments, and is adapted and used in this study as theoretical framework. 

Method: Latent transition analysis (LTA) is used to consider both the longitudinal aspect and the heterogeneity of the group of self-employed workers, in a unique and novel way. We investigate what profiles of mental health and wellbeing exist among self-employed workers, how common they are, and how the workers transition between these profiles over time. Further, we study how the profiles and transitions between them relate to entrepreneurial entrance and exit, work environment factors (ERI) and background variables (i.e., age and gender). 

We use data from the Swedish Longitudinal Occupational Survey of Health (SLOSH) The current study is based on participants who responded to the 5 th -7 th wave of SLOSH conducted in 2014 (response rate 53%), 2016 (response rate 51%) and 2018 (response rate 48%). In this study, we use respondents who were self-employed at any of the three time points (N=2327). 

Results: Results of all statistical analyses will be available when the conference takes place. Preliminary findings of factor analysis show that all scales have adequate fit and factor loadings. Based on previous research we expect to find at least one profile of relatively good mental health and wellbeing, as well as profiles with less advantageous mental health. We also expect that work environment factors are linked to health profiles such that better health is found in workers with less ERI. ERI, a well-documented theoretic model, is used to validate the health and wellbeing profiles. Probably, exits out of or entrance into self employment is related to changes in health and work environment. Mechanisms, the number of transitions, and the temporal order will be explored in our study. 

Limitations: The limitations of this study lie in the exploratory nature of the analysis, and more studies will be needed to further validate any found profiles. 

Relevance to congress theme: This study is relevant to the first theme of the congress: Careers and the labour market. Specifically, career transitions and employee mobility. With regard to the UN SDG, our study addresses good health and wellbeing and decent work and economic growth. 

Conclusions: Exact conclusions will depend on the findings, but the study is one of the first to focus on health profiles of self-employed workers, and ways in which these workers’ mental health and wellbeing changes in relation to ERI and decisions to change employment. The results will yield a better understanding of how self-employed workers thrive or struggle, and how to identify the ones that struggle. This will also help to discuss potential possibilities to create better circumstances or preventive tools to shape decent work and sustainability of careers that involve self employment.

Research goals and why the work was worth doing: Research of well-being and positive affect of workers have previous mainly been focused on a general level. These previous studies have not yet disentangled whether positive affect can be linked to task-by-task experience at work, or whether it mainly varies between different people with different types of work. The purpose of this study was to differentiate between the general level, task level, and type of employment in self-determination, meaningfulness of work and positive affect, thus contributing to the understanding of how to best assess well-being. The novelty and contribution of this study lies in the analysis strategy that allows for disentangling the effect that specific work tasks may have on workers' positive affect. Specifically, the use of multi-level modelling on the data gathered with the Day Reconstruction Method (DRM) allows us to describe relationships between positive affect, self-determination, and meaningfulness of work at both person and task level. Multilevel studies assessing the intrapersonal variability of experienced well-being on not only a day-level, but also a task level, are rare and much needed to better understand the dynamics of well-being during a workday.

Theoretical background: Researchers have connected positive affect – which represents momentary well-being experiences such as happiness, engagement, and inspiration – to high levels of general well-being and better health. High levels of positive affect is often attributed to higher levels of self-determination, and meaningfulness of work. Workers experiencing more self-determination and meaningfulness of work should experience more positive affect, and tasks experienced as more self-determined and meaningful should lead to more positive affect. Additionally, self-employed workers are suggested to have a more self-determined career choice in itself, and thus higher levels of positive affect.

Design/Methodology/Approach/Intervention: In this study we tested whether H1) workers experiencing more self-determination and meaningfulness of work report higher levels of positive affect, H2) tasks experienced as more self-determined and meaningful are related to more positive affect, and H3) self-employed workers experience stronger relationships of task level self-determination and meaningfulness with positive affect than employed workers. We used a sample of 175 high skilled self-employed and employed workers, who reported self-determination, meaningfulness of work and positive affect for a total of 560 tasks during a workday by the DRM. DRM facilitates access to momentary experiences stored in memory, providing reliable estimates of intensity and variations of affect during the day. First, we tested two separate multilevel multi-group confirmatory factor analysis (MCFA) models for momentary positive affect (outcome side of the model), as well as self-determination and meaningfulness of tasks (predictor side of the model), and then tested the models for measurement invariance. Since tasks were nested within individuals we fitted a bayesian structural equation model with random slopes with self-determination and meaningfulness of work and employment type as predictors and positive affect as an outcome variable.

Results obtained: Results indicated that workers experiencing more self-determination and meaningfulness of work reported more positive affect, that tasks experienced as more self-determined also elicited higher levels of positive affect, and that there was a small positive effect of self employment on positive affect. The self-determination and meaningfulness of tasks seem to be more important to positive affect than employment type. The relationship between self employment on positive affect have been assumed by earlier research, but our study is the first to test and show that this indeed may be the case. However, other factors such as self-determination might be more important to task level positive affect.

Limitations: We studied high-skilled worker, choosing this population facilitated comparison of groups of workers, as many background variables were similar, however, this does affect the generalizability of the results. As consequence, one limitation is that a fairly small sample. Further, we used DRM and a drawback of this method is that it is not in the moment assessment, but rather recorded after the tasks of the day. However, DRM still have practical benefits as it might elevate the response rate in contrast to in the moment reports, because it is difficult for the respondent to make pauses during their workday.

Research/Practical Implications: These findings may inform researchers on how to best assess well-being, and organizations on how to design work of workers to elevate positive affect and thus, well-being, and health. We have empirically confirmed the assumptions of a positive relationship between self employment and positive affect of previous studies, and that this relationship might be less important than other factors such as self-determination.

Originality/Value: The originality of this research lies in the multi-level structure of the method and analysis, as well as the comparison of groups of workers.

Studies investigating differences in mental health problems between self-employed and employed workers have provided contradictory results. Many of the studies utilized scales validated for employed workers, without collecting validity evidence for making comparisons with self-employed. The aim of this study was (1) to collect validity evidence for three different scales assessing depressive symptoms, emotional exhaustion, and sleep disturbances for employed workers, and combinators; and (2) to test if these groups differed. We first conducted approximate measurement invariance analysis and found that all scales were invariant at the scalar level. Self-employed workers had least mental health problems and employed workers had most, but differences were small. Though we found the scales invariant, we do not find them optimal for comparison of means. To be more precise in describing differences between groups, we recommend using clinical cut-offs or scales developed with the specific purpose of assessing mental health problems at work.

Purpose: Around 9% of the working population in Sweden consists of self-employed business owners, but a considerable amount of them struggle to consolidate or expand their businesses. Among the factors predicting business success the decisive role of long-term health of business owners has been acknowledged only recently, but longitudinal studies testing this assumption are scarce. Based on the conservation of resources theory, good health can be seen as a resource that helps business owners to tackle high workloads and make business succeed.

Design: Data from the Swedish Longitudinal Occupational Health Survey is used. Starting in 2012, N=554 self-employed have answered three or more times in the biannual data collection. Latent growth curve modelling is employed to study general and mental health trajectories and their associations with business survival over time.

Results: Preliminary descriptive analyses on biannual changes suggest that roughly one in ten self-employed leaves self-employment at follow-up. Job demands and emotional exhaustion are higher among those who leave compared to those who remain in business. After integrating new data collected in 2018, growth curve analyses are run over the whole longitudinal sample, and associations of health trajectories to business survival will be tested.

Limitations: Data is collected with questionnaires, and business success is operationalized as business survival only.

Research/Practical Implications: Study results increase knowledge on the self-employed’s health developments, vulnerable groups with poor health and risk of business failure can be detected.

Originality/Value: This is one of few studies on longitudinal developments of health in selfemployed business owners.