Influence of worklife on public health.

The paper discusses worklife changes with broad public health impacts. Central concepts for the analysis of the labor market are flexibility and differentiation. One conclusion is that there is ongoing polarization and differentiation--with an increased group of people in time-restricted (contingent) employment and self-employment and a reduced group of core workers. Greater demands for adaptability are being imposed on the majority of employees. Concepts related to flexibility and differentiation at an individual level are adaptability, identity formation, loss of control, trust and lack of trust, allostatic load, long-term strain, and psychological contracting. The labor market and organizational changes are discussed in relation to what can be called "institutional effectiveness". These changes refer to how institutions commissioned to act for the prevention of injuries and to contribute to worklife quality handle the new conditions. Finally, work-environment research is discussed in relation to a new and more complex pattern of exposures and interactions. One conclusion drawn is that it is becoming increasingly difficult to identify workplaces at risk.