Integrating nutrition and lifestyle: associations between employment type and health behaviors

INTRODUCTION: Health and well-being are associated with socioeconomic conditions, nutrition, and lifestyle behaviors. Although self-employment has become increasingly prevalent in developing economies, its implications for health remain unclear, particularly through nutrition- and lifestyle-related pathways. This study examines the associations between employment arrangements and self-rated health, dietary diversity, and lifestyle behaviors in Thailand, with particular attention to dietary behaviors.

METHODS: Data were drawn from the Thailand Health and Welfare Survey. Ordered probit models and an instrumental variable approach were employed to examine the associations between self-employment and self-rated health, dietary diversity, physical activity, smoking, and alcohol consumption. Heterogeneity across types of self-employment was also assessed by distinguishing employer self-employed individuals from solo self-employed workers.

RESULTS: Self-employment was associated with lower self-rated health and lower dietary diversity, indicating less varied diets. Self-employed individuals also exhibited less favorable lifestyle behaviors, including lower physical activity and higher probabilities of smoking and alcohol consumption. These associations varied by type of self-employment. Employer self-employed individuals tended to maintain healthier behaviors and better health outcomes, whereas solo self-employed workers were more vulnerable to lower dietary diversity and adverse health conditions.

DISCUSSION: The findings indicate that employment type is an important structural factor associated with nutrition, lifestyle behaviors, and health inequalities. Policies aimed at improving population health should integrate labor-market interventions with nutrition- and lifestyle-oriented strategies, with particular attention to vulnerable groups of solo self-employed workers.