Does improving vulnerable employment contribute to maternal and infant health: The mediating role of urbanization and gender gap analysis

Background This study uses transnational panel data from 166 countries between 1992 and 2019 to examine the relationship between the vulnerable employment rate, maternal mortality, infant mortality, and the mediating role of urbanization. Methods The World Bank database offers data on the vulnerable employment rate, maternal mortality rate, infant mortality rate, and urbanization levels. Panel regression is used to analyze the relationship between the vulnerable employment rate and maternal and infant mortality rates for each country, as well as the mediating effect of urbanization levels, while considering economic, demographic, and environmental factors. This paper also applies system GMM estimation and 2SLS estimation to handle potential endogeneity issues and determine causal links. Additionally, since male vulnerable employment mostly consists of own-account workers, whereas female vulnerable employment often involves contributing family workers, the study adjusts the regressions of male and female vulnerable employment rates on maternal and infant mortality rates to compare how gender disparities in vulnerable employment influence maternal and infant health. Finally, data are regressed based on each country's human development index level to examine heterogeneity. Results Overall, a significant positive correlation exists between the vulnerable employment rate and maternal and infant mortality rates (β = 3.116, 0.450, P < 0.01), with urbanization levels acting as a mediating factor (β = -2.643, -0.346, P < 0.01). Gender analysis shows that for every unit decrease in the male vulnerable employment rate, maternal mortality rate decreases by 0.357 units and infant mortality by 0.403 units. Conversely, for every unit decrease in the female vulnerable employment rate, maternal mortality rate decreases by 0.1 units and infant mortality rate by 0.243 units. Heterogeneity analysis reveals that in countries with low human development levels, there is a positive correlation between the vulnerable employment rate and infant mortality rate(β =0.574, P < 0.01), while the relationship with maternal mortality rate is not significant(β =0.933, P > 0.5). Conclusions A decline in the vulnerable employment rate is conducive to reducing maternal and infant mortality rates. As the vulnerable employment rate decreases, urbanization levels increase, which in turn can effectively lower the maternal mortality rate and infant mortality rate. A gender analysis indicates that improving male vulnerable employment is more beneficial for maternal and infant health. In countries with low levels of human development, maternal mortality is associated with various other factors.This study advocates for paying attention to the impact of the gender gap in vulnerable employment on maternal and infant health and recommends increasing investment in healthcare systems in countries with low human development levels to achieve greater health benefits, thus ultimately fulfilling the United Nations Sustainable Development Goals.