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I) Objective: The study aimed to explore the health effects of precarious employment relationships in Ontario, and understand how various forms of support shape health. II) Methods: Three measures make up our "Employment Strain" model: employment relationship uncertainty; employment relationship effort; and, employment relationship support. This new framework was used to measure the characteristics of precarious employment and their effect on health using data from a structured, self-administered, population-based survey completed by 3,244 workers, and 82 semi-structured interviews using a stratified sampling technique to select participants. III) Results: Precarious employment has negative health consequences for many workers. However, the relationship between precarious employment and health is complex, whereby the characteristics of the employment relationship and levels of support determine health outcomes. Using the "Employment Strain" framework, we found that workers exposed to High Employment Strain - workers with high levels of employment relationship uncertainty and high levels of employment relationship effort - have poorer health. Importantly, support does shapes health and can help to buffer the health risks associated with precarious employment.