Employment status, unemployment duration, and health-related metrics among US adults of prime working age: Behavioral Risk Factor Surveillance System, 2018-2019.
employment status
health equity
healthcare access
occupational health
unemployment
Journal
American journal of industrial medicine
ISSN: 1097-0274
Titre abrégé: Am J Ind Med
Pays: United States
ID NLM: 8101110
Informations de publication
Date de publication:
01 2022
01 2022
Historique:
revised:
21
10
2021
received:
23
08
2021
accepted:
25
10
2021
pubmed:
9
11
2021
medline:
4
2
2022
entrez:
8
11
2021
Statut:
ppublish
Résumé
While unemployment has been associated with poor health, few recent studies in the United States have comprehensively assessed associations between employment status (including duration unemployed) and healthcare access, health-related behaviors, and specific health outcomes. We assessed health-related metrics by employment status in 2018-2019 Behavioral Risk Factor Surveillance System respondents ages 25-54. We calculated the unadjusted prevalence and adjusted prevalence ratios to compare employed workers to respondents who were self-employed, short-term (<12 months) unemployed, long-term unemployed, and unable to work. Adverse health outcomes increased with unemployment duration and were highest for those unable to work. Non-Hispanic Blacks were most likely to be unemployed or unable to work. Short-term unemployment and self-employment were associated with poor healthcare access. Health behaviors and outcomes declined with increasing duration of unemployment and were worst for those unable to work. In the United States, access to affordable healthcare is problematic for both the self-employed and the short-term unemployed. Short-term unemployment is a particularly important locus for intervention and provision of resources to prevent health declines that may hinder re-employment.
Sections du résumé
BACKGROUND
While unemployment has been associated with poor health, few recent studies in the United States have comprehensively assessed associations between employment status (including duration unemployed) and healthcare access, health-related behaviors, and specific health outcomes.
METHODS
We assessed health-related metrics by employment status in 2018-2019 Behavioral Risk Factor Surveillance System respondents ages 25-54. We calculated the unadjusted prevalence and adjusted prevalence ratios to compare employed workers to respondents who were self-employed, short-term (<12 months) unemployed, long-term unemployed, and unable to work.
RESULTS
Adverse health outcomes increased with unemployment duration and were highest for those unable to work. Non-Hispanic Blacks were most likely to be unemployed or unable to work. Short-term unemployment and self-employment were associated with poor healthcare access. Health behaviors and outcomes declined with increasing duration of unemployment and were worst for those unable to work.
CONCLUSIONS
In the United States, access to affordable healthcare is problematic for both the self-employed and the short-term unemployed. Short-term unemployment is a particularly important locus for intervention and provision of resources to prevent health declines that may hinder re-employment.
Identifiants
pubmed: 34748231
doi: 10.1002/ajim.23308
pmc: PMC8678322
mid: NIHMS1755368
doi:
Types de publication
Journal Article
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
59-71Subventions
Organisme : Intramural CDC HHS
ID : CC999999
Pays : United States
Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
J Gerontol B Psychol Sci Soc Sci. 2011 Jul;66(4):478-89
pubmed: 21666144
Am J Public Health. 2004 Jan;94(1):82-8
pubmed: 14713703
BMC Public Health. 2012 May 03;12:327
pubmed: 22554095
Eur J Public Health. 2018 Apr 1;28(2):269-275
pubmed: 29360958
BMC Public Health. 2014 Dec 22;14:1310
pubmed: 25535401
Dtsch Arztebl Int. 2013 Jun;110(23-24):413-9
pubmed: 23837086
BMC Med. 2017 Feb 15;15(1):33
pubmed: 28196524
Health Econ. 2009 Feb;18(2):161-79
pubmed: 18536002
J Epidemiol Community Health. 2009 Feb;63(2):92-8
pubmed: 18930981
NCHS Data Brief. 2012 Jan;(83):1-8
pubmed: 22617552
J Health Econ. 2019 Jan;63:34-51
pubmed: 30453224
J Clin Oncol. 2016 Mar 20;34(9):980-6
pubmed: 26811521
Scand J Public Health. 2017 Aug;45(18_suppl):22-29
pubmed: 28856985
Health Aff (Millwood). 2018 Aug;37(8):1238-1242
pubmed: 30080453
Soc Sci Med. 2014 Apr;106:28-34
pubmed: 24530614
Scand J Work Environ Health. 1997 Dec;23(6):403-13
pubmed: 9476803
Occup Environ Med. 2014 Oct;71(10):730-6
pubmed: 24556535
J Epidemiol Community Health. 2012 Jul;66(7):586-92
pubmed: 21422028
Disabil Health J. 2012 Jan;5(1):60-3
pubmed: 22226300
Eur J Public Health. 2012 Jun;22(3):429-33
pubmed: 21602222
Am J Public Health. 2015 Feb;105(2):317-23
pubmed: 25521897
Eur J Health Econ. 2019 Feb;20(1):59-73
pubmed: 29725787
JAMA Intern Med. 2016 Oct 1;176(10):1501-1509
pubmed: 27532694
Ann Intern Med. 2018 Apr 17;168(8):577-578
pubmed: 29677265
Am J Public Health. 2003 Feb;93(2):226-31
pubmed: 12554574
Prev Chronic Dis. 2020 Dec 03;17:E151
pubmed: 33274701
PLoS One. 2013;8(1):e51333
pubmed: 23341881
Eur J Public Health. 2015 Aug;25(4):662-7
pubmed: 25417939
Ann Fam Med. 2018 Sep;16(5):447-460
pubmed: 30201643
BMC Public Health. 2019 Jun 13;19(1):740
pubmed: 31196081
J Public Econ. 2020 Nov;191:104273
pubmed: 33012869
J Health Psychol. 2017 Jun;22(7):864-873
pubmed: 26628216
BMC Med Res Methodol. 2013 Mar 24;13:49
pubmed: 23522349
Public Health Rep. 2001 Sep-Oct;116(5):404-16
pubmed: 12042604
Arch Phys Med Rehabil. 2017 Aug;98(8):1567-1575.e1
pubmed: 28115071
Disabil Rehabil. 2019 Sep;41(19):2299-2307
pubmed: 29779408
Occup Environ Med. 2007 Mar;64(3):144-9
pubmed: 17095549
J Health Soc Behav. 2010;51 Suppl:S28-40
pubmed: 20943581
Am J Public Health. 2018 Mar;108(3):306-311
pubmed: 29345994
Scand J Work Environ Health. 2013 Mar 1;39(2):134-43
pubmed: 22961587