Transitions Between Forms of Employment Quality and Associations With Self-Rated Health and Mental Health in the United States, 2008-2022.

Five unique employment quality types were identified for men and four for women using latent transition analysis of U.S. Medical Expenditure Panel Survey data.

• Male EQ types: 1. Salaried-Intensive; 2. Standard Employment Relationship (SER)-like; 3. Standard but Economically Vulnerable; 4. Precarious; and 5. Unemployed.
• Female EQ types: 1. SER-like, Union; 2. SER-like, non-Union; 3. Precarious; and 4. Unemployed.
• Data spanned 2008 to 2022 with n = 71,957 respondents (weighted n = 126,312,273).
• The study used U.S. Medical Expenditure Panel Survey (MEPS) data.

Respondents transitioning to or from low employment quality arrangements reported poor or fair self-rated health more frequently than those in high-EQ types.

• Low-EQ arrangements included precarious employment and unemployment.
• High-EQ types included SER-like employment arrangements.
• Associations of poor/fair self-rated health (SRH) with each EQ type were measured using generalized estimating equations.
• The probability of reporting poor/fair SRH within each EQ transition was measured descriptively.

Respondents transitioning to or from low employment quality arrangements reported poor or fair self-rated mental health more frequently than those in high-EQ types.

• Self-rated mental health (SRMH) outcomes were measured alongside self-rated health (SRH).
• Low-EQ transitions (e.g., to or from precarious employment or unemployment) were associated with worse SRMH.
• Associations were measured using generalized estimating equations.
• Unemployed individuals were included in the EQ typology, unlike many prior studies.

Some respondents cycled between precarious employment and unemployment, potentially compounding the effects of employment instability on health.

• The probability of transitioning between each EQ type was measured using latent transition analysis (LTA).
• Cycling between precarious employment and unemployment was identified as a distinct pattern in the LTA results.
• This cycling pattern was identified for both men and women, as both had a Precarious and an Unemployed EQ type.
• The authors suggest this cycling may compound negative health effects of employment instability.

Unemployed individuals are frequently omitted from employment quality studies, representing a gap this study addressed by including unemployment as a distinct EQ state.

• Unemployment was included as a separate EQ type for both men (type 5) and women (type 4).
• The study notes that few prior studies have explored how transitions between types of EQ impact health in the U.S.
• Including unemployment allowed the authors to capture cycling between precarious employment and unemployment.

Improving employment conditions, particularly for those caught in cycles of precarious employment and unemployment, was identified as a potential avenue for improving population health in the U.S.

• This conclusion was drawn from the finding that low-EQ transitions were associated with worse self-rated health and mental health outcomes.
• The study covered a 14-year period from 2008 to 2022, encompassing multiple economic cycles.
• The weighted sample represented approximately 126,312,273 individuals in the U.S.