Precarious employment and mental health in the United States: Results from the Medical Expenditure Panel Survey (MEPS), 2008–2021

Objectives

To measure associations between employment precarity and mental health among United States (US) workers.

Methods

This study used data from the US Medical Expenditure Panel Survey for 2008–2021. Multivariable generalized estimating equations were used to measure associations between employment precarity (operationalized as a multi-dimensional exposure) and self-rated mental health after adjusting for relevant confounders. Marginal effects analysis was used to assess potential dose-response relationships between precarity and mental health.

Results

Our sample (n = 57,529) was representative of >106 million US workers employed throughout 2008–2021. Compared to those with low levels of employment precarity, those with medium and high levels of precarity had an increased odds of reporting poor/fair mental health (aOR = 1.21; 95% CI = 1.11, 1.32 and 1.51; 95% CI = 1.36, 1.68, respectively). Marginal effects analysis indicated that increasing levels of precarity were associated with an increased probability of reporting poor/fair mental health.

Conclusions

Increasing levels of employment precarity were associated with poor/fair self-rated mental health, findings potentially indicative of a dose-response relationship between the two. These nationally representative findings suggest employment precarity is an important social determinant of mental health. Future research could investigate how best to mitigate the negative effects of precarity on workers' lives and well-being, particularly regarding mental health.