Public Health Impacts of Underemployment and Unemployment in the United States: Exploring Perceptions, Gaps and Opportunities

Abstract

Background: Unemployment, underemployment, and the quality of work are national occupational health risk factors that drive critical national problems; however, to date, there have been no systematic efforts to document the public health impact of this situation. Methods: An environmental scan was conducted to explore the root causes and health impacts of underemployment and unemployment and highlight multilevel perspectives and factors in the landscape of underemployment and unemployment. Methods: included a review of gray literature and research literature, followed by key informant interviews with nine organizational representatives in employment research and policy, workforce development, and industry to assess perceived needs and gaps in practice. Results: Evidence highlights the complex nature of underemployment and unemployment, with multiple macro-level underlying drivers, including the changing nature of work, a dynamic labor market, inadequate enforcement of labor protection standards, declining unions, wage depression, and weak political will interacting with multiple social determinants of health. Empirical literature on unemployment and physical, mental, and psychological well-being, substance abuse, depression in young adults, and suicides is quite extensive; however, there are limited data on the impacts of underemployment on worker health and well-being. Additionally, organizations do not routinely consider health outcomes as they relate to their work in workforce or policy development. Discussion and Conclusions: Several gaps in data and research will need to be addressed in order to assess the full magnitude of the public health burden of underemployment and unemployment. Public health needs to champion a research and practice agenda in partnership with multisector stakeholders to illuminate the role of employment quality and status in closing the gap on health inequities, and to integrate workforce health and well-being into labor and economic development agendas across government agencies and industry.

Promising Occupational Safety, Health, and Well-Being Approaches to Explore the Future of Work in the USA: An Editorial

“…Pratap et al [28] perform an environmental scan of unemployment and underemployment via a literature review and key informant interviews. The authors highlight the pivotal role that employment (and lack thereof) plays in the work and home lives of individuals and the need to prioritize integrated workforce health and well-being approaches into labor and economic development agendas to reduce health inequities.…”

Occupational Safety and Health Staging Framework for Decent Work

“…Half the working population in the world is unemployed or underemployed [ 182 , 183 ]. The UN, WHO, and ILO need to consider how their programs can be delivered more effectively [ 184 ] and acknowledge the substantial contributions by migrant workers to both host countries and their countries of origin.…”

Health Equity and a Paradigm Shift in Occupational Safety and Health

“…Therefore, the world of work has powerful potential to be leveraged to address health inequities in general, not only those classified as “occupational.” At the societal level, labor policies and workforce development initiatives that improve the quality of jobs and increase access to “decent work” can be analyzed and understood through a public health lens [ 86 ]. Further research is needed to fully explicate the promise of public health impacts beyond the workplace of labor- and work-focused policies and interventions, such as job security, wage and hour laws, paid sick leave, and other factors [ 87 ]. At the organizational level, issues related to work design, such as contract, wage, hour, and benefit structures, can improve worker health and well-being on and off the job [ 88 ].…”