by Kim Krisberg

It’s not news that unemployment is bad for a person’s health. But it turns out that just the threat of unemployment is bad as well.

A recent study, published in the September issue of the Journal of Occupational and Environmental Medicine, found that perceived job insecurity is also linked to poor health outcomes, even among those who had jobs during the recession. Researchers found that perceived job insecurity was linked with “significantly higher odds” of fair or poor self-reported health as well as recent symptoms suggesting depression and anxiety attacks. The findings persisted even after researchers adjusted for sociodemographic characteristics, previous health problems, whether a person was a temporary worker and recent job loss.

“It’s an invisible problem — these people might not look like they need help,” Sarah Burgard, a professor at the University of Michigan and co-author of the study along with Lucie Kalousova and Kristin Seefeldt, told me. “It’s a growing problem in the United States over the last several decades because a lot of job creation has been in insecure jobs and jobs without benefits. It’s hard to care about people who are still employed when you’re in a recession.”

Based on data from about 440 adults older than 25 working in southeastern Michigan in 2009–2010, the study found that about 17.5 percent felt their employment situation was insecure — in other words, they felt they’d lose their job or get laid off in the next year (workers were asked to rate the chance of losing their jobs as very likely, fairly likely, not too likely or leaving the labor force). About 19 percent of these job-insecure respondents reported fair or poor health; only about 7 percent of job-secure respondents reported similar health statuses. More than 40 percent of job-insecure respondents reported symptoms of depression and 30 percent reported an anxiety attack in the previous month, versus about 7 percent and 10 percent, respectively, of those not reporting job insecurity. Those reporting that they were fairly or very likely to lose their jobs were more likely to be black, have a chronic illness, be a temporary worker, have experienced recent unemployment and were less likely to have a college degree.

The study also notes this interesting comparison: While this recent study found that almost 18 percent of 25- to 64-year-old workers in southeastern Michigan were insecure, a 2007 study found that between 1977 and 2002, only about 11 percent of respondents in a nationwide survey perceived job insecurity, “suggesting that insecurity is elevated in the postrecession period.”

“A worker perceiving job insecurity may experience stress due to anticipation about the problems associated with a job loss, the mental strain of being in a powerless position and ambiguity about the future,” the study stated. “This research has become increasingly salient in the wake of the Great Recession that began in December 2007; historically high unemployment rates followed by an unusually slow and ‘jobless’ economic recovery may have population health consequences.”

No easy answers for job insecurity

Burgard told me that workers who persistently and chronically experience job insecurity are sometimes, in fact, in worse health than the unemployed — “even though it’s really terrible to lose a job, it ends the serious gnawing and uncertainty about it.” And the impact of unemployment and diminished assets, though hardly an ideal situation, can be tempered through a variety of assistance programs. Addressing the health risks of job insecurity, however, is much less clear and straightforward.

Many readers of this study might think unions are the answer — and there’s no doubt that collective bargaining has improved worker status and conditions and empowered workers with a sense that they too have a say in their futures. But while Burgard agrees that “unions are designed to help with these type of matters,” they’ve also experienced sizable setbacks, old union jobs are disappearing and new jobs aren’t likely union jobs. The balance of power “between unions and corporations and businesses has shifted shockingly in a way that doesn’t benefit unions,” she said.

“We have enough trouble trying to help people who’ve actually lost their jobs, so I’ve never heard about an intervention program (that addresses the health effects of job insecurity),” Burgard said. “In the larger scope of things, it’s hard to convince people to address this…but this is a growing and more common problem in the workplace.”

Burgard stressed that it’s not really a problem that can be effectively addressed case by case — “people often hear ‘don’t blame yourself’ or ‘don’t worry,’ but that’s not a lot comfort to people with families to support…it puts all of the work and blame on the individual, who is usually in a situation they have no control over.”

“As a social scientist, we want people to think about this as a policy problem,” she told me. “Telling people to take better care of themselves…that won’t solve anything. This is a structural issue.”

So, what exactly to do? Of course, it would be helpful if employers could provide more information so that workers can plan ahead, “exercise a bit of agency,” she said. And workers who have job benefits that could help them cope with such stress should take advantage of them, she advised. But unfortunately, at the end of the day, “there aren’t a lot of great (current) options,” Burgard said.

“At least, I hope more people pay attention to this as a potential risk factor,” she said, noting that it’s an issue health care providers should ideally be aware of when treating people with stress-related problems. “It’s important to put on people’s radar, to have a conversation about it and see if any practical steps can be taken. It’s really about recognition more than anything else.”

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for the last decade.