Precarious Employment and Mental Health Among Lower-Wage Workers in the U.S

Background and Purpose: Work is becoming increasingly uncertain, unstable, and insecure (Kalleberg, 2009), particularly for lower-wage workers. The general phenomenon of precarious employment including the rise of “gig” work has been well studied (e.g., Katz & Krueger, 2017) and conceptualized and studied as a social determinant of health (Benach et al., 2014). Yet few studies have examined the link between precarious employment and mental health (Han et al., 2017; Jaramillo et al., 2022; Moscone, et al., 2016). For example, Bhattacharya and Ray (2021) found that precarious work was associated with the number of days of having poor mental health among U.S. workers. Similarly, while other research has examined precarious employment in terms of employment security, income volatility, and job attachment, there is limited research examining precarious employment through the lens of exploitative labor practices such as wage theft. This study builds on this nascent literature by examining precarious employment and mental health among lower-wage U.S workers and how changes in employment status relate to changes in mental health.

Methods: Data for this study are from Waves One (November 2023) and Two (June 2024) of the Workforce Economic Inclusion and Mobility (WEIM) survey administered with nationally representative samples of U.S. households with lower-wage workers from the AmeriSpeak panel. We restricted the sample to respondents who worked for an employer (N=1,584 in Wave 1; 1,290 in Wave 2) and defined precarious employment as having one or more of the following conditions: temporary position, wage theft, unpredictable scheduling, or a lack of paid sick leave. Mental health was measured using the PHQ4 scale, which screens for anxiety and depression. We use probit regression models to produce predicted probabilities of having moderate or severe anxiety and depression and linear models to assess PHQ4 score changes over time, controlling for demographic variables (e.g., age, family composition), household income, non-retirement savings, and self-assessed health status.

Results: We find that having precarious employment is associated with predicted probabilities of having moderate (p < .01) and severe (p < .001) anxiety and depression at Wave One after controlling for demographic and financial characteristics and general health status. PHQ4 scores at both Waves One (M=4.82) and Two (M=4.68) were highest among workers with persistent precarious employment and lowest among workers with persistent non-precarity at Wave One (M=3.06) and Wave Two (M=2.94). Entries into and exits from precarious employment were associated with increased and decreased PHQ4 scores, respectively. In addition, workers with precarious employment were almost twice as likely to report difficulty accessing mental health care as those with non-precarious employment (p < .01).

Conclusions and Implications: Precarious employment may be a social determinant of mental health. Whether precarious employment results in poorer mental health, or workers with poorer mental health are more likely to be employed precariously, federal and state laws concerning wage theft, paid sick leave, and predictable work schedules should be passed.