Employment

What Is It?

Employment measures aim to show the percentage of the population that is unemployed and seeking work. Unemployment figures shed light on a community’s overall economic situation and provide information about the percentage of the population that may be at risk for various health concerns associated with unemployment.

Why Do We Measure It?

In 1987, a British longitudinal study published the first convincing evidence of a causal relationship between unemployment and declines in health status.[1] Numerous studies have since continued to document an association between employment and health.[2] Employment has been shown to correlate positively with health and is associated with slower declines in health status over time.[3] Along with income, employment influences access to a variety of resources that help people maintain or improve their health.[3] A study in Mississippi considered whether socioeconomic factors – employment, education, and access to health insurance – affect self-rated health. Researchers found that respondents who were employed at any point in the previous year were more likely to report good health than were those who were unemployed.[4] Schnittker reviewed self-rated health among women from 1974 to 2004. Among his findings, Schnittker reports that women who are employed, regardless of the number of hours they work or how they combine their work responsibilities with family obligations, report better health than those who are not employed.[5]

While employment has been associated with health improvements, unemployment has been linked with declines in health status. Unemployment may lead to physical health responses ranging from self-reported physical illness to mortality, especially suicide.[6] It has also been shown to lead to an increase in unhealthy behaviors related to alcohol and tobacco consumption, diet, exercise, and other health-related behaviors, which in turn can lead to increased risk for disease or mortality.[6] Dooley and Fielding et al. go on to note that a few studies also have found links between unemployment and such behaviors as increased aggression, divorce, and child abuse, and other studies have examined behaviors that have an indirect bearing on health, such as criminal deviance.[6]

Measurement Strategies

The Bureau of Labor Statistics Local Area Unemployment Statistics (LAUS) calculates six measures of unemployment:

• U-1, persons unemployed 15 weeks or longer, as a percent of the civilian labor force;
  
• U-2, job losers and persons who completed temporary jobs, as a percent of the civilian labor force;
  
• U-3, total unemployed, as a percent of the civilian labor force (this is the definition used for the official unemployment rate);
  
• U-4, total unemployed plus discouraged workers, as a percent of the civilian labor force plus discouraged workers;
  
• U-5, total unemployed, plus discouraged workers, plus all other marginally attached workers, as a percent of the civilian labor force plus all marginally attached workers; and
  
• U-6, total unemployed, plus all marginally attached workers, plus total employed part-time for economic reasons, as a percent of the civilian labor force plus all marginally attached workers.
  

Measures U-3 and U-4 are most commonly used.  

Another potential measure of unemployment looks at the number of people receiving unemployment compensation. This measure underestimates the number of people who are unemployed because not every worker has unemployment insurance and those who do are eligible only for a limited period of time, regardless of whether new employment is found.[6]

What Is the County Health Rankings Measurement Strategy?

The County Health Rankings uses the annual average unemployment rate (U-3). This measure includes those age 16 and older. 

Measure Strengths & Limitations

The LAUS data is readily available and reliably covers 99.9% of U.S. counties, making it ideal for use in the County Health Rankings. 

Some analysts find the official unemployment measure flawed because individuals who want work but who have given up seeking work ‑ discouraged workers ‑ are not counted as officially unemployed.[6] This group can comprise a significant enough percentage of the population to skew unemployment figures. Dooley and Fielding et al. note that, in difficult economic times, if many job seekers became discouraged the official unemployment rate could actually decrease.[6]

None of the measures reliably discern the unemployed who cannot find work at their preferred wage level from those who cannot find work at any wage.[6]

References

[1] Moser KA, Goldblatt PO, Fox AJ, Jones DR. Unemployment and mortality: comparison of the 1971 and 1981 longitudinal study census samples. Br Med J. 1987;294(6564):86-90.
[2] Mathers CD, Schofield DJ. The health consequences of unemployment: The evidence. Med J Aust. 1998;168:178-182.
[3] Ross CE, Mirowsky J. Does employment affect health? J Health Soc Behav. 1995;36:230-243.
[4] Green JJ, Kerstetter K, Nylander AB. Socioeconomic resources and self-rated health: A study in the Mississippi Delta. Sociol Spectr. 2008;28:194-212.
[5] Schnittker J. Working more and feeling better: Women's health, employment, and family life, 1974-2004. Am Sociol Rev. 2007;72:221-238.
[6] Dooley D, Fielding J, Levi L. Health and unemployment. Annu Rev Public Health. 1996;17:449-465.