County Health Rankings & Roadmaps, A Healthier Nation, County by County

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Employment provides income and, often, benefits that can support healthy lifestyle choices. Unemployment and under employment limit these choices, and negatively affect both quality of life and health overall. The economic condition of a community and an individual’s level of educational attainment both play important roles in shaping employment opportunities.


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Why Is Employment Important to Health?

Most adults spend nearly half their waking hours at work. Working in a safe environment with fair compensation often provides not only income, but also benefits such as health insurance, paid sick leave, and workplace wellness programs that, together, support opportunities for healthy choices.

These opportunities, however, are greater for higher wage earners - usually those with more education. The estimated 10 million workers who are part of the "working poor" face many challenges: they are less likely to have health insurance and access to preventive care than those with higher incomes, and are more likely to work in hazardous jobs. Working poor parents may not be able to afford quality child care, and often, lack paid leave to care for their families and themselves [1,2].

Those who are unemployed face even greater challenges to health and well-being, including lost income and, often, health insurance. Unemployed individuals are 54% more likely to be in poor or fair health than individuals who are employed, and are more likely to suffer from increased stress, high blood pressure, heart disease, and depression. Racial and ethnic minorities and those with less education, often already at-risk for poor health outcomes, are most likely to be unemployed [1,2].

Some jobs pose risks to mental and physical health. Lack of control over working conditions and non-standard hours are associated with increased illness, injury, and mortality. Thousands of fatal work-related injuries occur each year. Nonfatal work-related injuries number in the millions, and cost billions of dollars in lost income, workers compensation, and productivity [1]. 

Employers and communities can work together to create opportunities to increase job skills for their residents, enhance local employment opportunities, and create supportive and safe work environments – to the benefit of the entire community.

What Is the County Health Rankings Measurement Strategy?

The County Health Rankings use the annual average unemployment rate: the total unemployed persons, as a percent of the civilian labor force ages 16 and older. 

For more information about measuring Employment click here.


[1] An J, Braveman P, Dekker M, Egerter S, Grossman-Kahn R. Work, workplaces and health. Princeton: Robert Wood Johnson Foundation (RWJF); 2011. Exploring the Social Determinants of Health Issue Brief No. 4.
[2] Robert Wood Johnson Foundation. Stable jobs = healthier lives. NewPublicHealth blog. January 14, 2013. Accessed March 4, 2014.