Brock O’Neil and Dr. Marie Cornwall, Sociology
Job loss is a stressful life event that results in many changes in life. For some time, researchers have noted that there is a strong relationship between job loss and declines in health outcomes (Brenner 1979). When two things are related, such as job loss and poor health outcomes in this study, it is difficult to establish which one causes the other. That is, does job loss result in poor health or does poor health cause one to lose work? A number of researchers have examined this problem and have demonstrated, quite convincingly, that job loss does lead to declines in health (Brenner 1983; Joelson and Wahlquist 1987; Kessler, Turner, and House 1987; Mathers and Schofield 1998). What has not been clearly established is how job loss leads to declines in health status.
In this study, we examined data collected by the BYU Sociology Department of displaced Geneva Steel workers. Geneva Steel was a manufacturing plant located in Vineyard, Utah. After decades of operation, the plant filed for bankruptcy and laid off most of the steel workers. For a few long months management of the plant tried to secure financing in order to reopen, but when that was not accomplished, the plant announced that it would not reopen. Data were collected from the displaced workers during the summer of 2002 and a follow-up collection was done the next year in 2003. About half of the respondents provided information so that we could create a panel data set, or a data set in which we linked the respondents’ information from the first data collection period with the second. In this way, we were able to track changes in the lives of the respondents as a result of job displacement.
The purpose of this study was to examine the mechanism of how job loss results in declines in health status. With the exception of one group of researchers, no one has examined this issue (Kessler et al. 1987). In addition, no one has examined this mechanism using changes in health insurance status as one of the variables. As part of the project, I learned to use a powerful statistical technique that has not been used to examine this question; we performed a path analysis using AMOS 4.01.
The survey that we used provided unique information about various aspects of the workers and their families lives. Thus, we were able to examine how job loss caused changes in many parts of their lives, and how those changes were related to declines in health status. The areas that we examined were: 1) stress and depression, 2) financial strain, and 3) health insurance and access to health care.
Stress was measured by examining the number of life events that occurred in the period after displacement. Life events refer to experiences like divorce, death of a family member, or filing for bankruptcy. We also used a measure of life stressors like negative changes in marital satisfaction, sense of self, and sex life. Financial Strain was measured by questions that inquired about the degree of difficulty in fulfilling various economic responsibilities like paying for groceries and home and credit card payments. Access to health care was measured by two variables. The first was a dichotomous variable of the individual’s insurance status: insured or uninsured. The second was a scale that measured the difficulty in obtaining health care services during the year after the plant closure. Finally, we examined health outcomes using two scales that measure pain and depression.
The analysis demonstrated that there is both a direct and indirect negative impact of unemployment on health. Simply being without work causes a direct reduction in health. In addition, there are a number of other mechanisms whereby job loss indirectly results in declines in health. The degree of stress created by life events and life stressors as a result of job loss leads to declines in health. Financial strain did not have a direct effect on health, while access to health care services did.
The most important finding of the research project was the importance of access to health care services to health. Surprisingly, we did not find a direct relationship between financial strain and declines in health as has been suggested by other researchers (Turner, Kessler, and House 1991). Instead, we found that the strongest impact on general health was the ability to have access to health care services. Financial strain had an indirect impact on health, but only as a result of decreased ability to access health care services. A disruption in access to health care has been proposed as one of the mechanism to declines in health as a result of job loss, yet no other researchers have attempted to examine this relationship empirically.
These findings raise a number of policy issues given the likelihood that more manufacturing jobs will disappear in the coming years. Most policy experts have focused on job creation, paying little attention to implications for human services organizations in a state. Available programs offer unemployment benefits and job retraining, but not health insurance or health care that might ameliorate the health declines associated with job loss. Many states have programs to cover children who are uninsured or to allow individuals to purchase health insurance for themselves and their family. But the costs of such programs are often out of range for the people who need them.
References
- Brenner, M. Harvey, Anne Mooney. 1983. “Unemployment and Health in the Context of Economic Change.” Social Science and Medicine 17(16): 1125-1138.
- Brenner M. Harvey 1979. “Mortality and the national economy.” Lancet. 2:568-573.
- Joelson, Lars, Leif Wahlquist. 1987. “The Psychological Meaning of Job Insecurity and Job Loss: Results of a Longitudinal Study.” Social science and Medicine 25(2): 179-182.
- Kessler, Ronald C., James S. House, and J. Blake Turner. 1987. “Intervening Processes in the Relationship Between Unemployment and Health.” Psychological Medicine 17: 979-61.
- Mathers, Colin D., Deborah J. Schofield. 1998. “The Health Consequences of Unemployment: The Evidence.” MJA 168: 178-182.
- Turner, J. Blake, Ronald C. Kessler, James S. House. 1991. “Factors Facilitating Adjustment to Unemployment: Implications for Intervention. American Journal of Community Psychology. 19 (4): 521-542.