title: Gain of employment and perceived health status among previously unemployed persons: evidence from a longitudinal study in the United States.
abstract: OBJECTIVE
  Using longitudinal datasets, we investigated whether gaining employment was associated with improvements in perceived mental health and overall health among previously unemployed U.S. residents. We additionally examined whether the association varied across types of employment and socio-demographic characteristics.
  
  
  METHODS
  We used multiple two-year panel datasets of the Medical Expenditure Panel Survey during 2004-2012. We studied two health outcomes: perceived mental health and overall health. Our independent variables were employment status: full-time, part-time, self-employment, and unemployment. To examine the association between gaining employment and perceived health, we employed population-averaged models with generalized estimating equations. We secondarily examined the association across subpopulations (gender, race/ethnicity, and education).
  
  
  RESULTS
  Those who gained full-time, part-time, and self-employment were more likely to report good mental health than those who stayed unemployed (AOR [Adjusted Odds Ratio] = 2.90, 95% CI 2.23 to 3.78, AOR = 1.63, 95% CI 1.28 to 2.06, and AOR = 3.24, 95% CI 1.08 to 9.70, respectively). Those who became full-time and part-time employed were more likely to report good overall health relative to those who stayed unemployed (AOR = 2.28, 95% CI 1.82 to 2.86 and AOR = 1.91, 95% CI 1.52 to 2.40, respectively). For both measures of perceived health, the magnitudes of the association were larger for those who gained full-time employment than part-time employment. AORs were relatively higher for males, black persons, and people with less than a college education relative to other groups in each subpopulation.
  
  
  CONCLUSIONS
  Improving employment outcomes may improve perceived health. Transiting toward full-time employment, in particular, may maximize the benefits of employment.
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA. Electronic address: scpark7@uw.edu.
authors.forename: S
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA; Department of Biostatistics, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA. Electronic address: kcgchan@uw.edu.
authors.forename: K C G
authors.initials: KC
authors.lastname: Chan
authors.affiliation: Department of Health Services, School of Public Health, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, USA; Health Services Research and Development (HSR&D), Veterans Affairs (VA) Puget Sound Health Care System, 1660 S. Columbian Way S-152, Seattle, WA 98108, USA. Electronic address: Emily.Williams3@va.gov.
authors.forename: E C
authors.initials: EC
authors.lastname: Williams
mesh_terms: D000328:Adult; D000368:Aged; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014478:Unemployment / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult
keywords: Employment; Full-time employment; Panel data; Perceived health status; United States