Yixuan Li, S. Zeger, A. Elmi, M. Wilder, M. Mccarthy
{"title":"Job loss negatively impacts the mental health of working Medicaid beneficiaries","authors":"Yixuan Li, S. Zeger, A. Elmi, M. Wilder, M. Mccarthy","doi":"10.1108/jpmh-12-2022-0127","DOIUrl":null,"url":null,"abstract":"\nPurpose\nFew have studied the relationship between employment and health in the Medicaid population. The purpose of this study is to estimate the impact of job loss on the mental health of working Medicaid beneficiaries.\n\n\nDesign/methodology/approach\nThis study conducted a post hoc analysis of 1,538 adult Medicaid beneficiaries enrolled in a prospective cohort study. The authors matched participants who lost their job to participants who remained employed based on demographics, illness severity and social determinants of health. The authors estimated the effect of job loss on the odds of a diagnosis of depression and/or anxiety and self-reported mental health during a one-year follow-up period, stratified by prior history of depression and/or anxiety as documented in the Medicaid claims.\n\n\nFindings\nAmong participants with no preexisting depression or anxiety, the incidence of depression or anxiety was 17% versus 7% (aOR = 2.85; 95% confidence interval (CI): 1.88 to 4.34) between those who lost versus kept their job, respectively, and the mean difference in self-reported mental health was −4.3 (95% CI: −6.02 to −2.58). Self-reported mental health was also poorer between those who lost versus kept their job among participants with preexisting depression and/or anxiety (x = −4.78 (95% CI: −8.90 to −0.66).\n\n\nResearch limitations/implications\nLimitations of this study are as follows: we may not have matched on all factors that influence retaining a job; we do not distinguish between involuntary and voluntary job loss; generalizability is limited; and employment information is based on self-report.\n\n\nPractical implications\nOur society should invest more resources into supporting low-wage workers such as Medicaid beneficiaries.\n\n\nSocial implications\nActive labor policies that connect people to jobs, help them retain their job and support skills training to secure a better quality job, could reduce health disparities in the Medicaid population.\n\n\nOriginality/value\nUse of both claims and self-reported mental health information to evaluate the impact of job loss on working Medicaid beneficiaries.\n","PeriodicalId":45601,"journal":{"name":"Journal of Public Mental Health","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Public Mental Health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1108/jpmh-12-2022-0127","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose
Few have studied the relationship between employment and health in the Medicaid population. The purpose of this study is to estimate the impact of job loss on the mental health of working Medicaid beneficiaries.
Design/methodology/approach
This study conducted a post hoc analysis of 1,538 adult Medicaid beneficiaries enrolled in a prospective cohort study. The authors matched participants who lost their job to participants who remained employed based on demographics, illness severity and social determinants of health. The authors estimated the effect of job loss on the odds of a diagnosis of depression and/or anxiety and self-reported mental health during a one-year follow-up period, stratified by prior history of depression and/or anxiety as documented in the Medicaid claims.
Findings
Among participants with no preexisting depression or anxiety, the incidence of depression or anxiety was 17% versus 7% (aOR = 2.85; 95% confidence interval (CI): 1.88 to 4.34) between those who lost versus kept their job, respectively, and the mean difference in self-reported mental health was −4.3 (95% CI: −6.02 to −2.58). Self-reported mental health was also poorer between those who lost versus kept their job among participants with preexisting depression and/or anxiety (x = −4.78 (95% CI: −8.90 to −0.66).
Research limitations/implications
Limitations of this study are as follows: we may not have matched on all factors that influence retaining a job; we do not distinguish between involuntary and voluntary job loss; generalizability is limited; and employment information is based on self-report.
Practical implications
Our society should invest more resources into supporting low-wage workers such as Medicaid beneficiaries.
Social implications
Active labor policies that connect people to jobs, help them retain their job and support skills training to secure a better quality job, could reduce health disparities in the Medicaid population.
Originality/value
Use of both claims and self-reported mental health information to evaluate the impact of job loss on working Medicaid beneficiaries.