The Role of Job Insecurity in Explanations of Racial Health Inequalities

The Role of Job Insecurity in Explanations of RacialHealth Inequalities1

Andrew S. Fullerton2 and Kathryn Freeman Anderson3

The literature documenting substantial health differences for racial minorities in the United States is

well developed and has considered a multitude of explanations for such disparities. However, the litera-

ture seldom addresses the health effects for racial minorities produced in the workplace. This study

bridges these two literatures in order to understand the mediating role of job insecurity in explanations

of racial health disparities. Our central argument is that racial differences in job insecurity resulting

from the marginalized labor market positions of racial minorities are partially responsible for racial dis-

parities in health. This study utilizes adjacent category and partial adjacent category logit models of

general health using data from the 2000 to 2010 General Social Survey in order to test this claim. Over-

all, the results from this study indicate that there are substantial racial differences in job insecurity, and

both race and job insecurity are important predictors of general self-rated health. Additionally, racial

differences in job insecurity help explain a portion of the racial disparities in health. We conclude with a

discussion of the implications for the study of health disparities in the United States.

KEY WORDS: health; inequality; job insecurity; race; stress process theory; work.

INTRODUCTION

A well-established and vast body of literature spanning numerous academicdisciplines documents significant differences in health for racial and ethnicminorities in the United States. This relationship is most notable in mortalitystatistics, which demonstrate that African Americans have an overall mortalityrate that is 60% higher than whites and far greater for certain causes of death,such as diabetes, stroke, cerebrovascular disease, HIV/AIDS, and homicide toname a few (Williams 1999; Williams and Jackson 2005). This effect is moststriking in mortality statistics but is also seen in numerous studies on healththroughout the life course, including overall health, birth weight and infant mor-tality, women’s health, and self-reported health and activity (Hummer 1996).

1 The authors thank Jeffrey Dixon for his comments on an earlier draft. Authors names are listed inreverse alphabetical order; each is an equal coauthor. The authors presented a previous version ofthis paper at the 2012 meeting of the Pacific Sociological Association in San Diego, California.

2 Department of Sociology, Oklahoma State University, 431 Murray, Stillwater, Oklahoma 74078.;e-mail: [email protected].

3 Department of Sociology, University of Arizona, P. O. Box 210027, Tucson, Arizona 85721.

Sociological Forum, Vol. 28, No. 2, June 2013

DOI: 10.1111/socf.12020

308

© 2013 Eastern Sociological Society

Furthermore, studies show that these differences are persistent over time andhave even increased for certain illnesses and causes of death (Williams andBraboy Jackson, 2005). The principal goal of this and similar studies is to under-stand the social sources of how these disparities are generated and sustained.

Moreover, much research has recently been conducted analyzing the impactof job insecurity on a variety of health outcomes. Although “objective” indica-tors of job insecurity are important, several recent studies show that the per-ceived threat of job loss in the near future has a substantial negative impact onseveral aspects of workers lives, including physical and mental health (e.g.,L�aszl�o et al. 2010). In this study, we use the term “job insecurity” to refer to thisperceived threat of unemployment. Some have argued that job insecurity in thisregard may be more detrimental to an individual’s health than unemployment(Burgard et al. 2009). Studies also show that with the rise of flexible employmentarrangements, job insecurity is a more common feature in the contemporaryworkplace, therefore increasingly more deserving of scholarly attention (Fuller-ton and Wallace 2007; Kalleberg 2009). These studies demonstrate that job inse-curity can have profound effects on worker health, including generally poorermental and physical health, depressive symptoms, an increased risk of cardiovas-cular disease, and higher blood pressure (Ferrie 2001; Roxburgh 2009). Theyalso show that these effects may become worse over time with prolonged expo-sure to the stress from job insecurity.

This study aims to further our understanding of the social sources of racialhealth inequalities by taking into consideration the potentially mediating role ofjob insecurity. While researchers have provided various theoretical and empiricalexplanations of racial health inequalities, the principal foci of these studies areon the lower socioeconomic position of racial and ethnic minorities in Americansociety and, more recently, the various ways in which racism can affect minorityhealth (Hummer 1996; Williams and Braboy Jackson, 2005). Although studieson the effects of discrimination on health have observed a variety of negativehealth impacts from both institutional and individual forms of racism, few haveexamined the workplace. The workplace can serve as both a source of racismand of negative health outcomes, yet few researchers have attempted to under-stand how these sources of stress interact with one another in the creation andperpetuation of racial health inequalities. The focus of the present study is onone source of workplace stress, job insecurity. Studies have shown that racialminorities are more likely to be subject to a variety of negative workplace condi-tions, including job insecurity (Martin and Tuch 1993; Mong and Roscigno2010; Wilson et al. 2006; Wilson and Mossakowski 2009). Our central argumentis that since minorities are more likely hold “bad jobs” and be subject to jobinsecurity, and job insecurity is related to poor health outcomes, then such pre-carious work situations for minorities likely explains part of the associationbetween race and a variety of negative health outcomes.

Using stress process theory as a conceptual framework, we have two mainresearch questions that this study addresses. First, are there racial differences injob insecurity? Second, if there are racial differences in job insecurity, does this

Job Insecurity in Explanations of Racial Health Inequalities 309

help explain racial disparities in health? We hypothesize that as job insecurityhas been shown to produce a variety of negative health effects it will be animportant explanatory factor for understanding the connection between raceand reduced health status. Although studies have examined the separate influ-ences of race and job insecurity on health, the possibility that racial and ethnicminorities (e.g., African Americans and Hispanics) have poorer overall healthdue to greater job insecurity remains unexplored, which is what this paper willaccomplish.

LITERATURE REVIEW AND THEORETICAL FRAMEWORK

The Stress Process

The theoretical framework for this study is rooted in stress process theory,which outlines how various stressors can impact an individual’s well-being. Inparticular, this research focuses on social stress within the stress process (Ane-shensel 1992; Pearlin 1989). Social stress theory emphasizes the social sources ofstress factors that may impact mental and physical health outcomes (Aneshensel1992; Pearlin 1989). The theory argues that certain groups within society are in adisadvantaged social position, which leads to an increased exposure to socialsources of stress and fewer resources with which to cope with such sources ofstress (Aneshensel 1992; Dressler et al. 2005). In this study, we focus on job inse-curity as a social source of stress that potentially explains racial disparities inhealth.

Pearlin et al. (1981) identify three conceptual components to the stressprocess: the sources, mediators, and manifestations of stress. As it relatesto this study, we emphasize social stressors as the sources of stress thatmay impact health outcomes. These may be chronic or life event stressors(Pearlin 1989; Pearlin et al. 1981, 2005). In this study, we examine bothrace/ethnicity and job insecurity as two sources of social stress that mayhave health implications. The second facet of stress process theory involvesmediating resources. Several social stress researchers have highlighted theimportance of social support and coping mechanisms as mediating factors,which may mitigate some of the (direct) effects of both life event andchronic sources of stress (Aneshensel 1992; Pearlin 1989; Pearlin et al.1981). They contend that improved sources of social support, such as fam-ily and social networks, and positive, healthy coping strategies may lessenthe effects of the stress process on physical and mental health (Aneshensel1992; Pearlin 1989; Pearlin et al. 1981). Conversely, the lack of theseresources and negative coping strategies, such as substance abuse, mayheighten the adverse effects of stress (Pearlin et al. 1981). In this study, weaccount for a variety of positive mediating resources, such as family, educa-tion, or income, that could mitigate both sources of social stress empha-sized here. Furthermore, we emphasize the role of job insecurity as a

310 Fullerton and Anderson

negative mediating factor, as it indicates a lack of resources or sense ofself-efficacy that could mitigate the health effects of social stress. Finally,social stress may indicate various manifestations. The manifestations ofstress are difficult to operationalize, as there is no single, obvious indicatorof stress (Pearlin et al. 1981). However, most stress researchers agree thatstress produces psychological distress, which can in turn lead to bothmental and physical manifestations, which can be detrimental to health(Aneshensel 1992; Pearlin et al. 1981, 2005; Turner et al. 1995). Each ofthese three components culminates in the stress process, which, as it per-tains to this research, may lead to detrimental health consequences (Pearlinet al. 1981).

Job Insecurity and Health

A number of studies have been conducted demonstrating a variety ofhealth impacts of the labor market. For example, these studies show thatjob loss is associated with poor general physical and mental health, specificphysical health outcomes, depressive symptoms, and poor emotional func-tioning (Burgard et al. 2007; Gallo et al. 2006; Hamilton et al. 1993; Kessleret al. 1989; Libby et al. 2010; Tausig and Fenwick 1999; Turner 1995).However, more recently, researchers have turned their attention to theimpact of job insecurity, not definitive job loss, on health. With the growthof flexible employment arrangements since the 1970s, job insecurity hasbecome an increasingly more common feature of the American workplace(Fullerton and Wallace 2007).

The literature examining the relationship between job insecurity and healthincludes two major types of studies. First, a variety of studies have been con-ducted examining stress and health outcomes for a group of workers employedat a specific facility or office that is closing or downsizing. For these workers, thethreat of job loss is much more imminent, and these studies examine the mentaland physical health effects during the process of workplace closure or downsiz-ing. These studies demonstrate a variety of negative health impacts of closureand downsizing, including higher serum uric acid and cholesterol levels (Kasl etal. 1968), higher blood pressure (Kasl and Cobb 1970), cardiovascular riskfactors (Mattiasson et al. 1990), increased hospital treatment for cardiovasculardisease (Iversen et al. 1989), poorer self-rated health (Ferrie et al. 1995, 2003,2005), physical symptoms (Heaney et al. 1994), minor psychiatric morbidity anddepression (Ferrie et al. 2005), psychological symptoms (Burchell 2011; Joelsonand Wahlquist 1987), and mental health problems (Hamilton et al. 1990; Hell-gren and Sverke 2003).

A second group of studies examines perceived job insecurity as it relates tohealth outcomes. Perceived job insecurity refers to a subjective evaluation ofone’s likelihood of job loss in the near future (Fullerton et al. 2011). These stud-ies are broader in scope and often involve survey data from a workforce. They


typically do not pinpoint a specific jobsite, industry, or group of workers, butrather ask respondents to generally assess the likelihood of losing their jobs. Thisgroup of studies is more pertinent to the present study, which focuses on per-ceived job insecurity and may be more reflective of the current trends in thelabor market. These studies find that perceived job insecurity is related to poorself-rated health (Burgard et al. 2009; Cheng et al. 2005; L�aszl�o et al. 2010), anincreased risk of coronary heart disease for women (Lee et al. 2004), short-termand long-term health effects (Schreurs et al. 2010), depressive symptoms (Bur-gard et al. 2009; Rugulies et al. 2006), and increased help seeking for psychologi-cal distress (Catalano et al. 1986). While this growing body of literature hasdemonstrated a strong connection between job insecurity and negative healthoutcomes, none have considered it as a potential explanation for racial dispari-ties in health.

Race and Job Insecurity

Race is a central aspect of employment and workplace dynamics. Studiesreveal vast racial disparities in employment opportunities, employment net-works, job roles, levels of job authority and autonomy, job satisfaction, and jobrewards (Kluegel 1978; Kmec 2007; Martin and Tuch 1993; Mong and Roscigno2010; Pager 2007; Tuch and Martin 1991; vonLockette 2010; Wilson 1996). Dueto these workplace disadvantages, research reveals that racial minorities aremuch more likely to experience job insecurity compared to their white counter-parts (Fullerton and Wallace 2007; Manski and Straub 2000; Wilson et al. 2006;Wilson and Mossakowski 2009). Recent studies of race and job insecurity findthat racial minorities feel more insecure in their jobs primarily due to workplacediscrimination and marginalized positions in the labor market rather than differ-ences in human capital or dispositional factors (Wilson et al. 2006; Wilson andMossakowski 2009). The channeling of racial and ethnic minorities into the“marginal sector” (Wallace and Fullerton 2003) produces racial and ethnic dif-ferences in job insecurity due to the prevalence of “bad jobs” (Kalleberg et al.2000) and contingent forms of employment (Wallace and Fullerton 2003).

Combined with our previous discussion of the health disparities associatedwith race and job insecurity, the presence of racial differences in job insecurityleads us to expect that job insecurity at least partially mediates the relationshipbetween race and health. In other words, we argue that racial and ethnic minori-ties have poorer health compared to whites in part because they have higher lev-els of job insecurity. It is possible that racial and ethnic minorities (AfricanAmericans and Hispanics, in particular) have higher job insecurity because theyare more likely to work in “bad jobs” (Kalleberg et al. 2000) than whites. Wewill test this possible explanation for the mediating role of job insecurity by con-trolling for occupation and job-related characteristics. Finally, given our focuson job insecurity as a mediating factor, we are concerned primarily with theexplanation of racial differences in health among employed individuals.


DATA

In order to examine the relationship between race, job insecurity, andhealth, we combined several years of the General Social Survey (GSS). The GSSis a multistage, stratified sample of the non-institutionalized, English-speakingadult population living in the United States. Because this is a study of the effectsof perceived job insecurity, the sample of GSS respondents will be limited torespondents who are working full- or part-time from 2000 to 2010.4

The first dependent variable in this study is job insecurity, which is based onthe perceived likelihood of job loss within the next 12 months (1 = not at alllikely, 2 = not too likely, 3 = fairly likely, and 4 = very likely).5 Due to the rela-tively small sample sizes in categories 3 and 4, we combine these two categories.Our second dependent variable is self-rated general health, which has the follow-ing response options: poor, fair, good, and excellent. Only 1.45% of respondentsclaim to be in “poor” health. Therefore, we combine this with the “fair” category.

Job insecurity is also included as a key independent variable in the modelsof self-rated general health. We refer to the three categories of insecurity as low(“not at all likely”), medium (“not too likely”) and high (“fairly or very likely”).The other main independent variable is race. We combined a variable for raceand a variable for Hispanic ethnicity. Using this method, we divided the newvariable into four categories representing four main racial and ethnic groups:non-Hispanic white (reference), non-Hispanic African American, Hispanic, andother race.

We also examine the effects of other key independent variables. These vari-ables are included to account for the various mediating resources outlined instress process theory that may mitigate the effect of social stress on health. Forjob-related variables, we include earnings (logged),6 part-time (<35 hours perweek = 1, � 35 hours per week = 0), and occupation (nine binary variables [ref-erence = professional]). Finally, we control for several additional socio-demo-graphic variables in the models, including year (six binary variables[reference = 2000]), age (in years), female (sex: 1 = female, 0 = male), education(in years), married (marital status: 1 = married, 0 = else), children (0 to 8), andSouth (region: 1 = South, 0 = else). We indicate in each model whether or notthe control variables are included, but we do not present the coefficients in thetables (results are available upon request). Finally, we present the distributionsof dependent variables and descriptive statistics for independent variables inTable I.

4 We do not include GSS respondents before 2000 due to missing data on a key variable (Hispanic).The years included in the sample are 2000, 2002, 2004, 2006, 2008, and 2010.

5 We also considered using a measure of labor market insecurity (i.e., the perceived difficulty of find-ing a comparable job if unemployed). However, there are no racial differences in labor market inse-curity, and adding it to the model only reduces the coefficients for black and Hispanic by 2.8% and0.03%, respectively. Additionally, an index combining job and labor market insecurity is not reli-able (a = 0.22) due to the relatively weak association between these two measures (c = 0.22).

6 We also include a binary variable for missing earnings (1 = missing earnings, 0 = valid value forearnings). Additionally, we recode the missing value to 0 for log earnings.


METHOD

The dependent variables in this study are both ordinal, which means thatthe traditional OLS regression model is not appropriate (Long 1997). For themodels of general self-rated health, we use adjacent category logit, which is a

Table I. Descriptive Statistics for Variables in Adjacent Category and Partial Adjacent CategoryLogit Models of Job Insecurity and General Health in the United States, 2000–2010

Dependent variables %

General self-rated health1 = Poor or fair 16.652 = Good 50.073 = Excellent 33.27

Job insecurity1 = Not at all likely (low) 64.112 = Not too likely (medium) 25.203 = Fairly or very likely (high) 10.69

Independent Variables Mean SD Range Description

RaceWhite (ref.) 0.71 0.45 0 to 1 1 = White, 0 = elseAfrican American 0.14 0.35 0 to 1 1 = African American, 0 = elseHispanic 0.10 0.30 0 to 1 1 = Hispanic, 0 = elseOther race 0.04 0.20 0 to 1 1 = Other race, 0 = else

Year2000 (ref.) 0.31 0.46 0 to 1 1 = 2000, 0 = else2002 0.10 0.30 0 to 1 1 = 2002, 0 = else2004 0.11 0.31 0 to 1 1 = 2004, 0 = else2006 0.21 0.41 0 to 1 1 = 2006, 0 = else2008 0.14 0.34 0 to 1 1 = 2008, 0 = else2010 0.14 0.34 0 to 1 1 = 2010, 0 = else

Age 41.65 12.92 18 to 86 Respondent age in yearsFemale 0.49 0.50 0 to 1 1 = female, 0 = maleEducation 13.87 2.85 0 to 20 Years of schoolingMarried 0.49 0.50 0 to 1 1 = married, 0 = elseChildren 1.62 1.51 0 to 8 Number of childrenSouth 0.38 0.49 0 to 1 1 = southern residence, 0 = elseEarningsLog earnings 8.30 3.53 0 to 13.08 Log of respondent’s annual

earnings in dollarsMissing earnings 0.14 0.35 0 to 1 1 = missing value for

earnings, 0 = elsePart time 0.19 0.40 0 to 1 1 = <35 hours per week, 0 = elseOccupationProfessional (ref.) 0.22 0.41 0 to 1 1 = professional, 0 = elseManagerial 0.16 0.37 0 to 1 1 = managerial, 0 = elseSales 0.12 0.32 0 to 1 1 = sales, 0 = elseClerical 0.12 0.32 0 to 1 1 = clerical, 0 = elseCraftsman 0.10 0.29 0 to 1 1 = craftsman, 0 = elseOperatives 0.09 0.28 0 to 1 1 = operatives, 0 = elseLabor 0.03 0.18 0 to 1 1 = labor, 0 = elseService 0.16 0.36 0 to 1 1 = service, 0 = elseFarm 0.02 0.14 0 to 1 1 = farm, 0 = else

Notes: N=2,750. Data come from the 2000–2010 General Social Survey.


relatively under-utilized method for ordinal outcomes. Although the morewidely used proportional odds (or “cumulative odds”) model is also appropriate,we found that the parallel regression assumption was violated for several keyvariables, such as race. Although the adjacent category model also relies on thisassumption, it was not violated for any of the variables in the models of generalself-rated health. For an ordinal outcome with three categories (1–3), the adja-cent category logit model simultaneously estimates the following two cutpointequations (Fullerton 2009: 321; Long and Cheng 2004: 275):

LnPrfy ¼ 1jxgPrfy ¼ 2jxg

� �¼ s1 � xb ð1Þ

LnPrfy ¼ 2jxgPrfy ¼ 3jxg

� �¼ s2 � xb ð2Þ

where x is a vector of independent variables, τ1 and τ2 are cutpoints, and b is avector of logit coefficients. The only difference between the two equations is thecutpoint. The effects of the independent variables are the same across equations.Although the focus is on comparisons of adjacent categories, one may also thinkof the model as a constrained version of multinomial logit (Fullerton 2009;Goodman 1983; Long 1997). The proportional odds assumption was violated forthe year and occupation binary variables in the models of job insecurity. There-fore, we utilize partial adjacent category models for job insecurity, which simul-taneously estimates the following two cutpoint equations (Fullerton 2009:321):

LnPrfy ¼ 1jx;xgPrfy ¼ 2jx;xg

� �¼ s1 � xb� xg1 ð3Þ

LnPrfy ¼ 2jx;xgPrfy ¼ 3jx;xg

� �¼ s2 � xb� xg2 ð4Þ

where x is a vector of independent variables and g is a vector of logit coefficientsthat vary across cutpoint equations.

In the tables, we present odds ratios for the effects of variables on the logodds of categories 3 versus 2 and 2 versus 1.7 This corresponds to the log oddsof “greater” job insecurity and “better” self-rated general health. We present x-standardized odds ratios for the continuous variable in the tables (log earnings)and unstandardized odds ratios for the remaining binary variables.

RESULTS

The analysis proceeds in three stages. First, we examine bivariate associa-tions between race, job insecurity, and health using cross-tabulations. Second,

7 One could multiply the coefficients by �1 in order to focus on the log odds of 1 versus 2 and 2 ver-sus 3 instead.


we examine racial differences in job insecurity using partial adjacent category lo-git models. Third, we examine racial differences in self-rated general health andthe potential mediating role of job insecurity using adjacent category logitmodels.

We present the crosstabs for race, job insecurity, and health in Table II. Itis clear from these descriptive patterns that there are substantial racial differ-ences in both job insecurity and health. African Americans and Hispanics aremore likely than whites to have high levels of job insecurity and poor health.For example, only 8% of whites have a high level of job insecurity, whereas17% of African Americans and 21% of Hispanics have high job insecurity. Inaddition, only 15% of whites say that they have poor or fair health, but 21% ofAfrican Americans and 24% of Hispanics claim to have poor or fair health.Finally, job insecurity is also clearly related to health. Workers with the highestlevel of job insecurity are almost twice as likely to say that they have poor or fairhealth compared with workers with the lowest level of job insecurity (27% vs.14%). The chi-square tests are statistically significant (p < .001) for each cros-stab, which indicates that there are statistically significant bivariate associationsbetween race, job insecurity, and health. In the next set of analyses, we utilizepartial adjacent category logit models in order to examine racial differences injob insecurity net of other individual and job characteristics.

We present odds ratios for the partial adjacent category logit models of jobinsecurity in Table III. In Model 1, we present the results from a reduced modelwith race as the only independent variable. According to the results from a Waldtest, the gross racial differences in job insecurity are statistically significant(p < .001). The odds of higher job insecurity (i.e., high vs. medium or mediumvs. low insecurity) are 53% greater for African Americans and 77% greater forHispanics than for whites. In other words, African Americans and Hispanics aresignificantly more likely than whites to have medium and high levels of job inse-curity.8 Although the odds ratio is larger for Hispanic than African American,the logit coefficients for these two variables are not significantly different (basedon Wald tests) in any of the models presented in Tables III and IV.

In Models 2 and 3, respectively, we add the control variables and other keyindependent variables. The proportional odds assumption is relaxed for the bin-ary occupation variables in Model 3. Therefore, we present two coefficients (andz-ratios) for each occupation variable in Model 3 (one for each cutpoint equa-tion: medium vs. low and high vs. medium job insecurity). The addition of thesekey and control variables reduces the magnitude of racial differences in job inse-curity, but the net effects remain significant based on the Wald test (p < .001).After controlling for demographic characteristics, occupation, and job charac-teristics, African Americans and Hispanics are once again significantly morelikely than whites to have medium or high levels of job insecurity. Given thelarge number of recent studies that find a link between job insecurity and health,

8 We do not interpret the results for “other race” given the fact that it combines several differentracial and ethnic minority groups.


these findings suggest that part of the relationship between race and health inthe United States may be due to racial differences in job insecurity.

We further examine job insecurity as a potential explanation for racialhealth inequalities by estimating adjacent category logit models of general self-rated health. We present odds ratios from these models in Table IV. In Model 1,we present the results from a reduced model with race as the only independentvariable. According to the results from a Wald test, the gross racial differencesin health are statistically significant (p < .001). The odds of “better health” (i.e.,excellent vs. good or good vs. fair/poor) are 31% lower for African Americansand 42% lower for Hispanics than for whites. In other words, African Ameri-cans and Hispanics have significantly poorer overall health than whites.

In Model 2, we add job insecurity to the model in order to explain the grossracial differences in health. Job insecurity has a significant, negative impact on

Table II. Cross-Tabulations between Race, Job Insecurity, and General Self-Rated Health

Racial Differences in Job InsecurityRace

Job Insecurity WhiteAfricanAmerican

Hispanic Other Race Total

Not at all likely (low) 67.77% 56.57% 51.81% 57.26% 64.11%Not too likely (medium) 24.38% 26.52% 27.54% 29.06% 25.20%Fairly or very likely (high) 7.85% 16.92% 20.65% 13.68% 10.69%Total 100.00% 100.00% 100.00% 100.00% 100.00%

Chi-square = 72.81***

Racial Differences in General Self-Rated HealthRace

HealthWhite African

AmericanHispanic Other Race Total

Poor or fair 14.79% 21.46% 23.91% 14.53% 16.65%Good 48.39% 52.53% 56.16% 55.56% 50.07%Excellent 36.82% 26.01% 19.93% 29.91% 33.27%Total 100.00% 100.00% 100.00% 100.00% 100.00%

Chi-square = 51.83***

Health Differences by Level of Job InsecurityJob Insecurity

Health Low Medium High Total

Poor or fair 13.56% 20.20% 26.87% 16.65%Good 49.01% 51.37% 53.40% 50.07%Excellent 37.44% 28.43% 19.73% 33.27%Total 100.00% 100.00% 100.00% 100.00%

Chi-Square = 65.39***

Notes: N = 2,750.***p<.001.


health, and it helps explain a portion of the racial differences in health. Based onthe change in the logit coefficients, job insecurity explains approximately 13%–14% of the racial gaps in health for African Americans and Hispanics. Althoughthe racial differences remain statistically significant in Model 2, a portion of thegross racial differences in health is due to the higher levels of job insecurityamong African-American and Hispanic workers.

In Models 3 and 4, we remove job insecurity and add control andother key independent variables to the model. The demographic, occupa-tion, and job characteristics in Model 4 help explain 33% of the AfricanAmerican–white differences and 31% of the Hispanic–white differences inhealth. However, the net racial differences in health are significant accord-ing to the Wald test (p < .001). In Model 5, we add job insecurity back tothe model in order to explain the net racial differences in health. Job inse-curity helps explain an additional 9% of the initial racial gaps for bothgroups (i.e., totals of 42% and 40% of the racial gaps explained for Afri-can Americans and Hispanics, respectively). In other words, we can explain40%–42% of the racial gaps in health for African Americans and Hispan-ics, and 21%–23% of these “explained” racial differences are due solely tojob insecurity. In addition, the net effect of job insecurity on health is sub-stantial. Having a high (vs. low) level of job insecurity is predicted to

Table III. Odds Ratios from Partial Adjacent Category Logit Models of Job Insecurity

Model 1 Model 2 Model 3

Racea

African American 1.526*** (5.510) 1.381*** (3.903) 1.388*** (3.898)Hispanic 1.768***(6.619) 1.518*** (4.442) 1.545*** (4.601)Other race 1.418** (2.643) 1.531** (3.112) 1.557** (3.165)

Log earnings 0.648*** (-3.571)Part time 1.100 (1.236)

2 vs.1 3 vs. 2Occupation (Ref. = Professional)Manager 1.027 (0.181) 1.254 (0.769)Sales 0.882 (�0.744) 1.711 (1.842)Clerical 1.178 (1.018) 1.410 (1.210)Craftsman 0.979 (�0.115) 3.184*** (3.994)Operatives 1.032 (0.164) 2.333** (2.799)Labor 0.531 (�1.956) 6.290*** (4.553)Service 0.748 (�1.821) 2.241** (3.082)Farm 0.628 (�1.163) 5.075** (3.273)

Control variables No Yes YesWald testsRace 64.150*** 34.660*** 36.050***

AIC 4739.553 4673.284 4642.117BIC 4769.150 4797.590 4878.891

Notes: 1 = low job insecurity, 2 = medium job insecurity, 3 = high job insecurity. N=2,750. Z-ratiosare in parentheses. The models with log earnings also include a binary variable for missing earnings.The odds ratio for log earnings is x-standardized and the remaining odds ratios are unstandardized.aReference = White.**p<.01, ***p<.001.


TableIV

.OddsRatiosfrom

AdjacentCategory

LogitModelsofGeneralSelf-RatedHealth

Model1

Model2

Model3

Model4

Model5

Race

a

AfricanAmerican

0.690***(�

4.630)

0.727***(�

3.915)

0.767**(�

3.072)

0.780**(�

2.840)

0.805*

(�2.452)

Hispanic

0.577***(�

5.858)

0.621***(�

4.989)

0.691***(�

3.652)

0.686***(�

3.700)

0.717**(�

3.226)

Other

race

0.866(�

1.031)

0.908(�

0.687)

0.731*(�

2.172)

0.745*(�

2.029)

0.778(�

1.717)

JobInsecurity

b

Medium

0.728***(�

4.792)

0.751***(�

4.161)

High

0.560***(�

6.158)

0.640***(�

4.543)

Logearnings

1.487**(3.200)

1.425**(2.839)

Parttime

1.025(0.306)

1.036(0.440)

Occupation(R

ef.=Professional)

Manager

1.121(1.151)

1.128(1.214)

Sales

0.887(�

1.101)

0.888(�

1.083)

Clerical

1.026(0.236)

1.044(0.393)

Craftsm

an

1.052(0.406)

1.087(0.660)

Operatives

0.984(�

0.124)

1.007(0.056)

Labor

0.783(�

1.360)

0.799(�

1.229)

Service

0.974(�

0.251)

0.974(�

0.247)

Farm

0.999(�

0.004)

1.025(0.107)

Controlvariables

No

No

Yes

Yes

Yes

Wald

tests

Race

48.380***

34.680***

22.260***

21.070***

15.680**

Jobinsecurity

50.210***

31.030***

AIC

5,521.536

5,474.458

5,415.202

5,414.805

5,387.482

BIC

5,551.133

5,515.894

5,509.911

5,574.628

5,559.144

Notes:N=2,750.Z-ratiosare

inparentheses.Themodelswithlogearningsalsoincludeabinary

variableformissingearnings.Theoddsratioforlogearnings

isx-standardized

andtheremainingoddsratiosare

un-standardized.

aReference

=White.

bReference

=Low.

*p<.05,**

p<.01,**

*p<.001.


decrease the odds of better health by 36%. Overall, these results suggestthat race and job insecurity are important social determinants of health,and job insecurity partially mediates the influence of race on health in theUnited States.

We examined the results from Model 5 in Table IV further by calculatingthe predicted probabilities for each category of health by race and job insecurity.We present these predicted probabilities in Table V.9 Whites with low job inse-curity are predicted to have the lowest probability of poor or fair health (.12)and the highest probability of excellent health (.38), which we would expectbased on the results in Table IV. The results in Table V also indicate that jobinsecurity has a substantial effect on the probabilities of poor/fair and excellenthealth for every racial and ethnic group. Having a high (vs. low) level of job inse-curity decreases the probability of having excellent health by .10–.12. Addition-ally, African Americans and Hispanics with the lowest level of job insecurity arepredicted to have a greater likelihood of excellent health than whites with thehighest level of job insecurity (.32 and .29 vs. .26, respectively). Although thesedifferences are not statistically significant, the lack of significant racial differ-ences between whites with a high level of job insecurity and African Americansand Hispanics with a low level of job insecurity provides further evidence for theimportance of job insecurity as a predictor of health disparities. However, Afri-can Americans and Hispanics are much less likely than whites to have a low levelof job insecurity. On balance, these results suggest that job insecurity and raceare both important sources of health disparities for workers in the United States,and racial minorities tend to have worse health in part because they feel moreinsecure in their jobs.

DISCUSSION AND CONCLUSIONS

The results presented here indicate that job insecurity plays an importantrole in explanations of racial health disparities. The evidence also relates to ourexpectations from stress process theory. First, with regard to the sources ofstress, both race and job insecurity as social sources of stress are related topoorer self-rated health (Aneshensel 1992; Pearlin 1989). Second, the presence ofpositive mediating resources, such as higher educational attainment and higherearnings, significantly reduces the direct effect of race on health (Pearlin et al.1981). However, negative mediating factors, such as job insecurity, contribute topoor health outcomes and account for some of the relationship between raceand health (Pearlin et al. 1981). Finally, regarding the manifestations of stress,these stressors demonstrate a strong negative effect on self-rated physical health.Overall, the findings confirm our theoretical expectations from the stress process

9 When calculating the predicted probabilities, we hold the remaining independent variables (otherthan race and job insecurity) at their means.


model and demonstrate that racial differences in job insecurity are partiallyresponsible for the persistence of racial health inequalities.

In addition, the effect of job insecurity on health is substantial, indicatingthat job insecurity as a source of social stress negatively impacts health. Thesefindings are important to our understanding of these issues for several main rea-sons. Although the literatures on the effects of race and job insecurity on healthare quite robust, the two literatures have seldom intersected in previous research.The literature on racial health disparities rarely considers the workplace andlabor market, and the literature on job insecurity and health disparities oftendoes not even include race as a variable. The results presented here providesupport for the claim that one should not consider the importance of race or jobinsecurity for health disparities in isolation.

While the results provide evidence for a closer examination of job insecurityin studies of racial health inequalities, there are some limitations to the presentstudy. First, the main health outcome of the study is based on self-reports. Manystudies have shown self-rated health to be a reliable measure of health status.For example, studies demonstrate that self-rated health is highly related to moreobjective measures of health and functional ability (Ferraro and Yu 1995;

Table V. Predicted Probabilities for Different Levels of Health by Race and Job Insecurity

Predicted probabilities for self-rated general health

Pr(Poor or Fair) Pr(Good) Pr(Excellent)

Low job insecurityWhite 0.12 0.50 0.38African American 0.16 0.52 0.32Hispanic 0.18 0.53 0.29Other race 0.16 0.53 0.31

Medium job insecurityWhite 0.17 0.53 0.30African American 0.22 0.54 0.25Hispanic 0.24 0.54 0.22Other race 0.22 0.54 0.24

High job insecurityWhite 0.20 0.54 0.26African American 0.25 0.54 0.21Hispanic 0.28 0.53 0.19Other race 0.26 0.54 0.20

Changes in the Predicted Probabilities for Self-Rated General Health

Pr(Poor or Fair) Pr(Good) Pr(Excellent)

From low to high job insecurityWhite 0.08 0.04 �0.12African American 0.09 0.02 �0.11Hispanic 0.10 0.00 �0.10Other race 0.10 0.01 �0.11

Notes: The remaining variables are held at their means when calculating the predicted probabilities.


Goldberg et al. 2001; Idler and Kasl 1995) and is a strong predictor of mortality(Idler and Benyamini 1997). Self-reported health is also commonly used in thecurrent literature on job insecurity and health (Burgard et al. 2009; Ferrie et al.2005; Schreurs et al. 2010). Yet, others question the subjective nature of self-rated health and demonstrate some variation in health reporting based on socialfactors, such as socioeconomic status and culture (Jylh€a 2009; Layes et al. 2012).However, objective or more nuanced measures of health were not available inthe General Social Survey, which also includes a measure of job insecurity. Assuch, the results in this study should be understood as differences in subjective,self-reported well-being. Future research linking these two literatures would ben-efit from an examination of a variety of different health indicators, includingones that are more objective in nature.

The data used here, while beneficial in their general nature, also do not pro-vide very specific or nuanced measures of job insecurity. The present study isalso limited to examining only racial differences among employed individuals.Future research should consider perceptions of economic insecurity (not limitedto jobs) as a potential mediating factor between race and health regardless ofemployment status. Additionally, the research on racial health disparities couldbenefit from examining more specific elements of discrimination in the labormarket and how these sources of social stress for African Americans and His-panics may affect health. While this study is cross-sectional, this line of researchcould also gain from the use of longitudinal methods to capture the longer termeffects of both of these sources of social stress and their negative health conse-quences. Despite these limitations, the results presented here provide initial evi-dence that studies on racial disparities in health should consider the mediatingrole of job insecurity and other labor market-based explanations.

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The Role of Job Insecurity in Explanations of Racial Health Inequalities