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Primary Submission Category: Structural factors

Labor Market Institutions and Mental Health in America

Authors:  Megan Reynolds, Akansha Batra, Jeb Wu, Chelsea Michalka,

Presenting Author: Mutiu Fakorede*

Health scholars are increasingly focused on how the structural characteristics of states contribute to widely observed geographic variations in health and health inequalities. Despite this high-level perspective emphasizing structural contexts, surprisingly little attention has been paid to cross-state differences in the labor market institutions that shape the exposure to, and meaning of, work-related factors that impinge on health. Following from emerging literature that individual-level wages, union membership, and unemployment insurance affect health, this study investigates whether the generosity of labor market institutions in a state are associated with population health. Our investigation employs a novel investigator-built calculator that uses state parameters to impute the dollar value of minimum-wage work, labor union income (i.e., wage and health insurance premiums), and unemployment insurance for a worker in a given state and year. Linking this state-year data to roughly 4,000 individuals each of 20 repeated cross-sections of the Behavioral Risk Factor Surveillance System from 1999-2019, we characterize the relationship between labor market institutions and mental health among individuals across the income distribution. We use state random slope models to evaluate the extent to which labor market institution generosity is associated with individual level health as well as how that associations may vary across states. The results of our study contribute to knowledge on population health by highlighting the potential pertinence of labor market institutions as a structural determinant of health.