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Job loss negatively impacts the mental health of working Medicaid beneficiaries

Yixuan Li (Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA)
Scott L. Zeger (Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA)
Angelo Elmi (Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA)
Marcee E. Wilder (Department of Emergency Medicine, George Washington University, Washington, District of Columbia, USA)
Melissa L. McCarthy (Department of Health Policy and Management, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA)

Journal of Public Mental Health

ISSN: 1746-5729

Article publication date: 13 June 2023

Issue publication date: 26 June 2023

46

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.

Keywords

Acknowledgements

National Institute of Minority Health and Health Disparities R01MD011607.

Conflict of interest statement: This study was funded by the National Institute of Minority Health and Health Disparities, grant number R01MD011607 and supported the work on this study by all of the authors. The funder did not have any role in the study design, collection, analysis and interpretation of the data, writing the report or the decision to submit the report for publication.

None of the authors have any other conflicts of interest to report.

Financial Disclosure Statement: None of the authors have any financial disclosures to report.

Citation

Li, Y., Zeger, S.L., Elmi, A., Wilder, M.E. and McCarthy, M.L. (2023), "Job loss negatively impacts the mental health of working Medicaid beneficiaries", Journal of Public Mental Health, Vol. 22 No. 2, pp. 83-92. https://doi.org/10.1108/JPMH-12-2022-0127

Publisher

:

Emerald Publishing Limited

Copyright © 2023, Emerald Publishing Limited

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