IDEAS home Printed from
   My bibliography  Save this article

The social context of health selection: a longitudinal study of health and employment


  • McDonough, Peggy
  • Amick, Benjamin C.


Health selection out of the labour force has received considerable attention by analysts attempting to disentangle the "true" biological dimensions of ill-health from its social meaning. Rejecting this dualistic separation, we argue that the effect of health on labour force participation is an inherently social process reflecting differential access to material and symbolic rewards that are structured by social position. Using longitudinal data from the US-based Panel Study of Income Dynamics, we examine the extent to which structural arrangements, including those designated by gender, race, education and age, differentially affect the risk of a labour market exit when health is compromised. Individuals employed at entry into the study (from 1984 - 1990) were followed for the duration of the study or until they left the labour force. Analyses were stratified by gender and age (25-39 and 40-61 years at baseline). We found suggestive evidence that the hazard of labour market exit in the context of perceived ill-health depended on gender, race and education, but in ways that were not constant across each of these social positions. For example, men may be more vulnerable to the labour market effects of poor health, but only in the younger group, black men were less likely to leave the labour force than white men, and education mattered, but only among younger women and older men. While these patterns may reflect differential access to disability pensions or other work-related benefits, we suggest that a more detailed analysis of trajectories of health and employment, as well as the meaning of health states, would be useful in further elucidating the social dimensions of health selection.

Suggested Citation

  • McDonough, Peggy & Amick, Benjamin C., 2001. "The social context of health selection: a longitudinal study of health and employment," Social Science & Medicine, Elsevier, vol. 53(1), pages 135-145, July.
  • Handle: RePEc:eee:socmed:v:53:y:2001:i:1:p:135-145

    Download full text from publisher

    File URL:
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Weden, Margaret M & Astone, Nan M & Bishai, David, 2006. "Racial, ethnic, and gender differences in smoking cessation associated with employment and joblessness through young adulthood in the US," Social Science & Medicine, Elsevier, vol. 62(2), pages 303-316, January.
    2. Myung Ki & Yvonne Kelly & Amanda Sacker & James Nazroo, 2013. "Poor health, employment transitions and gender: evidence from the British Household Panel Survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 58(4), pages 537-546, August.
    3. Cathy J. Bradley & David Neumark & Zhehui Luo & Heather L. Bednarek, 2007. "Employment-contingent health insurance, illness, and labor supply of women: evidence from married women with breast cancer," Health Economics, John Wiley & Sons, Ltd., vol. 16(7), pages 719-737.
    4. Strully, Kate, 2009. "Racial-ethnic disparities in health and the labor market: Losing and leaving jobs," Social Science & Medicine, Elsevier, vol. 69(5), pages 768-776, September.
    5. Boen, Courtney & Yang, Y. Claire, 2016. "The physiological impacts of wealth shocks in late life: Evidence from the Great Recession," Social Science & Medicine, Elsevier, vol. 150(C), pages 221-230.
    6. Hammarström, Anne & Janlert, Urban, 2005. "Health selection in a 14-year follow-up study--A question of gendered discrimination?," Social Science & Medicine, Elsevier, vol. 61(10), pages 2221-2232, November.
    7. Berchick, Edward R. & Gallo, William T. & Maralani, Vida & Kasl, Stanislav V., 2012. "Inequality and the association between involuntary job loss and depressive symptoms," Social Science & Medicine, Elsevier, vol. 75(10), pages 1891-1894.
    8. Vanessa Hunn & Claudia Heath, 2011. "Path Analysis of Welfare Use: Depression as a Mediating Factor," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 341-355, June.
    9. Schroeder, Ryan D. & Hill, Terrence D. & Haynes, Stacy Hoskins & Bradley, Christopher, 2011. "Physical health and crime among low-income urban women: An application of general strain theory," Journal of Criminal Justice, Elsevier, vol. 39(1), pages 21-29.
    10. Boen, Courtney, 2016. "The role of socioeconomic factors in Black-White health inequities across the life course: Point-in-time measures, long-term exposures, and differential health returns," Social Science & Medicine, Elsevier, vol. 170(C), pages 63-76.
    11. Tøge, Anne Grete & Blekesaune, Morten, 2015. "Unemployment transitions and self-rated health in Europe: A longitudinal analysis of EU-SILC from 2008 to 2011," Social Science & Medicine, Elsevier, vol. 143(C), pages 171-178.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:53:y:2001:i:1:p:135-145. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.