Job loss negatively impacts the mental health of working Medicaid beneficiaries

• Published in: Journal of public mental health 2023-06, Vol.22 (2), p.83-92
• Main Authors: Li, Yixuan, Zeger, Scott L., Elmi, Angelo, Wilder, Marcee E., McCarthy, Melissa L.
• Format: Article
• Language: English
• Subjects: Anxiety; Beneficiaries; Cohort analysis; Employment; Employment policies; Generalizability; Health disparities; Health information; Job training; Low income groups; Medicaid; Medical diagnosis; Mental depression; Mental health; Self report; Skill development; Social factors; Unemployment; Voluntariness
• ISSN: 1746-5729; 1746-5729; 2042-8731
• DOI: 10.1108/JPMH-12-2022-0127

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.