Employment and Health Among Low-Income Adults and Their Children: A Review of the Literature

Publisher: Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families, Office of Planning, Research, and Evaluation
Mar 29, 2019
Emily Sama-Miller, Rebecca Kleinman, Lori Timmins, and Heather Dahlen

Key Findings:

  • Little research has been done on the causal relationship between employment and health among low-income Americans. Instead, the existing research is mostly correlational: it does not shed light on whether a change in employment is responsible for a change in health (or vice versa), while simultaneously ruling out the possibility that other factors are actually causing the changes in both. Much of the existing research is also based outside of the United States and/or on a general population, and thus, its findings may not apply to low-income adults and families in the United States.
  • Existing causal research typically does not directly test the effects of employment on health or vice versa. Instead, most of the research conducted to date tests the impact of welfare-to-work programs, which offer a bundle of employment services, on health.
  • The studies reviewed suggest that although the welfare-to-work programs did help people find jobs, they did not affect mothers’ well-being or have lasting effects on their children’s development. There was some evidence, however, that health programs that provided case management can help people find jobs.
  • Although aspects of the work environment were correlated with health, there was little causal evidence about this relationship.

In this report, researchers distilled the findings from a voluminous literature to draw conclusions from the existing research base about the causal relationship between employment and health. The review focused on surfacing evidence on whether a change in employment is responsible for a change in health or vice versa. Researchers also examined the causal relationship between work environment and health, because the nature and quality of a job might affect a person’s health, too. Findings from this literature review can help inform decisions about designing programs to improve health or employment outcomes for low-income adults and children in the United States, and also lay the groundwork for future research.