Does the Union Make Us Strong? Labor-Union Membership, Self-Rated Health, and Mental Illness: A Parametric G-Formula Approach.
Am J Epidemiol
; 190(4): 630-641, 2021 04 06.
Article
em En
| MEDLINE
| ID: mdl-33047779
ABSTRACT
Union members enjoy better wages and benefits and greater power than nonmembers, which can improve health. However, the longitudinal union-health relationship remains uncertain, partially because of healthy-worker bias, which cannot be addressed without high-quality data and methods that account for exposure-confounder feedback and structural nonpositivity. Applying one such method, the parametric g-formula, to US-based Panel Study of Income Dynamics data, we analyzed the longitudinal relationships between union membership, poor/fair self-rated health (SRH), and moderate mental illness (Kessler 6-item score of ≥5). The SRH analyses included 16,719 respondents followed from 1985-2017, while the mental-illness analyses included 5,813 respondents followed from 2001-2017. Using the parametric g-formula, we contrasted cumulative incidence of the outcomes under 2 scenarios, one in which we set all employed-person-years to union-member employed-person-years (union scenario), and one in which we set no employed-person-years to union-member employed-person-years (nonunion scenario). We also examined whether the contrast varied by sex, sex and race, and sex and education. Overall, the union scenario was not associated with reduced incidence of poor/fair SRH (relative risk = 1.01, 95% confidence interval (CI) 0.95, 1.09; risk difference = 0.01, 95% CI -0.03, 0.04) or moderate mental illness (relative risk = 1.02, 95% CI 0.92, 1.12; risk difference = 0.01, 95% CI -0.04, 0.06) relative to the nonunion scenario. These associations largely did not vary by subgroup.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Nível de Saúde
/
Transtornos Mentais
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
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Etiology_studies
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Incidence_studies
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Prognostic_studies
Aspecto:
Determinantes_sociais_saude
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Patient_preference
Limite:
Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Am J Epidemiol
Ano de publicação:
2021
Tipo de documento:
Article
País de publicação:
EEUU
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ESTADOS UNIDOS
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ESTADOS UNIDOS DA AMERICA
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EUA
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UNITED STATES
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UNITED STATES OF AMERICA
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US
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USA