Association between precarious employment and BMI in the United States

Objective: There is growing recognition that precarious employment is an important determinant of health, which may increase BMI through multiple mechanisms, including stress. It was investigated whether increases in precarious employment were associated with changes in BMI in the United States. Methods: Data were from the National Longitudinal Survey of Youth adult cohort (1996–2016) (N = 7280). Thirteen indicators were identified to operationalize seven dimensions of precarious employment (range: 0–7, 7 indicating most precarious): material rewards, working-time arrangements, stability, workers' rights, collective organization, interpersonal relationships, and training. The precarious employment–BMI association was estimated using linear regression models and an instrumental variables approach; state- and individual-level firm sizes were the instruments for precarious employment. Models also included individual and year fixed effects and controlled for age, marital status, education, region, and industry. Results: The average precarious employment score (PES) was 3.49 (95% CI: 3.46–3.52). The PES was the highest among Hispanic (4.04; 95% CI: 3.92–4.15) and non-Hispanic Black (4.02; 95% CI: 3.92–4.12) women with lower education. A 1-point increase in the PES was associated with a 2.18-point increase in BMI (95% CI: 0.30–4.01). Conclusions: Given that even small changes in weight affect chronic disease risk, policies to improve employment quality warrant consideration.