Employment is, and will continue to be, the primary source of income for most Americans. An estimated 83% of Americans state that their employment impacts their overall well-being . Adults in the US spend nearly half their waking hours at work. Whether we have access to employment, and the conditions we work under influence our population health. Working in a safe environment with fair compensation often provides not only income, but also benefits such as health insurance, paid sick leave, and workplace wellness programs that, together, support opportunities for healthy choices and stability for a healthy life .
The importance of employment status to health is well documented. People who are employed have better health, and individuals and families supported by stable employment are better positioned to use preventative services and consistently practice healthy behaviors.
The increased health risks of unemployment are also well known; not only is it linked to loss of health insurance but depression and increases in unhealthy coping behaviors. People who are unemployed are 54% more likely to have fair or poor health and 83% more likely to develop stress-related conditions and other diseases . In the 2019 DC Community Health Needs Assessment survey, 30% of respondents identified job opportunities as one of the top five most important things their community would need to reach its full potential as a healthy community.
The DC Healthy People 2020 goal on this topic area is to:
1. Decrease the unemployment rate
Within the District, the unemployment rate varies widely across neighborhoods and wards. The distribution of employment rate for the adult population across the 51 Health Planning Neighborhoods ranges from a low of 70% to a high of 97.6%. Wards 2, 3, and 6, have the highest employment rates, and are where there are high concentrations of residents of prime working age, and smallest percentages of young children and older adults .
I do think that, the fact that the people that we serve are often times chronically unemployed, and then when they are employed, they work at low-wage jobs, that often, too often, don’t have benefits, and then they pay a disproportionate amount of their income on housing. I think you have to address those realities if you are going to have people who can have a better shot at staying healthy and have a better general health, mental and physical health.
— DC Health Equity Key Informant, 2018
A workforce that is multi-generational, as well as more racially, ethnically, and gender representative is a potential plus for equity and opportunity. It is also more responsive to the changing perspectives and expectations of both employees and employers. In 2017, the DC council passed the "ban the box" law which prevents employers from screening job applicants based on criminal convictions. The 21st-century workforce is predicted to face greater uncertainty, have multiple employers, and require ongoing enhancements of skills over the course of their working careers.
Opportunities for employment in safe environments with fair compensation however are usually greater in those with more education. The estimated 10 million workers in the US who are part of the "working poor" face many challenges: they are less likely to have health insurance and access to preventive care than those with higher incomes, and are more likely to work in hazardous jobs. Working poor parents may not be able to afford quality child care, and often lack paid leave to care for their families and themselves .
Occupational Industries, Earnings, and Insights
As the nation’s capital, the federal government is the District’s largest employer . The labor force consists of people in paid employment, including the self-employed, as well as the unemployed. Unemployed people are those who report that they are without work; that they are available for work; and that they have taken active steps to find work. It is well known that when unemployment is high, some people become discouraged and may stop looking for work .
Some jobs pose risks to mental and physical health. Lack of control over working conditions and non-standard hours are associated with increased illness, injury, and mortality. Thousands of fatal work-related injuries occur each year, and nonfatal work-related injuries number in the millions, and cost billions of dollars in lost income, workers compensation, and productivity .
Since 2003, the Bureau of Labor Statistics (BLS) has had cooperative agreements with the District of Columbia to conduct the Survey of Occupational Injuries and Illnesses (SOII) to collect occupational injury and illness data on an annual basis. In 2016, the District's Annual Survey of Occupational Injuries and Illnesses found there were 2,840 work-related injury and illness cases reported in private industry that required days away from work. Sprains, strains, and tears accounted for 31% of these cases and were the most frequent type of injury or illness. Food preparation and serving-related occupations were the major occupational group that experienced injuries.
Access to Employment Opportunities
Other factors can influence employment opportunities in our communities such as violence. A 2017 neighborhood-level analysis on the economic impact of gun violence from the Urban Institute shows that, in the District, every 10 additional gunshots in a community were associated with 20 fewer jobs among new establishments, one less new business opening, and one more business closing the same year . District-wide, each additional gun homicide was associated with two fewer retail and service establishments the next year. Employers and communities can work together to create opportunities to increase job skills for District residents, enhance local employment opportunities, and create supportive and safe work environments – to equitably benefit the entire community.
Assets & Resources
Promising Practices & Policies:
Citations & Additional Data Resources
1. DC Health Office of Health Equity. Health Equity Report. 2018
2. County Health Rankings. Employment. 2018
3. Robert Wood Johnson Foundation. Stable Jobs and Healthier Lives. 2013
4. DC Department of Employment Services. Labor Statistics. 2019
5. Robert Wood Johnson Foundation. Work, Workplaces and Health. 2011
6. U.S. Census Bureau, 2017 American Community Survey 1-Year Estimates
7. Urban Institute. A Neighborhood-Level Analysis of the Economic Impact of Gun Violence. 2017