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Associations Between Dependent-Related Job Lock And Adult Mental And Physical Health.
Tiffany L Lemon1, Marisa E Domino2, Nalani Thomas3
1Tiffany L. Lemon (tiffany.lemon@asu.edu), Arizona State University, Phoenix, Arizona.
Health Affairs (Project Hope)
|November 3, 2025
Summary
Many parents stay in jobs solely to keep health insurance for their children, a situation called dependent-related job lock. This can negatively impact caregiver health, especially for families with children with special health care needs.
Area of Science:
- Health Services Research
- Public Health
- Health Economics
Background:
- Employer-sponsored insurance is a primary source of health coverage for children in the US.
- Job lock, where individuals remain employed to maintain health insurance, is a known phenomenon.
- The specific impact of dependent-related job lock on caregiver health is less understood.
Purpose of the Study:
- To estimate the prevalence of dependent-related job lock among families with children covered by employer-sponsored insurance.
- To examine the association between dependent-related job lock and caregiver mental and physical health.
- To identify specific subgroups of children with special health care needs that experience higher rates of job lock.
Main Methods:
- Utilized data from the 2016-2023 National Survey of Children's Health.
- Conducted regression analyses to estimate prevalence and associations.
- Performed sensitivity analyses to assess potential confounding by employment status.
Main Results:
- Nationally, 8.9% of families with children on employer-sponsored insurance reported dependent-related job lock.
- Prevalence was significantly higher (23.1%) among families with children with special health care needs, particularly those with emotional, behavioral, or developmental problems.
- Dependent-related job lock was associated with increased odds of poor or fair caregiver mental health (4.5-7.1 percentage points) and physical health (3.7-4.3 percentage points).
Conclusions:
- Dependent-related job lock affects a notable proportion of families, disproportionately impacting those with children with special health care needs.
- This phenomenon is linked to poorer caregiver health outcomes, highlighting a significant public health concern.
- Policy reforms are needed to mitigate insurance-related barriers, reduce health disparities, and improve employment mobility for caregivers.
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