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Job Quality as an Upstream Social Determinant of Health in Middle Age

Tessa Bonney¹, Kristin L Moilanen, Kathleen M Rospenda

¹From the University of Illinois Chicago, Chicago, Illinois (T.B., K.L.M., K.M.R.); and University of Nebraska-Lincoln, Lincoln, Nebraska (K.L.M.).

Journal of Occupational and Environmental Medicine

|November 14, 2025

Abstract

Objective:

This study aimed to examine whether the association between job quality and health can be explained by its effects on other social determinants of health (SDOH).

Methods:

We ran hybrid path analyses using data from two waves of a national survey of middle-aged adults to test direct and indirect effects of T1 job quality on health outcomes at T2, through effects on T2 housing, health care, social, and money challenges.

Results:

Poor job quality predicted housing, health care, social, and money challenges in all models. Indirect effects of T1 poor job quality emerged for T2 physical health-related quality of life via housing challenges, T2 drug misuse via housing and health care challenges, and T2 depressive symptoms via housing and social challenges.

Conclusions:

Results support job quality as an upstream issue that can affect health through its impact on other SDOH.

Keywords:

depressive symptoms health-related quality of life job quality middle aged precarious employment social determinants of health substance use

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