Economic Hardship and Health Within Sociodemographic and Occupational Groups — Behavioral Risk Factor Surveillance System, United States, 2022–2023

Economic hardship can limit the ability of workers to prevent and address adverse health conditions. Using 2022 and 2023 Behavioral Risk Factor Surveillance System data, this exploratory analysis assessed economic hardship measures and self-rated health among currently employed and recently unemployed (<12 months) U.S. adults. Measures of economic hardship were 1) employment instability, 2) food insecurity, 3) housing insecurity, 4) utility insecurity, 5) lack of reliable transportation, 6) receipt of food stamps or Supplemental Nutrition Assistance Program benefits, 7) lack sof health insurance, and 8) cost as a barrier to needed medical care. Overall, 6.9% of currently or recently employed U.S. adults in 36 states and the U.S. Virgin Islands had high levels of economic hardship (reporting at least four of eight economic hardship indicators), and 12.5% reported having fair or poor health. High levels of economic hardship were more common among persons who were recently unemployed, were aged 18-49 years, were female, were Hispanic or Latino (Hispanic) or non-Hispanic Black or African American, had a high school education or less, or had a household income <$50,000 per year than among all workers combined. Fair or poor self-rated health was most common among workers who were Hispanic or were from lower educational attainment and income categories. By occupational group, the prevalence of high levels of economic hardship was highest in farming, fishing, and forestry (18.5%); building and grounds cleaning and maintenance (18.2%); and food preparation and serving (16.0%) and was lowest in the legal occupations (1.2%). Among occupational groups, the prevalence of fair or poor health generally increased with the prevalence of high economic hardship, and almost every occupational group with a high level of economic hardship had a statistically significantly elevated prevalence of fair or poor health compared with that among all workers combined. Given associations between unmet economic needs and health, these findings can be used by policymakers to identify groups of workers with disproportionate economic hardships and develop strategies to enhance economic security and health for all workers.