A feasibility study exploring precarious employment and stress-related health among women

Stress is a hypothesized mechanism through which precarious employment (PE) may contribute to poor health; however, there is a limited understanding of this potential mechanism in the U.S. This study aimed to (1) provide preliminary insights into the biological stress profiles of women experiencing varying levels of PE and (2) test the feasibility of at-home collection of stress biomarkers, c-reactive protein (CRP), and salivary cortisol, among women in Chicago, Illinois. We recruited 101 working-age women between August-October 2023. An online survey collected information on demographics, PE, and self-reported mental (Center for Epidemiologic Studies Depression Scale, Cohen’s Perceived Stress Scale) and physical (self-reported health, body mass index) health. We mailed home-collection kits to collect capillary blood (120 𝜇L) and saliva (3 samples on 2 workdays). We used 27 employment indicators to construct a multidimensional PE score (PES) (range:0–10) and estimated descriptive statistics overall and by tertile of PE. We reached our recruitment target of ~ 50 women/month, and 70% returned the test kits. The sample was diverse in age (18–40 years: 57%, 41–64 years: 43%) and education ($$\:\le\:$$highschool: 11%, some college: 29%, $$\:\ge\:$$bachelor’s: 60%). Non-Hispanic (NH)-Black (33%) and Hispanic (36%) women were over-represented, compared to NH-White women (28%). More than half earned <$40,000, and the average PES was 3.6 (SE = 0.3). The most precariously employed women identified as NH-Black and Hispanic, had lower levels of educational attainment, experienced discrimination and had poorer self-reported physical and mental health. Those lost-to-follow-up between the online survey and biospecimen collection were lower-education, lower-income, more precariously employed, identified as Hispanic, and had poorer health. Biomarker patterns across PE tertiles were inconsistent; however, there was some suggestive evidence that the most precariously employed group may have lower recovery cortisol trends throughout the day, compared to the low and mid PE groups. We demonstrate the feasibility of at-home data collection of biospecimen samples among working women. Larger studies of PE and health are warranted.