Gig work dependence and psychological distress in chronic illness

Chronic illness is associated with lower quality of life, yet it remains unclear whether this association differs by employment arrangements, particularly gig work. Using longitudinal data (2019-2024) from a nationally representative sample of 22,712 British workers, we examined how regular and gig employment moderate the association between chronic illness and psychological distress (GHQ-12; range: 0-12). Random-effects models indicate that individuals with chronic illness report 1.44 points higher psychological distress than those without such conditions (p < 0.001). This association is weaker among individuals in regular employment and low-dependence gig work, who report 0.64 and 0.56 points lower psychological distress, respectively, than those who are unemployed (p < 0.001). Although women with chronic illness experience greater psychological distress overall, among men with chronic illness, high-dependence gig work is associated with a 1.60-point increase in psychological distress relative to regular employment (p = 0.004), whereas no such pattern is observed among women. Taken together, the moderating role of gig work in health-related quality of life varies with workers' dependence on gig work. Reducing the mental health burden of chronic illness may require access not only to employment, but also to high-quality jobs.