The Effects of Workplace Social Status on Minority Health Disparities

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PROJECT SUMMARY/ABSTRACT Employment rank within workplaces has long been known to be correlated with a wide a range of health outcomes, including morbidity and life expectancy. Our proposed project will extend the research on workplace social status as a determinant of health by examining the associations between a wide range of social status measures and health outcomes separately by race, ethnicity, and gender. We will examine whether inequality in earnings within workplaces exacerbates the impacts of employment rank on minority health disparities, and whether demographic homophily between workers and firm managers is a social determinant of health. To do this we will use a novel database that links health insurance enrollment records and medical claims to administrative earnings data for more than 1.8 million workers and 50,000 firms in Utah. Using a broad set of firms will allow us to separate the impacts of financial resources from within-firm social status measures. We will consider two distinct research designs to evaluate whether workplace social status has a causal effect of health. The first will leverage quasi-experimental shocks to workplace social status caused by firm mergers, splits, and by industry-specific international trade shocks that alter worker promotion rates. The second will examine the health impacts of changes in social status when workers move jobs. To account for the endogeneity of changes in social status we will construct instrumental variables based on network statistics from the labor market. We will connect each worker to their coworkers, and instrument for changes in social status measures with the changes of each worker’s former coworkers who also changed jobs. We will use this design to understand the importance of job referral networks on the segregation of labor market opportunities, which can create structural barriers to minority workers escaping psychosocial and physical workplace hazards. Finally, we will link workers to their adult children in the workforce to quantify the intergenerational persistence of health disparities that operates through the workplace social status channel, and how this channel contributes to structural racial and ethnic health disparities.