ArticleEpidemiology (Cambridge, Mass.)2021
Union Burying Ground: Mortality, Mortality Inequities, and Sinking Labor Union Membership in the United States.
Article in Epidemiology (Cambridge, Mass.), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.
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Who cites it
7 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of Evaluated Labor Market Initiatives Addressing Precarious Employment: Findings and Public Health Implications.International journal of social determinants of health and health services · 2025Pooled it
- "We adjusted for race": now what? A systematic review of utilization and reporting of race in American Journal of Epidemiology and Epidemiology, 2020-2021.Epidemiologic reviews · 2023Pooled it
- Straining Under Contradiction? Contradictory Class Locations and Job Strain in the United States.International journal of social determinants of health and health services · 2026Article
- Therapists' work conditions as patients' treatment conditions: A qualitative study of unionized public mental health therapists.The American journal of orthopsychiatry · 2025Article
- Personal and work-related factors associated with mental health among auto workers during the COVID-19 pandemic in the United States.Preventive medicine reports · 2022Article
- Wage theft and life expectancy inequities in the United States: A simulation study.Preventive medicine · 2022Article
- Free agents or cogs in the machine? Classed, gendered, and racialized inequities in hazardous working conditions.American journal of industrial medicine · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundOver the last several decades in the United States, socioeconomic life-expectancy inequities have increased 1-2 years. Declining labor-union density has fueled growing income inequities across classes and exacerbated racial income inequities. Using Panel Study of Income Dynamics (PSID) data, we examined the longitudinal union-mortality relationship and estimated whether declining union density has also exacerbated mortality inequities.
methodsOur sample included respondents ages 25-66 to the 1979-2015 PSID with mortality follow-up through age 68 and year 2017. To address healthy-worker bias, we used the parametric g-formula. First, we estimated how a scenario setting all (versus none) of respondents' employed-person-years to union-member employed-person-years would have affected mortality incidence. Next, we examined gender, racial, and educational effect modification. Finally, we estimated how racial and educational mortality inequities would have changed if union-membership prevalence had remained at 1979 (vs. 2015) levels throughout follow-up.
resultsIn the full sample (respondents = 23,022, observations = 146,681), the union scenario was associated with lower mortality incidence than the nonunion scenario (RR = 0.90, 95% CI = 0.80, 0.99; RD per 1,000 = -19, 95% CI = -37, -1). This protective association generally held across subgroups, although it was stronger among the more-educated. However, we found little evidence mortality inequities would have lessened if union membership had remained at 1979 levels.
conclusionsTo our knowledge, this was the first individual-level US-based study with repeated union-membership measurements to analyze the union-mortality relationship. We estimated a protective union-mortality association, but found little evidence declining union density has exacerbated mortality inequities; importantly, we did not incorporate contextual-level effects. See video abstract at, http://links.lww.com/EDE/B839.
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