Gender disparities in job flexibility, job security, psychological distress, work absenteeism, and work presenteeism among U.S. adults.

Background: While international research has examined the relationship between job characteristics and mental health, including gender differences, few studies have assessed these associations at the national level in the U.S., which has unique labor markets, health care systems, and societal structures that may exacerbate gender disparities. This study investigates gender differences in the associations between job flexibility, job security, mental health outcomes, work absenteeism, work presenteeism, and mental health care utilization among a representative sample of working U.S. adults. Methods: We analyzed cross-sectional population-based survey data from employed adults in the 2021 National Health Interview Survey. Job characteristics included perceived job flexibility and security. Outcomes included serious psychological distress, frequency of anxiety, work absenteeism, work presenteeism, and mental health care utilization. Multivariable logistic and binomial regression analyses examined associations of interest, with statistical interaction tests conducted to assess gender differences. Findings: The study sample included 18,112 respondents weighted to represent a population of 168,068,586 civilian, non-institutionalized working U.S. adults (47.7% female). Females with low job security had a decreased probability of serious psychological distress than males with low job security (F Interpretation: Findings highlight the need for policies and practices that recognize and address gender-specific workforce experiences and needs. Tailored interventions that enhance job flexibility and security, support caregiving responsibilities, and provide comprehensive mental health services can address such challenges.