Assessing associations between insecure income and US workers’ health: An IPUMS-MEPS analysis

Gig economy compensation policy initiatives, such as California Prop 22, are increasing the number of US workers receiving piece rate pay (PRP) and other forms of insecure income. However, there is limited evidence about how this trend affects people's health. Using data from the 2008-19 IPUMS Medical Expenditure Panel Survey (MEPS), we examined associations between insecure compensation and US adults' self-reported overall health as well as psychological distress. We report significant associations with three types of insecure income — PRP, hourly, and daily pay — on overall health and psychological distress. These effects were robust to adjustment for suspected confounders, but point estimates suggested that the effect of each type of non-salary compensation differed by sex, level of education, income level, and health insurance coverage. These findings warrant policy makers' consideration as they balance the purported benefits of gig economy non-salary compensated work with implications for workers' health. •Insecure income is a growing concern in the United States and globally.•IPUMS-MEPS is a US-national survey containing important work and health questions.•Three of the most common insecure compensation methods are piece rate, hourly, and daily pay.•We found 50%+ increases in poor physical and mental health with insecure income.•These associations were moderated by education, health insurance, poverty, and sex.