Bad Health, Bad Jobs, But for Whom? Health Status, Gender, and Sorting Into Precarious Work

Extensive research has documented the adverse health consequences of precarious work schedules. Far less attention has been paid, however, to whether—and for whom—health status may sort workers into precarious work. Using panel data from the National Longitudinal Survey of Youth 1997 and cross-lagged panel models with individual fixed effects, this study examines the bidirectional relationship between schedule precarity and health, along with potential gender differences. Our findings challenge the prevailing view that precarious work primarily causes poor health. While we observe some evidence of deteriorating health following exposure to precarious schedules, our longitudinal analyses accounting for temporal ordering point more strongly to health-based selection: individuals in poorer health are disproportionately sorted into precarious work, likely due to employer perceptions of diminished reliability and lower entitlement to schedule autonomy. The feedback loop in which poor health increases exposure to precarious work, thereby compounding health risks, is disproportionately concentrated among women, who already face structural disadvantages in employment. To account for this gendered health penalty, we extend sociological queuing models by theorizing a matching process, where workers’ preferences for stable, autonomous schedules (job queue) intersect with employers’ preferences for “ideal workers” (labor queue); the interaction of gender and health signals within the labor queue positions women in poor health at the bottom—perceived as less reliable and less deserving of schedule flexibility and autonomy. By uncovering a bidirectional, gendered dynamic between health and work precarity, this study highlights an important yet underrecognized mechanism through which labor market inequalities are (re)produced.