Health and the unemployed

Nearly half the jobless cite poor physical or mental health as the primary cause

In the first few months after Pearl Harbor, the Selective Service rejected a stunning 45% of the two million young men who reported for the draft because they suffered from disease or had a physicial disability. President Franklin D. Roosevelt called it “an indictment of America.” Gen. Lewis B. Hershey, who would run the draft board until 1969, said, “We nationally should be thoroughly ashamed.”

Fast forward 80 years and the same issue is bedeviling the job market, which is experiencing its fastest growth in more than a generation and is desperate for more workers. Forget the Great Resignation, which has become the media’s misguided raison d'être for the phenomenon. It’s time to pay attention to what’s really keeping people from taking jobs.

A new survey of 5,000 adults by McKinsey & Co. found 30% of the unemployed blamed poor physical health as the primary cause of their continued joblessness. Another 15% cited mental health issues.

Most significantly, 45% of the unemployed weren’t even bothering to look for work. “Respondents who say they’ve stopped looking for work were the most likely to cite physical or mental health as a cause of their joblessness,” the McKinsey authors noted.

A problem decades in the making

Declining labor force participation isn’t a new problem. The rate at which adults under 65 are either working or actively looking for work has been falling steadily for more than two decades after reaching a postwar high of 67% in 1999.

The pandemic sent labor market participation into rapid freefall. And although it has bounced back somewhat in recent months, it hasn’t recovered to pre-pandemic levels and remains a full five percentage points below its peak.

No doubt some of the drop since January 2020 is the Covid-related. But the Great Resignation had nothing to do with it. As Atlantic writer Derek Thompson noted last week, other than a modest increase in pandemic-related early retirement by Baby Boomers, most people quitting their jobs today are low-wage workers who are seeking better-paying opportunities in a surging economy.

Health and the workforce

So what accounts for the long-term falloff in the labor participation rate? As the McKinsey survey respondents said, it’s mostly about health.

Let’s look at some disastrous upticks in public health that correspond with the two-decade-long downtrend in labor market participation. Between 1999 and 2018, according to the Centers for Disease Control and Prevention, obesity prevalence in the U.S. rose from 30.5% to 42.4%. During the same time period, the prevalence of severe obesity increased from 4.7% to 9.2%.

Obesity is the biggest contributor to the ongoing pandemics of Type 2 diabetes, uncontrolled hypertension and the disabilities associated with chronic heart disease. It also is a major risk factor for many forms of cancer.

Pollution, sedentary life styles, low quality food — all are major contributors to declining participation by working-age adults. The number of Americans with two or more chronic conditions such as arthritis, asthma, chronic lung disease, diabetes or heart disease has been growing steadily. It now stands at 28%, which is six percentage points more than the next highest country (Canada) and more than 10 percentage points higher than the average for 11 wealthy nations surveyed by the Commonwealth Fund in 2020.

The number of adults receiving treatment for mental health conditions reached 20.3% in 2020. Again, U.S. rates of depression and anxiety is among the highest for 11 well-off nations. It had the highest rate of total mental health diagnoses.

Finally, suicide rates increased 33% between 1999 and 2019, according to the CDC, and has become the 10th leading cause of death in the U.S. The rate, too, is the highest among wealthy nations.

Systemic problems

Instead of talking about reluctant workers, the press should start paying attention to what is behind the dismal state of population health in the U.S.. These are the factors that prevent a greater share of adults here from being ready and willing to work.

For instance, the food and agriculture system in the U.S. contributes mightily to the obesity epidemic (not to mention exacerbates the global warming crisis through its production methods). Sugar-laced beverages and breakfast cereals; salt-laden processed and restaurant foods; poor access to fruits and vegetables; portion sizes all out of proportion with caloric needs: all should be on the public agenda if we want to grow the workforce.

The shift to non-carbon-based fuels will not only reduce the threat from global warming. It will substantially reduce the incidence of asthma, chronic lung disease and associated cancers that come from exposure to their toxic emissions. Again, a person not hacking and wheezing is a person more ready to go to work.

The U.S. needs to make a major commitment to understanding the social roots of the behavioral health and substance abuse crises. It needs to take concrete steps to address those root causes.

The Covid-19 pandemic has exposed the rickety state of the public health delivery system in the U.S., and the limits to the general public’s willingness to heed its recommendations. It also exposed how individuals immersed in a toxic media environmnent will refuse to take responsibility for their own care, and thus can’t be expected to self-cure the chronic diseases that have infected the American workforce over the last several decades.

Government action needed

If policymakers want more adults ready and eager to report for work, they must develop programs for improving their health. Only an activist government can rein in the actions of companies whose business models have proven injurious to public health.

It should look to the past. In the final years of WWII, Congress held hearings that focused on the poor health status of men reporting for the draft. It determined poor nutrition during childhood was a major contributor. It was a different era. Just months before the 1946 elections when Republicans seized control of Congress, both houses passed the National School Lunch Act. It received widespread bipartisan support.

President Biden’s Build Back Better bill begins to tackle many of today’s problems that are undermining the health of the U.S. workforce. The McKinsey survey found access to health care, nutritious food and childcare were the top three issues serving as barriers to economic well-being. All are addressed in the bill.

If it passes in the weeks ahead, it will garner few if any Republican votes. Sadly, that’s how far we’ve come from being a nation willing to grapple with its most serious problems.