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Is gig work killing people? Researchers link poor health to income insecurity

Those who work piece-rate jobs are more likely to suffer from health issues

Researchers, using self-reported data from an 11-year period, have found that gig workers suffer from poorer health than salaried workers. (Photo: Jim Allen/FreightWaves)

Many assume the gig economy is a new form of work, but that would be wrong. In 1776, economist Adam Smith remarked that workers “when they are liberally paid by the piece, are very apt to overwork themselves, and to ruin their health and constitution in a few years.”

The formation of unions in the early 20th century ended many of these practices, but the practice has made a comeback in recent years with the evolution of the gig economy — in which workers are paid based on individual tasks or jobs — and there is now some research that suggests this type of work is unhealthy for individuals.

Many workers have embraced the gig economy work model, preferring the freedom to work when and where they want. Opponents argue that companies are taking advantage of workers, who have few labor protections enjoyed by full-time and even part-time employees. These protections include workers’ compensation, paid time off and health benefits.

The research was led by University of Texas Health Science Center at Houston School of Public Health (UTHealth) alumnus Robert Thomas; Gretchen Gemeinhardt, associate professor of management policy and community health; Paula Cuccaro, assistant professor of health promotion and behavioral sciences; and John Davis, the immediate past commissioner of the Texas Workforce Commission. The authors concluded that gig work leads to a “negative impact on the overall health and well-being of U.S. workers,” according to a news release from the school.

The research was published in the August issue of Social Science & Medicine Journal and is based on data collected from the 2008-19 IPUMS Medical Expenditure Panel Survey (MEPS). The annual MEPS is a voluntary survey that is conducted as part of the National Health Interview Survey. More than 1 million responses were included in the MEPS during this study time frame.

Researchers found that “insecure income earners” reported a 50% increase in poor overall health compared to those who earned a salary. The research was conducted using pre-COVID-19 data, leading researchers to conclude that the health outcomes have likely deteriorated further.


“The longer-term economic burden will ultimately be passed onto the U.S. consumer as we see increases in worker shortages, increases in prices from gig companies, and increases in unreimbursed health care utilization,” Thomas said in a news release. “It is reasonable to project that the U.S. taxpayer will pay more for uninsured chronic morbidity care of uninsured U.S. workers who are paid an insecure income.”

Previous research, the authors noted, has made a connection between “precarious” work that leads to increased stress levels that impact overall health. The new research found that gig work contributed to poor health outcomes including a sicker workforce, higher unreimbursed health care costs and greater costs to the consumer.

“The pathways and relationships between precarious work and poor health outcomes are complex, with numerous factors serving as potentially significant triggering mechanisms,” the authors noted.

A 2021 online survey of 2,788 U.S. adults by payments firm daVinci Payments had some other surprising facts about the nation’s gig workforce. The survey was based on the 35% of respondents who responded and identified themselves as gig participants.

The survey found that 63% of gig workers (approximately 59 million out of the total 93 million gig workers in the country) also held full-time jobs in 2020, a 19% increase from 2019. The number of gig workers who earned less than $15,000 in 2020 was 69.8 million, a 35% increase from 2019. That is 74% of all gig workers. The average gig worker income was $17,445 in 2020, up from $16,926 in 2019, daVinci said.

The survey found about 50% of gig workers had a household income below $50,000 per year and 6% had income above $150,000. The average U.S. household income in 2020 was $68,703, according to the Census Bureau

“Income insecurity, a component of precarious work, has been found to be associated with workers’ physical, emotional, and psychological health, including self-reported poor health (SRH), depression, anxiety, hypertension, weight-gain and weight-gain related illnesses,” the UTHealth authors pointed out.

“When compared to those working annual salary positions, daily pay, hourly pay, and PRP were all significantly associated with higher odds of reporting fair or poor SRH,” the researchers noted.

In analyzing the data, the researchers found that poor health outcomes were more likely among those reporting lower income levels or who identified as Black of Hispanic. However, they also found some evidence that higher hourly pay rate, regardless of the work type, “partially mediated[d] the association” with a poor health outcome.

“These findings warrant policy makers’ consideration as they balance the purported benefits of gig economy non-salary compensated work with implications for workers’ health,” the authors wrote.

Click for more Modern Shipper articles by Brian Straight.

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Brian Straight

Brian Straight leads FreightWaves' Modern Shipper brand as Managing Editor. A journalism graduate of the University of Rhode Island, he has covered everything from a presidential election, to professional sports and Little League baseball, and for more than 10 years has covered trucking and logistics. Before joining FreightWaves, he was previously responsible for the editorial quality and production of Fleet Owner magazine and fleetowner.com. Brian lives in Connecticut with his wife and two kids and spends his time coaching his son’s baseball team, golfing with his daughter, and pursuing his never-ending quest to become a professional bowler. You can reach him at [email protected]