The Prevalence of Depression and Its Impact on Employment Earnings among Canadian Labor Force Participants

Abstract

Depression is among the largest health capital threats to Canada’s labor force population. It is unclear how depression prevalence has been behaving over time among the Canadian working-age population, and its impact on and co-occurrence with labor market outcomes, such as employment earnings. In this dissertation, I quantify trends in major depressive episode (MDE) prevalence among various segments of the Canadian labor force and determine how experiencing depression influences employment earnings trajectories over the working life. My first study employed a cross-sectional time series methodology to quantify the trend in the prevalence of annual MDEs among different segments of the Canadian labor force from 2000 to 2016. Findings suggest that prevalence of annual MDEs was stable between 2000 and 2016; average prevalence of annual MDEs over this period was roughly double that among those unemployed or not participating in the labor force compared to those who were employed. My second study linked annual administrative tax records to population health data to determine how experiencing a MDE influences employment earnings over the subsequent decade among working-aged Canadian men and women. Using a propensity score-matched cohort design and longitudinal multi-level modeling, results suggested a crude, cumulative ten-year earnings loss of ~$71,000 CAD for working-aged women and ~$115,000 for working-aged men who experienced a MDE. My last study employed parallel latent growth modeling to quantify the number of concurrent trajectories of depression-related mental health and employment earnings over a 19-year period. The study examined an American cohort entering the labor force in 1997, followed until 2017. Four latent classes were uncovered: one class with stable poor mental health and the lowest earnings (~$32,000 USD in 2017), and three classes with stable positive mental health and earnings ranging from ~$39,500 to $196,000 in 2017. Being a woman, Black or Hispanic, poor adolescent socioeconomic status, adolescent marijuana use, and overweight body weight in 1997 was associated with higher odds of belonging to the poor mental health, lowest earnings class. Taken together, this dissertation highlights the persistent nature of depression prevalence and its longstanding impact on earnings among labor force participants over the past 20 years.