Duke Study Suggests That “Unions Are Better For Your Health”

Here’s a workforce health study that might raise your blood pressure: two researchers at Duke University say that their research suggests that labor unions are good for your health.

The Duke research indicates “that more unionized American workers consider themselves healthy than do their non-union counterparts,” according to David Brady, a Duke sociology professor and co-author of the study who talked to the Duke Research Blog.

The study appears in the latest issue of Social Forces, and it “examines survey results of more than 11,000 full-time workers, both union and non-union, who answered questions about their general health. The data is from the General Social Survey, a massive effort of the National Opinion Research Center providing more than three decades of data “

85% of union workers say they are in good health

The key finding, and the one that seems to be driving the notion that “unions are better for your health,” is that 85 percent of union workers reported being in good health, compared to 82 percent of non-union workers. That may not sound like much, but as the Duke Research Blog story notes, “in real numbers, that 3 percent gap represents 3.7 million American workers.”

Three percent may not seem like a lot,” said Megan Reynolds, a Duke doctoral student and lead author of the study. “But when you start looking at the number of workers in the United States, that’s a lot of people.”

(Duke Sociology professor and study co-author David) Brady and Reynolds say the difference is comparable to the physical benefits found to be associated with being married rather than divorced or being five years younger.

Union workers comprise just about 11 percent of the American workforce.

“Unions are taking a beating in American culture,” Brady said. “But here we can say that not only are unions better for your wages, they’re good for your health.”

Yes, but do union workers have better health care?

I’ve skimmed the research by Brady and Reynolds, and it is deep and impressive as research goes. But where I struggle is with the blanket conclusion that unions “are good for your health.” After all, as the researchers point out, only slightly more than 10 percent of the U.S. workforce (the BLS pegs it as 11.8 percent in 2011) is unionized. And, it wouldn’t even be that large were it not for the disproportionate skewing of public sector workers who are represented by a labor union.

According to the Bureau of Labor Statistics, 37 percent of public sector workers were unionized as of 2011, compared to just 6.9 percent in the private sector. And as we all know given the growing debate over public sector worker benefits that flow from such a high degree of union representation (see Wisconsin for more details), public sector workers get richer health care benefits pretty much across the board, including lower levels of individual contribution, lower (or no) co-pays, and in some cases, little or no employee contribution to health care at all.

That means, at least in my analysis, that these highly unionized public sector workers are likely to consume more health care. They are likely to opt to go see the doctor at the first sign of sniffle or sore throat, while their non-unionized public sector counterparts (who make up the overwhelming majority of workers in this country) are probably more likely to wait to save their money and wait to see the doctor until they really need it.

Yes, my take would be that it’s not surprising that more unionized workers report that they are in good health compared to their non-unionized breatheren. That’s to be expected when you have a better health plan and little to no out of pocket costs. You use it more and see the doctor more because there is little to no cost out of your pocket for doing so. That one reason why health care is so costly in America these days — some people who pay very little (or nothing) for it use too much of it because they don’t pay any part of the bill.

Reasons for skepticism

Is this a factor that the Duke researchers have failed to account for as they tout that “unions are better for their health?”

Maybe. In a section in the study titled “Reasons for Skepticism,” authors Brady and Reynolds note:

Before making the case for an effect of labor unions on health, it is worthwhile to question whether such an effect exists. Unionization is not distributed evenly and the unionized are not a representative sample of workers. The nature of highly unionized jobs (e.g., in the manufacturing or public sector) or the individual characteristics (e.g., human capital) associated with those jobs, rather than union membership itself, may be what influences health. Thus, if we find that union membership significantly benefits health, it could be because more healthy workers or those with healthier jobs select into unions. Any remaining effect of union membership could easily be overshadowed by the myriad social, psychological and behavioral factors that shape health. Thus, unionized workers could have better or even worse health for reasons unrelated to or despite union membership.”

I’d also throw in one more caveat: unionized public sector workers have been largely sheltered by the huge increases in health care costs since their public sector employer (again, that’s where most unionized U.S. workers are) is not particularly worried about the bottom line impact of such increases as private sector employers are.

Yes, some public sector workers have been asked to pay more for their health care, but their unions are fighting this everywhere. In the private sector, employees were simply hit with higher health care costs as the recession and the ever-rising cost of health care zoomed upward. That had to depress health care usage among non-unionized private sector workers, and I would be surprised if that didn’t manifest itself in those workers reporting they felt “less healthy.”

So, take this study with a grain of salt. You may see it differently and your mileage may vary. I don’t automatically jump to the conclusion that “unions are better for your health” after looking at this survey, as the authors do, but you should take a good read (you’ll find it here) and decide for yourself.