Invited Commentary: Linking Job Security and Mental Health-Challenges and Future Directions.

Research in the social and health sciences has linked job insecurity to poorer mental health but relies on observational data and faces challenges of causal inference. LaMontagne et al. (Am J Epidemiol. 2021;190(2):207-215) innovate by using both within-person fixed-effects and random-effects regression to analyze data from 14 annual waves of an Australian survey spanning 2002-2015. Using this more rigorous design, they find that improvements in perceived job insecurity were associated with improvements in Mental Health Inventory-5 scores in a large, nationally representative panel study. By using each respondent as their own control, fixed-effects models remove the influence of time-invariant confounders. Innovative new approaches are still needed to address the causal directionality of the association and to capture both those whose exposure changes as well as those for whom it persists. Future work should also consider potential modifying factors including societal conditions, macroeconomic and other period effects, and characteristics of individuals, as well as drawing on multidisciplinary approaches that consider jobs as a combination of multiple health-relevant exposures and embed individual workers in families and communities to assess the full reach and consequences of perceived job insecurity.