Full Employment and Public Health

  • Date: Jan 01 1995
  • Policy Number: 9508

Key Words: Employment

The American Public Health Association,

Recognizing that the right of all persons to a freely chosen job paying wages sufficient to support a dignified existence has been proclaimed in multiple international human rights agreements concluded since the Second World War;1-5 and

Noting that the right to a useful and remunerative job in the industries or shops or farms or mines of the nation, earning enough to provide adequate food and clothing and recreation, was included in the Economic Bill of Rights proposed by President Franklin D. Roosevelt;6 and

Understanding that the social welfare system of the United States was originally designed to stand on two legs: (1) Employment assurance to those members of society who were expected to be self-supporting through work; and (2) Social and economic security for those members of society who are not expected to work or who are only temporarily unemployed;7 and

Understanding that with the arrival of full employment during the Second World War, the supplementary government employment programs established in the 1930s were terminated, with the result that "since then, we have tried to walk on one leg only, to hobble along with half a social welfare system;"8 and

Having expressed the APHA principles of Social Welfare Policy to include full employment and the equitable distribution of income,9 full employment being defined as consisting of the following three components:1

  1. Unemployment periods for an individual are short, meaning that they do not last longer than the amount of time covered by unemployment insurance;
  2. There are always more vacant positions than unemployed people, i.e., labor is in relatively short supply. The vacant positions are matched to existing labor skills; and
  3. Jobs are paid at "fair" wages;10

Recognizing that there exists a strong correlation between the rate of unemployment and such key measures of public health as the overall mortality rate, specific mortality rates from cardiovascular disease, cirrhosis, suicide, and homicide, and admissions to psychiatric hospitals;11-13 and

Noting that specific psychological effects observed in unemployed people include depression, suicide, and apathy and that every increase in the unemployment rate results in an increase in crime, in the breakdown of families, child abuse, drug abuse, and domestic violence;14 and

Noting the deterioration of job security and the inexorable increase in the level of long-term layoffs, downsizing by business and industry affecting a wide spectrum of social classes, and the exclusion or margina-lization of many minority workers and immigrants from access to jobs with adequate earnings and job security;15 and

Recalling with concern the increase in the numbers of those uninsured or under-insured as a result of higher levels of unemployment and reduction or elimination of health care insurance by employers;16 and

Noting that the periodic raising of interest rates by the Federal Reserve Board to "control inflation" results in consistent increases in unemployment in the United States that have not been effective in dealing with the threat of inflation;17 and

Noting that private industry in the United States has historically proven incapable of reaching the objective of jobs for all (on an annual basis, the United States has achieved a rate of unemployment of 2 percent or less only seven times in the past century, with an average rate of unemployment over the past century of 7.1 percent);18 and

Noting that APHA policy is committed to the right to meaningful, productive employment, with adequate income;19 therefore

  1. Finds that present and projected levels of unemployment and underemployment constitute a direct hazard to public health; and
  2. Encourages the development and implementation of a United States full employment policy ensuring employment guaranteed at a living wage to every adult man or woman who is unable to find adequately remunerative work in the regular labor market. Such employment should include, at a minimum, health insurance benefits equivalent to those available to federal government employees, safe and healthy working conditions, and affordable, quality childcare services. Short-term unemployment benefits programs should be maintained and strengthened as an adjunct to this policy of providing guaranteed employment.


  1. Universal Declaration of Human Rights, U.N. Doc A/811 (1948), Art. 23.
  2. International Covenant on Economic, Social and Cultural Rights, G.A. Res. 2200, 21 U.N. GAOR Supp. (No. 16) at 49, U.N. Doc A/6316 (1966), Arts. 6,7.
  3. European Social Charter, Europ T.S. No. 35,529 U.N.T.S. 89(1961, Art. 1).
  4. Convention Concerning Employment Policy (International Labor Organization Convention No. 122), adopted 15 July 1966, reprinted in ILO, International Labour Conventions and Recommendations, 1919-1981 (Geneva:ILO, 1982):67-68.
  5. Draft Protocol Additional to the American Convention on Human Rights Organization of American States, Annual Report of the Inter-American Commission on Human Rights, 1985-1986. Washington, DC: General Secretariat, Organization of American States. 1986:201, Art.6.
  6. Message to the Congress on the State of the Union (11 January 1944), reprinted in SI Rosenman, ed., The Public Papers and Addresses of Franklin D. Roosevelt, 13 vols. New York: Harper & Brothers, 1950;13:32-42.
  7. Report of the Committee on Economic Security, 15 January 1935, reprinted in National Conference on Social Welfare, The Report of the Committee on Economic Security of 1935. 1985:3-4.
  8. Harvey P. Securing the Right to Employment. Social Welfare Policy and the Unemployed in the United States. Princeton, NJ: Princeton University Press, 1989:20.
  9. American Public Health Association (APHA). The Nation's Health, February 1995;4.
  10. Beveridge WH. Free Employment in a Free Society. New York: Norton, 1945.
  11. Brenner MH. Mental Illness and the Economy. Cambridge, MA: Harvard University Press, 1973.
  12. Brenner MH: Estimating the Social Costs of National Economic Policy: Implications for Mental and Physical Health, and Criminal Aggression. A Study prepared for the use of the Joint Economic Committee, Congress of the United States. Washington, DC: U.S. Government Printing Office, 1976.
  13. Brenner MH. Estimating the Effects of Economic Change on National Health and Social Well-being: A Study. U.S. Congress, 98th, 2nd Session, Senate Print. 1984;98-198.
  14. Ginsberg H. Full Employment and Public Policy: The United States and Sweden. Lexington, MA: Heath, 1983;93-99.
  15. Dembo D, Morehouse W. Joblessness and the Pauperization of Work in America-The Underbelly of the US Economy. New York: Apex Press, 1994.
  16. National health overview shows one in five without health insurance. Public Health Reports. 1984;109:713.
  17. Eisner R. Our non-accelerating inflation rate of unemployed (NAIRU) limit-the governing myth of economic policy. American Prospect. Spring 1995;58-63.
  18. Harvey P. Securing the Right to Employment. Social Welfare Policy and the Unemployed in the United States. Princeton, NJ: Princeton University Press, 1989:14.
  19. American Public Health Association Resolution No. 6811(PP): Health and Poverty. APHA Public Policy Statements, 1948 to present, cumulative. Washington, DC: American Public Health Association, current volume.

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