Most adults in the United States spend well over a third of their waking hours in the workplace. There is little doubt that workplace issues directly affect the health of employees, While employers are often not obligated to offer certain benefits to employees, clearly there exists a symbiotic relationship between employer and employee. The central focus of this proposed Independent Scientist Award application is to study the critical role, both currently realized and in potential, that employers play in the health of their employees. This K02 award would provide an unparalleled opportunity to develop abroad-based research frame in a coherent and unified manner that ties several lines of research together, instead of the piecemeal approach that would otherwise be necessary. The central goal is to leverage the support from this award to explore three broad aspects of employer provided health benefits. The first area of research proposes to explore the interaction between local health care market factors, particularly the local health care safety net, and the employer's decision to offer health insurance and the employee's subsequent decision to accept insurance when it is offered. The second area proposes to examine firm behavior with respect to the provision of health care benefits at a national level by specifically looking at responsible health care purchasing behavior by firms. The third area proposes to extend ongoing collaborative relationships to examine several specific disease areas and conditions that employers may affect, such as mental illness, substance abuse, arid leave policies to care for elderly parents. By elucidating the processes by which the majority of Americans receive their health benefits and the characteristics of the benefits in general and for specific conditions, it will be possible to achieve a greater understanding of the means by which coverage and health can be improved for all.
