Purpose: To explore employment as a social determinant of health through examining the relationship between employment status and physical health. Method: The authors explored the causal relationship between employment status and physical health through conducting a systematic review of 22 longitudinal studies conducted in Finland, France, the Netherlands, Nigeria, Sweden, United Kingdom, and the United States. Results: Five common trajectories were identified as employment, unemployment, job loss, reemployment, and retired. Unemployment and job loss were associated with poorer physical health. Employment and reemployment were associated with better physical health. Conclusion: To enhance employment outcomes, it is important for service providers to acknowledge the interaction between the client's physical health and employment status, and assess client physical functioning. Additional research is necessary to further elucidate this interaction.