Epidemic Intelligence Service, Centers for Disease Control and Prevention, United States of America; Health Informatics Branch, Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, United States of America.
Economics Research and Support Office, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, United States of America.
Prev Med. 2024 Sep;186:108090. doi: 10.1016/j.ypmed.2024.108090. Epub 2024 Aug 2.
To measure associations between employment precarity and mental health among United States (US) workers.
This study used data from the US Medical Expenditure Panel Survey for 2008-2021. Multivariable generalized estimating equations were used to measure associations between employment precarity (operationalized as a multi-dimensional exposure) and self-rated mental health after adjusting for relevant confounders. Marginal effects analysis was used to assess potential dose-response relationships between precarity and mental health.
Our sample (n = 57,529) was representative of >106 million US workers employed throughout 2008-2021. Compared to those with low levels of employment precarity, those with medium and high levels of precarity had an increased odds of reporting poor/fair mental health (aOR = 1.21; 95% CI = 1.11, 1.32 and 1.51; 95% CI = 1.36, 1.68, respectively). Marginal effects analysis indicated that increasing levels of precarity were associated with an increased probability of reporting poor/fair mental health.
Increasing levels of employment precarity were associated with poor/fair self-rated mental health, findings potentially indicative of a dose-response relationship between the two. These nationally representative findings suggest employment precarity is an important social determinant of mental health. Future research could investigate how best to mitigate the negative effects of precarity on workers' lives and well-being, particularly regarding mental health.
衡量美国工人就业不稳定与心理健康之间的关联。
本研究使用了 2008-2021 年美国医疗支出面板调查的数据。采用多变量广义估计方程，在调整相关混杂因素后，衡量就业不稳定（多维暴露）与自我报告的心理健康之间的关联。边际效应分析用于评估不稳定与心理健康之间潜在的剂量-反应关系。
我们的样本（n=57529）代表了 2008-2021 年期间就业的超过 1.06 亿美国工人。与低就业不稳定水平的人相比，中高就业不稳定水平的人报告心理健康不佳/一般的几率更高（优势比[aOR]=1.21；95%置信区间[CI]为 1.11，1.32 和 1.51；95%CI 分别为 1.36，1.68）。边际效应分析表明，不稳定程度的增加与报告心理健康不佳/一般的概率增加有关。
就业不稳定程度的增加与心理健康不佳/一般的自我报告有关，这一发现可能表明两者之间存在剂量-反应关系。这些具有全国代表性的发现表明，就业不稳定是心理健康的一个重要社会决定因素。未来的研究可以探讨如何最好地减轻不稳定对工人生活和福祉的负面影响，特别是对心理健康的影响。
