Precarious employment and stress: any differences between objective or subjective measures of stress?

Abstract

Abstract Background Precarious employment is an emerging social determinant of health and health inequalities. It is known that it has an impact on health and could be a potential stressor. This study aims to examine the association between precarious employment and stress measured in two different ways: subjectively (questionnaire) and objectively (cortisol and its metabolites concentrations in hair, considered biomarkers of chronic stress). Methods Cross-sectional study in a sample of 256 workers of Barcelona, Spain, aged 25-60. We conducted a survey including questions on multidimensional precarious employment assessed by EPRES (Precarious Employment Scale), and perceived stress (measured through the Perceived Stress Scale (PSS)). We also collected hair samples to measure cortisol and metabolites concentrations. The associations between precarious employment and stress were assessed using lineal regression models, stratified by sex and adjusted for age and BMI. Results Preliminary analyses show an association between precarious employment and perceived stress for both men and women (B = 5.4,CI95%:3.8-7.1 and B = 5.4,CI95%:3.2-7.7 respectively). While we did not find significant association between precarious employment and Cortisol, we did in several biomarkers of the Hypothalamic-pituitary-adrenal axis for the case of women: 20α-Dihydrocortisol (B = 2.4;CI95%:0.1-4.6), 20β-Dihydrocortisol (B = 1.6;CI95%:-0.4-2.7) and 11-Dehydrocorticosterone (B = 0.6;CI95%:0.0-1.2). Conclusions This study found evidence of association between precarious employment and stress. The results were more robust when stress is measured by means of subjective self-reports than by objective measures of cortisol metabolites, implying that precarious employment has a clearer impact on wellbeing and mental health than in physical and hormonal responses. Further research is needed to validate and understand differences among outcomes, as well as differences between men and women. Key messages Some evidence of association between precarious employment and stress, measured both by subjective self-reported measures and by objective measures of cortisol metabolites existed. More research is needed to understand the differences between objective and subjective stress on the impact of precarious employment and differences among indicators for men and women.