Psychosocial work factors and social inequalities in psychological distress: a population-based study

Caroline S Duchaine,Chantal Brisson,Clermont E Dionne,Manon Levesque,Xavier Trudel,Neil Pearce,Michel Vézina,Ruth Ndjaboué,Mahée Gilbert-Ouimet,Benoît Mâsse

doi:10.1186/s12889-017-4014-4

Abstract

BackgroundMental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers.MethodsData were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women.ResultsLow education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women.ConclusionsThese results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.

Highlights

Mental health problems (MHP) are the leading cause of disability worldwide
Women were slightly more exposed to adverse psychosocial work factors from the DCS and Effort-Reward Imbalance (ERI) models (PD, Job control (JC), and reward), except for Social support at work (SS)
Individuals with missing values on household income were comparable from individuals without missing values in terms of psychological distress and psychosocial works factors exposure

Summary

Introduction

Mental health problems (MHP) are the leading cause of disability worldwide. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers. Social inequalities in mental health problems (MHP) have previously been documented in several studies [4, 5]. MHP are the leading cause of disability worldwide [6]. Their prevalence, long duration and high risk of recurrence [7] place a considerable burden on health and social care systems and important productivity losses for employers [6]. Understanding the pathways that link SEP to MHP is of important public health significance [3]

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