Abstract
BackgroundIn the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers' mental health. Nevertheless, much less attention has been dedicated towards understanding the pathways through which other pivotal life environments might also concomitantly intervene, along with the work environment, to bring about mental health outcomes in the workforce. The aim of this study consisted in conducting a systematic review examining the relative contribution of non-work determinants to the prediction of workers' mental health in order to bridge that gap in knowledge.MethodsWe searched electronic databases and bibliographies up to 2008 for observational longitudinal studies jointly investigating work and non-work determinants of workers' mental health. A narrative synthesis (MOOSE) was performed to synthesize data and provide an assessment of study conceptual and methodological quality.ResultsThirteen studies were selected for evaluation. Seven of these were of relatively high methodological quality. Assessment of study conceptual quality yielded modest analytical breadth and depth in the ways studies conceptualized the non-work domain as defined by family, network and community/society-level indicators. We found evidence of moderate strength supporting a causal association between social support from the networks and workers' mental health, but insufficient evidence of specific indicator involvement for other analytical levels considered (i.e., family, community/society).ConclusionsLargely underinvestigated, non-work determinants are important to the prediction of workers' mental health. More longitudinal studies concomitantly investigating work and non-work determinants of workers' mental health are warranted to better inform healthy workplace research, intervention, and policy.
Highlights
In the past years, cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers’ mental health
Measurements for mental health needed to be based on multidimensional, psychometrically sound instruments; we considered both continuous and binary statistical treatments of mental health outcomes [26,27]
We considered strength of evidence “strong” if all three criteria were cumulatively satisfied, “moderate” if consistent results were obtained from highquality studies only or a mixture of high- and low-quality studies in the anticipated direction for exposure-outcome association independently from the strength of association, and “insufficient” if consistency could not be reached or was based on low-quality studies only
Summary
Cumulative evidence has convincingly demonstrated that the work environment is a critical determinant of workers’ mental health. For the past three decades, epidemiological research, influenced predominantly by the Demand-Control-Support [1] and Effort-Reward Imbalance [2] models, has highlighted the connection between key features of the psychosocial work environment (e.g., decision latitude, psychological demands, social support, rewards) and the deterioration of workers’ mental health. This substantial body of work has recently been the focus of several systematic reviews of work-specific determinants [3,4,5] and leveraged interventions [6,7,8,9,10]. In line with the sociological theory of agency-structure [17,18], we view macro- (e.g., society), meso- (e.g., workplace, networks) and microsocial structures of the daily life (e.g., family) as many life environments in which workers routinely find themselves
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