Dr Anthony D. LaMontagne1
Dr Rennie Marceline D’Souza2
1 McCaughey Centre, Melbourne School of Population Health, University of Melbourne
2 National Centre of Epidemiology and Population Health, Australian National University, Canberra
3 Beyond Blue
In association with ACT Health Job Stress and Workplace Mental Health Study
Beyond Blue grant
Project completion year
This study aimed to provide information for action paralleling these specific aims:
- To identify the demographic and work setting correlates of poor mental health (depression and anxiety) among working Australians in order to identify those groups and settings most urgently in need of intervention. This will assist Beyond Blue to appropriately target promotion of the package/intervention after the ACT Health Job Stress and Workplace Mental Health Project is complete and the national roll-out commenced.
- To validate the associations of job stressors (using individual and combined job stressors measures of ‘job pressure’ and ‘job quality’) and mental health in two samples:
o a representative sample of working Victorians
o a diverse sample of workers from 10 Canberra-area worksites.
- To test whether poor quality jobs are more harmful to mental health when coupled with low socioeconomic status.
Two independent samples of working Australians were used, one from the Australian Capital Territory (ACT) and the other from Victoria.
The ACT study was conducted in 2009 and had 842 participants with an overall participation rate of 44 per cent across 10 sites. This study included organisations of different sizes, from both government and non-government employers. The ACT sample comprised of 36 per cent males and 64 per cent females.
Secondary analysis of a population-based cross-sectional survey of working Victorians aged over 18 years was completed in November 2010 with a 66 per cent response rate from eligible households to yield a sample of 1,101 working Victorians. The Victorian sample comprised of 48 per cent males and 52 per cent females. Over half of the sample (55 per cent) was between the ages of 30 and 50 years while 24 per cent were under the age of 30 years and 21 per cent were over 50 years.
Objective 1 – Demographic and work setting correlates of poor mental health
The overall prevalence of poor mental health assessed by SF12 mental health scores was 21 per cent, with females having a higher prevalence compared to males (24 per cent versus 17 per cent). The prevalence of poor mental health decreased as age increased and was highest in those with post-graduate education. Those who lived alone had a higher prevalence of poor mental health (25 per cent) compared to those who were married or lived with a partner (17 per cent). All these factors were statistically significantly associated with poor mental health, even when adjusted for each other. After adjustment for socio-demographics, none of the work setting correlates assessed was significantly associated with poor mental health.
(a) Adverse psychosocial work conditions (job strain, job insecurity, job pressure) are related to poor mental health
In the ACT, 18 per cent had high job strain, 10 per cent reported high job insecurity and 13 per cent had high job pressure. Only 26 per cent reported optimal working conditions while 50 per cent, 20 per cent and four per cent reported having one, two or three work stressors respectively.
In Victoria, 23 per cent had high job strain, five per cent reported high job insecurity and 7 per cent had high job pressure. Only 18 per cent reported optimal working conditions while 48 per cent, 25 per cent and five per cent reported having one, two or three adverse work conditions respectively.
After adjustment for confounders like age, education, marital status and personality (negative affectivity), high job strain and high job insecurity, when examined together remained significantly associated with depression and anxiety symptoms in the ACT and with poor mental health in Victoria.
Moderate and high job pressure also showed significantly higher depression and anxiety symptoms in the ACT and with poor mental health in Victoria.
(b) Poor quality jobs are related to poor mental health
Exposure to two, three and four adverse work conditions showed significantly higher odds of depression and anxiety symptoms in the ACT study, as well as increasing odds of poor mental health in the Victorian sample.
In the ACT sample, even when long working hours and low social support were included in a job quality measure, there was a stepwise increase in depression and anxiety symptoms as the number of adverse work conditions increased.
In Victoria, measures of job quality that included long working hours and sexual advances were associated with a stepwise increase in the prevalence of poor mental health as the number of adverse work conditions increased.
Adverse work conditions were also associated with sickness absence. However, this was assessed only crudely, with no adjustment for socio-demographic or other potential determinants of poor mental health (no multivariate regression modelling was conducted).
(c) Poor quality jobs are more harmful to mental health when coupled with low socioeconomic status in Victoria
The effect of work conditions on poor mental health varied by education in Victoria. Work stressors had a greater adverse effect on mental health among those with lower education (some schooling, completed school or vocational qualifications) compared to those who had post-graduate or undergraduate education.
Adverse work conditions that are associated with poor mental health are potentially amenable to change. Findings suggest that psychosocial working conditions are a major determinant of population mental health and that policy and practice initiatives to improve psychosocial working conditions could have major population health benefits. To reduce the current and future burden of depression, anxiety and other mental illness in the workplace, reducing work-related contributions to mental illness is an essential complement to clinical interventions.
A. D. LaMontagne, R. M. D'Souza & C. B. Shann (2012): Socio-demographic and work setting correlates of poor mental health in a population sample of working Victorians: application in evidence-based intervention priority setting, International Journal of Mental Health Promotion, http://dx.doi.org/10.1080/14623730.2012.703048