Precarious Work as Risk Factor for 5-Year Increase in Depressive Symptoms

Abstract

Objectives: The aim was to investigate the longitudinal relationship between precarious work and depressive symptoms in a representative cohort of employees in Germany.

Methods: In the German Study on Mental Health at Work (S-MGA) (n = 2009), depressive symptoms were assessed by the Patient Health Questionnaire (PHQ-9). Precarious work was measured through baseline (2012) self-reported job insecurity, marginal part-time, fixed-term contract, hourly wage and-during follow-ups 2012-2017-unemployment. Among employees without depressive symptoms at baseline (2012), we ran logistic regression analyses stratified by gender with depressive symptoms at follow-up in 2017 as the dependent variable, adjusting for baseline (2012) age, gender, socioeconomic position and partner status.

Results: Among men, job insecurity (OR: 2.47; 95% 95% CI: 1.37-4.48) and low wage (3.79; 1.64-8.72) at baseline were significantly associated with depressive symptoms at follow-up. Among women, indicators of precarious work were not associated with depressive symptoms at follow-up. Among men, a cumulative exposure index of precarious work was significantly associated with the development of depressive symptoms (one indicator: 1.84; 0.94-3.60, ≥two indicators: 7.65; 3.30-17.73). This index was not associated with depressive symptoms among women. The population attributable fraction of precarious work due to depressive symptoms among men was approximately 30%.

Conclusions: Among employees in Germany, precarious work seems to be a risk factor for the subsequent development of depressive symptoms among men, but not among women. Research on precarious employment in different countries is needed.

Keywords: mental health; non-standard work; precarious work; prospective analyses.

Figure 1

Flow diagram of participation in S-MGA’s 2012baseline and in the 2012–2017 cohort.

Figure 2

Association between precarious work index in 2012–2017 and depressive symptoms in 2017, among 1061 male employees in Germany aged 31 to 60 years, including those with depressive symptoms in 2012. Odds ratios. Precarious work index is calculated as number of exposures to (a) job insecurity at baseline, (b) low wage at baseline and (c) unemployment during follow-up. This figure illustrates the results shown in Table A9. The total area of the three bars represents all cases of depressive symptoms at follow-up. The area above the odds ratio of 1 of the two bars to the right represents those cases attributable to the elevated odds of experiencing job insecurity, unemployment or low wage. This area makes up 27% of the total area of all tree bars.