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. 2024 Apr 1;50(3):218-227.
doi: 10.5271/sjweh.4150. Epub 2024 Mar 10.

Change in employment status and its causal effect on suicidal ideation and depressive symptoms: A marginal structural model with machine learning algorithms

Jaehong Yoon, Ji-Hwan Kim, Yeonseung Chung, Jinsu Park, Ja-Ho Leigh, Seung-Sup Kim  1
Affiliations

Change in employment status and its causal effect on suicidal ideation and depressive symptoms: A marginal structural model with machine learning algorithms

Jaehong Yoon et al. Scand J Work Environ Health. .

Abstract

Objective: This study aimed to assess the causal effect of a change in employment status on suicidal ideation and depressive symptoms by applying marginal structural models (MSM) with machine-learning (ML) algorithms.

Methods: We analyzed data from the 8-15th waves (2013-2020) of the Korean Welfare Panel Study, a nationally representative longitudinal dataset. Our analysis included 13 294 observations from 3621 participants who had standard employment at baseline (2013-2019). Based on employment status at follow-up year (2014-2020), respondents were classified into two groups: (i) maintained standard employment (reference group), (ii) changed to non-standard employment. Suicidal ideation during the past year and depressive symptoms during the past week were assessed through self-report questionnaire. To apply the ML algorithms to the MSM, we conducted eight ML algorithms to build the propensity score indicating a change in employment status. Then, we applied the MSM to examine the causal effect by using inverse probability weights calculated based on the propensity score from ML algorithms.

Results: The random forest algorithm performed best among all algorithms, showing the highest area under the curve 0.702, 95% confidence interval (CI) 0.686-0.718. In the MSM with the random forest algorithm, workers who changed from standard to non-standard employment were 2.07 times more likely to report suicidal ideation compared to those who maintained standard employment (95% CI 1.16-3.70). A similar trend was observed in the analysis of depressive symptoms.

Conclusions: This study found that a change in employment status could lead to a higher risk of suicidal ideation and depressive symptoms.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow-chart of the study population.
Figure 2
Figure 2
Cross-validated performance of the machine learning algorithms according to the AUC.
Figure 3
Figure 3
Balance in the unweighted sample (blue circle) and weighted sample with weights generated by the random forest (red diamond).
See this image and copyright information in PMC

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