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BMC Public Health
Published in: BMC Public Health 1/2015

Open Access 01-12-2015 | Research article

Do unfavourable working conditions explain mental health inequalities between ethnic groups?: cross-sectional data of the HELIUS study

Authors: Karen Nieuwenhuijsen, Aart H. Schene, Karien Stronks, Marieke B. Snijder, Monique H. W. Frings-Dresen, Judith K Sluiter

Published in: BMC Public Health | Issue 1/2015

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Abstract

Background

Ethnic inequalities in mental health have been found in many high-income countries. The purpose of this study is to test whether mental health inequalities between ethnic groups are mediated by exposure to unfavourable working conditions.

Methods

Workers (n = 6278) were selected from baseline data of the multi-ethnic HELIUS study. Measures included two indices of unfavourable working conditions (lack of recovery opportunities, and perceived work stress), and two mental health outcomes (generic mental health: MCS-12 and depressive symptoms: PHQ-9). Mediation of the relationships between ethnicity and mental health by unfavourable working conditions was tested using the bias-corrected bootstrap confidence intervals technique. Linear models with and without the mediators included, and adjusted for gender and age. Attenuation was calculated as the change in B between the models with and without mediators.

Results

The sample comprised Dutch (1355), African Surinamese (1290), South-Asian Surinamese (1121), Turkish (1090), Ghanaian (729), and Moroccan (693) workers. After controlling for age and gender, all ethnic minorities had a higher risk of mental health problems as compared to the Dutch host population, with the exception of Ghanaians in the case of depressive symptoms, and African Surinamese workers with regard to both outcomes. The Turkish group stands out with the lowest mental health on both mental health indices, followed by Moroccan and South-Asian Surinamese workers. A lack of recovery opportunities mediated the relationship between ethnic group and a higher risk of mental health problems. Perceived work stress did not contribute to the explanation of ethnic inequalities.

Conclusions

The higher risk of mental health problems in ethnic minority groups can be partly accounted for by a lack of recovery opportunities at work, but not by perceived work stress. This may imply that workplace prevention targeting recovery opportunities have the potential to reduce ethnic inequalities, but ethnic-specific experiences at the workplace need to be further explored.
Literature
1.
Manseau M, Case BG. Racial-ethnic disparities in outpatient mental health visits to U.S. Physicians, 1993–2008. Psychiatr Serv. 2013;65(1):59–67.CrossRef
2.
Weich S, Nazroo J, Sproston K, McManus S, Blanchard M, Erens B, et al. Common mental disorders and ethnicity in England: the EMPIRIC study. Psychol Med. 2004;34(8):1543–51.CrossRefPubMed
3.
Riolo SA, Nguyen TA, Greden JF, King CA. Prevalence of depression by race/ethnicity: findings from the national health and nutrition examination survey III. Am J Public Health. 2005;95(6):998–1000.CrossRefPubMedPubMedCentral
4.
Hollander AC, Bruce D, Burstrom B, Ekblad S. The association between immigrant subgroup and poor mental health: a population-based register study. J Nerv Ment Dis. 2013;201(8):645–52.CrossRefPubMed
5.
Cantor-Graae E, Pedersen CB. Full spectrum of psychiatric disorders related to foreign migration: a Danish population-based cohort study. JAMA Psychiatry. 2013;70(4):427–35.CrossRefPubMed
6.
de Wit MA, Tuinebreijer WC, Dekker J, Beekman AJ, Gorissen WH, Schrier AC, et al. Depressive and anxiety disorders in different ethnic groups: a population based study among native Dutch, and Turkish, Moroccan and Surinamese migrants in Amsterdam. Soc Psychiatry Psychiatr Epidemiol. 2008;43(11):905–12.CrossRefPubMed
7.
Schrier AC, de Wit MA, Rijmen F, Tuinebreijer WC, Verhoeff AP, Kupka RW, et al. Similarity in depressive symptom profile in a population-based study of migrants in the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2010;45(10):941–51.CrossRefPubMed
8.
Fryers T, Melzer D, Jenkins R. Social inequalities and the common mental disorders: a systematic review of the evidence. Soc Psychiatry Psychiatr Epidemiol. 2003;38(5):229–37.CrossRefPubMed
9.
10.
Ahonen EQ, Porthe V, Vazquez ML, Garcia AM, Lopez-Jacob MJ, Ruiz-Frutos C, et al. A qualitative study about immigrant workers’ perceptions of their working conditions in Spain. J Epidemiol Community Health. 2009;63(11):936–42.CrossRefPubMed
11.
Arcury TA, Grzywacz JG, Chen H, Mora DC, Quandt SA. Work organization and health among immigrant women: Latina manual workers in North Carolina. Am J Public Health. 2014;104(12):2445–52.CrossRefPubMedPubMedCentral
12.
Miller GV, Travers CJ. Ethnicity and the experience of work: job stress and satisfaction of minority ethnic teachers in the UK. Int Rev Psychiatry. 2005;17(5):317–27.CrossRefPubMed
13.
Hoppe A. Psychosocial working conditions and well-being among immigrant and German low-wage workers. J Occup Health Psychol. 2011;16(2):187–201.CrossRefPubMed
14.
Rosmond R, Lapidus L, Bjorntorp P. A cross-sectional study of self-reported work conditions and psychiatric health in native Swedes and immigrants. Occup Med (Lond). 1998;48(5):309–14.CrossRef
15.
Morse N, Weiss R. The function and meaning of work and the Job. Am Sociol Rev. 1955;20(2):191–8.CrossRef
16.
Singh P. Meaning of work. Indian J Ind Relat. 1979;15(1):19–40.
17.
Bowling A. What things are important in people’s lives? A survey of the public’s judgements to inform scales of health related quality of life. Soc Sci Med. 1995;41(10):1447–62.CrossRefPubMed
18.
Ford E, Clark C, McManus S, Harris J, Jenkins R, Bebbington P, et al. Common mental disorders, unemployment and welfare benefits in England. Public Health. 2010;124(12):675–81.CrossRefPubMed
19.
Waddell G, Burton K, Aylward M. Work and common health problems. J Insur Med. 2007;39(2):109–20.PubMed
20.
van der Noordt M, IJzelenberg H, Droomers M, Proper KI. Health effects of employment: a systematic review of prospective studies. Occup Environ Med. 2014;71(10):730–6.CrossRefPubMed
21.
Nieuwenhuijsen K, Bruinvels D, Frings-Dresen M. Psychosocial work environment and stress-related disorders, a systematic review. Occup Med (Lond). 2010;60(4):277–86.CrossRef
22.
Wieclaw J, Agerbo E, Mortensen PB, Burr H, Tuchsen F, Bonde JP. Psychosocial working conditions and the risk of depression and anxiety disorders in the Danish workforce. BMC Public Health. 2008;8:280.CrossRefPubMedPubMedCentral
23.
Lahelma E, Lallukka T, Laaksonen M, Saastamoinen P, Rahkonen O. Workplace bullying and common mental disorders: a follow-up study. J Epidemiol Community Health. 2012;66(6):e3.CrossRefPubMed
24.
Stansfeld SA, Shipley MJ, Head J, Fuhrer R. Repeated job strain and the risk of depression: longitudinal analyses from the Whitehall II study. Am J Public Health. 2012;102(12):2360–6.CrossRefPubMedPubMedCentral
25.
Butterworth P, Leach LS, McManus S, Stansfeld SA. Common mental disorders, unemployment and psychosocial job quality: is a poor job better than no job at all? Psychol Med. 2013;43(8):1763–72.CrossRefPubMed
26.
Butterworth P, Leach LS, Strazdins L, Olesen SC, Rodgers B, Broom DH. The psychosocial quality of work determines whether employment has benefits for mental health: results from a longitudinal national household panel survey. Occup Environ Med. 2011;68(11):806–12.CrossRefPubMed
27.
Lunau T, Wahrendorf M, Dragano N, Siegrist J. Work stress and depressive symptoms in older employees: impact of national labour and social policies. BMC Public Health. 2013;13(1):1086.CrossRefPubMedPubMedCentral
28.
Szeto AC, Dobson KS. Mental disorders and their association with perceived work stress: an investigation of the 2010 Canadian Community Health Survey. J Occup Health Psychol. 2013;18(2):191–7.CrossRefPubMed
29.
Karasek RA. Job demands, job decision latitude, and mental strain: implications for job design. Adm Sci Q. 1979;24:285–308.CrossRef
30.
Siegrist J, Siegrist K, Weber I. Sociological concepts in the etiology of chronic disease: the case of ischemic heart disease. Soc Sci Med. 1986;22(2):247–53.CrossRefPubMed
31.
van Veldhoven MJ, Sluiter JK. Work-related recovery opportunities: testing scale properties and validity in relation to health. Int Arch Occup Environ Health. 2009;82(9):1065–75.CrossRefPubMed
32.
De Jonge J, Dormann C, Sonnentag S, Spoor E, Van den Tooren M. “Take a break?” Off-job recovery, job demands and job resources as predictors of active learning, creativity, and health. Eur J Work Organ Psychol. 2012;21:321–48.CrossRef
33.
Ursin H, Eriksen HR. Cognitive activation theory of stress (CATS). Neurosci Biobehav Rev. 2010;34(6):877–81.CrossRefPubMed
34.
Stronks K, Snijder MB, Peters RJ, Prins M, Schene AH, Zwinderman AH. Unravelling the impact of ethnicity on health in Europe: the HELIUS study. BMC Public Health. 2013;13:402.CrossRefPubMedPubMedCentral
35.
36.
37.
38.
Stronks K, Kulu-Glasgow I, Agyemang C. The utility of ‘country of birth’ for the classification of ethnic groups in health research: the Dutch experience. Ethn Health. 2009;14(3):255–69.CrossRefPubMed
39.
Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, et al. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case–control study. Lancet. 2004;364(9438):953–62.CrossRefPubMed
40.
Ware Jr J, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.CrossRefPubMed
41.
Jenkinson C, Chandola T, Coulter A, Bruster S. An assessment of the construct validity of the SF-12 summary scores across ethnic groups. J Public Health Med. 2001;23(3):187–94.CrossRefPubMed
42.
Gandek B, Ware JE, Aaronson NK, Apolone G, Bjorner JB, Brazier JE, et al. Cross-validation of item selection and scoring for the SF-12 health survey in nine countries: results from the IQOLA project. International quality of life assessment. J Clin Epidemiol. 1998;51(11):1171–8.CrossRefPubMed
43.
Gill SC, Butterworth P, Rodgers B, Mackinnon A. Validity of the mental health component scale of the 12-item Short-Form Health Survey (MCS-12) as measure of common mental disorders in the general population. Psychiatry Res. 2007;152(1):63–71.CrossRefPubMed
44.
Ware Jr J, Kosinski M, Keller SD. SF-12: How to score the SF-12 physical and mental health summary scales. Boston, MA: Edited by The Health Institute NEMC; 1995.
45.
46.
Kocalevent RD, Hinz A, Brahler E. Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. Gen Hosp Psychiatry. 2013;35(5):551–5.CrossRefPubMed
47.
Baas KD, Cramer AO, Koeter MW, van de Lisdonk EH, van Weert HC, Schene AH. Measurement invariance with respect to ethnicity of the Patient Health Questionnaire-9 (PHQ-9). J Affect Disord. 2011;129(1–3):229–35.CrossRefPubMed
48.
49.
Hayes AF. Beyond baron and kenny: statistical mediation analysis in the new millennium. Commun Monogr. 2009;76(4):408–20.CrossRef
50.
Hayes AF, Preacher KJ. Statistical mediation analysis with a multicategorical independent variable. Br J Math Stat Psychol. 2014;67(3):451–70.CrossRefPubMed
51.
Borg V, Kristensen TS. Social class and self-rated health: can the gradient be explained by differences in life style or work environment? Soc Sci Med. 2000;51(7):1019–30.CrossRefPubMed
52.
de Lange AH, Taris TW, Kompier MA, Houtman IL, Bongers PM. Different mechanisms to explain the reversed effects of mental health on work characteristics. Scand J Work Environ Health. 2005;31(1):3–14.CrossRefPubMed
53.
Samuelsson A, Ropponen A, Alexanderson K, Svedberg P. Psychosocial working conditions, occupational groups, and risk of disability pension due to mental diagnoses: a cohort study of 43,000 Swedish twins. Scand J Work Environ Health. 2013;39(4):351–60.CrossRefPubMed
54.
Stansfeld S, Candy B. Psychosocial work environment and mental health--a meta-analytic review. Scand J Work Environ Health. 2006;32(6):443–62.CrossRefPubMed
55.
Laine H, Saastamoinen P, Lahti J, Rahkonen O, Lahelma E. The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study. BMC Public Health. 2014;14:588.CrossRefPubMedPubMedCentral
56.
Hurtado DA, Sabbath EL, Ertel KA, Buxton OM, Berkman LF. Racial disparities in job strain among American and immigrant long-term care workers. Int Nurs Rev. 2012;59(2):237–44.CrossRefPubMed
57.
Bhui K, Stansfeld S, McKenzie K, Karlsen S, Nazroo J, Weich S. Racial/ethnic discrimination and common mental disorders among workers: findings from the EMPIRIC Study of Ethnic Minority Groups in the United Kingdom. Am J Public Health. 2005;95(3):496–501.CrossRefPubMedPubMedCentral
Metadata
Title
Do unfavourable working conditions explain mental health inequalities between ethnic groups?: cross-sectional data of the HELIUS study
Authors
Karen Nieuwenhuijsen
Aart H. Schene
Karien Stronks
Marieke B. Snijder
Monique H. W. Frings-Dresen
Judith K Sluiter
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2015
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-015-2107-5

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