Journal Article

Low-quality employment trajectories and risk of common mental disorders, substance use disorders and suicide attempt

Matilla-Santander, Nuria, Gunn, Virginia, Jonsson, Johanna, Burström, Bo, Davis, Letitia, Balogh, Rebeka, Wegman, David H, Orellana, Cecilia, Muntaner, Carles, Kreshpaj, Bertina, Hemmingsson, Tomas, Kjellberg, Katarina, Julià, Mireia, Padrosa, Eva, Bodin, Theo, Alderling, Magnus

2021

Overview

High-quality longitudinal evidence exploring the mental health risk associated with low-quality employment trajectories is scarce. We therefore aimed to investigate the risk of being diagnosed with common mental disorders, substance use disorders, or suicide attempt according to low-quality employment trajectories. A longitudinal register-study based on the working population of Sweden (N=2 743 764). Employment trajectories (2005-2009) characterized by employment quality and pattern (constancy, fluctuation, mobility) were created. Hazard ratios (HR) were estimated using Cox proportional hazards regression models for first incidence (2010-2017) diagnosis of common mental disorders, substance use disorders and suicide attempt as dependent on employment trajectories. We identified 21 employment trajectories, 10 of which were low quality (21%). With the exception of constant solo self-employment, there was an increased risk of common mental disorders (HR 1.07-1.62) and substance use disorders (HR 1.05-2.19) for all low-quality trajectories. Constant solo self-employment increased the risk for substance use disorders among women, while it reduced the risk of both disorders for men. Half of the low-quality trajectories were associated with a risk increase of suicide attempt (HR 1.08-1.76). Low-quality employment trajectories represent risk factors for mental disorders and suicide attempt in Sweden, and there might be differential effects according to sex - especially in terms of self-employment. Policies ensuring and maintaining high-quality employment characteristics over time are imperative. Similar prospective studies are needed, also in other contexts, which cover the effects of the Covid-19 pandemic as well as the mechanisms linking employment trajectories with mental health.

• Publisher: Finnish Institute of Occupational Health,Scandinavian Journal of Work, Environment & Health,Nordic Association of Occupational Safety and Health,Nordic Association of Occupational Safety and Health (NOROSH)
• Subject: alcohol / anxiety / cohort study / COVID-19 / depression / Disorders / drug / Drug addiction / Drug use / Employment / Employment - statistics & numerical data / employment trajectory / employment transition / epidemiology / Female / Health risks / Humans / Incidence / Labor contracts / Labor market / labor market trajectory / Longitudinal Studies / longitudinal study / Male / Medical diagnosis / Men / mental disorder / Mental disorders / Mental Disorders - complications / Mental Disorders - epidemiology / Mental health / Middle Aged / Mobility / Original / Original article / Pandemics / Population / precarious employment / Prospective Studies / public health / Regression analysis / Regression models / Risk analysis / Risk Factors / Risk reduction / Self employment / Sex Factors / Substance abuse / Substance use / Substance use disorder / Substance-Related Disorders - epidemiology / Substance-Related Disorders - etiology / Suicide / Suicide, Attempted - statistics & numerical data / Suicides & suicide attempts / Sweden / Sweden - epidemiology / Women / Workforce