Skip to main content

Table 5 Characteristics of studies included in review relating job quality and security, deprivation and socioeconomic status and mental health outcomes, 2004–2014

From: Mental health outcomes in times of economic recession: a systematic literature review

Study

Setting

Study design

N

Year

Age

Socioeconomic determinants

Mental health outcomes

Associations/Effects

Strengths

Limitations

[106]

National population sample, Finland

Cohort

3449

31 y

Individual-level indicators

Psychosocial job quality and Security

Psychological Well-being

Mental health distress caseness (HSCL-25)

Self-reports of GP

The precarious workers have more distress symptoms in comparison with permanent workers. No differences in doctor-diagnosed/treated illnesses between precarious and permanent workers.

It measures mental health and correlates with self-reports of doctor diagnosed/treated illnesses.

Temporal order of exposures and confounders affected all participants at the same time producing stronger causal conclusions.

Cannot make differential analysis of health-based selection.

The results and recommendations should not be generalized to other cohorts.

[107]

Regional population sample, Northern Sweden

Cohort

1071

30–42y

Individual-level indicators

Psychosocial job security

Psychological Well-being

Self-rated health, sleep quality and mental health

The adverse effects of job insecurity on health are present on both permanent and temporary employees.

The study has a follow-up design.

Temporal order of exposures affected all participants at the same time producing stronger causal conclusions.

The results and recommendations should not be generalized to other cohorts.

[108]

Community sample of workers from private organization, Italy

Cross-sectional

1236

(2010–2011)

Individual-level indicators

Psychosocial job quality and Security

Psychological Well-being

Mental health distress (GHQ12)

Job stress fully mediated the relationship between fear of the crisis and mental health of the workers.

Large sample and uses a well validated scale for detection of mental distress.

Its cross-sectional design removes the possibility of causal inference.

Possible response bias since those with mental distress may perceive and rate the same work environment more stressful than those without mental distress.

[109]

National Population sample, England, UK

Cross-sectional

2603

20–55 y

Individual-level indicators

Employment Status

Psychosocial job quality

Common Mental Disorders

CIS-R interview: Common Mental Disorders (CMD)

The prevalence of mental disorders among unemployed (33.1 %) was greater than in employed (12.9 %; OR 3.34, 95 % CI 2.06–5.42, p < 0.001). Results were similar for those respondents in the poorest quality jobs.

Uses a well validated scale for detection of common mental disorders.

Its cross-sectional design removes the possibility of causal inference.

Possible response bias since those with mental illnesses may perceive and rate the same work environment more negatively than those without a disorder.

[110]

National working population sample, UK

Cross-sectional

3581 (2007)

16–64y

Individual-level indicators

Psychosocial job security

Indebtedness

Common Mental Disorders

Depression

Risk of depression is greater for poor job security (OR = 1.58, 95 %; CI:1.22–2.06). Adj for age and sex, job insecurity (OR = 1.86, 95 % CI:1.47–2.35) and debt (OR = 2.17, 95 % CI:1.58–2.98) were independently associated.

Large representative sample.

Its cross-sectional design removes the possibility of causal inference: job insecurity may be more frequently reported by people rendered pessimistic by a mood disorder.

[111]

National population sample, USA

Cohort

34,653 (2001–02; 04–05)

≥20 y

Individual-level indicators

Household income

Socioeconomic inequalities

Common Mental Disorders

Substance use disorders (AUDADIS-IV)

A decrease in household income during the 2 time points was associated with an increased risk of incident mood, anxiety, or substance use disorders (adj OR = 1.30; 99 % CI:1.06–1.60)

Nationally representative sample and strong associations.

Temporal order of exposures produces stronger causal conclusions.

Unable to adjust for physical health conditions that may be potential confounders.

[112]

National population sample, New Zealand

Cohort

15,340 (2002–2004/05)

>25 y

Individual-level indicators

Total wealth

Socioeconomic inequalities

Psychological Well-being

Mental health distress (Kessler-10)

High psychological distress linked to lowest wealth quintile compared with the highest (OR 3.06, 95 % CI 2.68 to 3.50). Adj for age and sex did not alter the relationship; adj for income and area deprivation attenuated the OR to 1.73 (95 % CI 1.48 to 2.04); adj baseline health status reduced the OR to 1.45 (95 % CI 1.23 to 1.71).

Strong associations between inequalities in wealth and psychological distress. Temporal order of exposures and confounders affected all participants at the same time producing stronger causal conclusions.

The socioeconomic position at baseline was not controlled.

The results and recommendations should not be generalized to other cohorts.

[113]

National population sample, Britain, UK

Cohort

8185

(1991)

(2003)

Individual-level indicators

Indebtedness

housing payment problems

Psychological Well-being

Mental health distress caseness (GHQ-12)

Housing payment problems and debts have significant detrimental effects on mental Well-being. The sizes of these effects are in addition to and larger in magnitude than those associated with financial hardship.

Temporal order of exposures, confounders, and the outcome under consideration affected all participants at the same time producing stronger causal conclusions.

Generalizing findings may be reasonably limited to the UK’s welfare system in regard to housing payment problems. The results and recommendations should not be generalized to other cohorts.

[114]

Community sample, Detroit, USA

Cohort

1547

(2008)

(2010)

Individual-level indicators

Home foreclosure

Financial hardship

Common Mental Disorders

Major depression (PHQ-9) Generalized anxiety disorder (GAD-7)

Foreclosure was associated with an increased rate of major depression [incidence density ratio (IDR) 2.4, 95 %; CI:1.6–3.6] and GAD (IDR 1.9, 95 %; CI:1.4–2.6)

Establishes longitudinal associations between home foreclosure and common mental disorders producing stronger causal conclusions.

The sample is limited to a longitudinal cohort of pre-dominantly African-American adults.

Because mental health problems are common among individuals at risk of foreclosure, the observed associations may result, in part, from pre-existing psychopathology.

[115]

Community sample, Wales, UK

Cross-sectional

88,623

(2003/04–2010)

18–74 y

Individual-level indicators

Area income deprivation

Socioeconomic inequalities

Psychological Well-being

Mental health distress (MHI-5)

High neighbourhood income inequality was associated with better mental health in low-deprivation neighbourhoods (P = 0.036). Income inequality at regional level was significantly associated with poorer mental health (P = 0.012).

Uses a continuous measure of mental health symptoms.

Large sampling fraction.

No data were available on individual income.

Its cross-sectional design removes the possibility of causal inference.

[116]

Community sample, France

Cohort

1103 (1991–2009)

22–35 y

Individual-level indicators

Socioeconomic status

Level of education

Substance-Disorders tobacco, cannabis use, other illegal drug use

Low socioeconomic status was linked with higher rates of tobacco smoking [OR = 2.11, 95 % CI 1.51–2.96], cannabis use [OR = 1.75, 95 % 1.20–2.55], problematic cannabis use [OR = 2.44, 95 % CI 1.38–4.30] and other illegal drugs [OR = 2.27, 95 % CI 1.11–4.65].

Relatively large community sample of young adults. Longitudinal measures of family and juvenile characteristics obtained independently of participants’ reports of substance-use

The research focused only young adults whose parents worked in a large national company and were part of an ongoing epidemiological study. Other variables that can act as confounders were not controlled: family and peer characteristics.

[117]

National population sample, England, UK

Cross-sectional

7461

(2007)

35–54 y

Individual-level indicators

Indebtedness

Suicidal Behaviours

Suicidal ideation

Those in debt were twice as likely to think about suicide after controlling for socio-demographic, economic and lifestyle factors.

Representative sample.

Strong association between suicidal thoughts and being in debt.

No causal inference can be made due to the cross-sectional nature of the study.