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Choi et al. conducted a prospective study of 5-year follow-up to examine the association of employment status and income with self-rated health among waged workers with disabilities (1). Adjusted odds ratios (ORs) (95% confidence intervals [CIs]) of workers with a precarious employment status and lowest income for poor self-rated health were 1.22 (1.21-1.23) and 1.81 (1.80-1.83), respectively. I have some concerns about their study.
First, Ferrante et al. examined the association between precarious employment and mental health with special reference to financial strain (2). Mental health status was assessed by the Patient Health Questionnaire 2-item scale score or the Mental health Component Summary 12-item scale score. Adjusted prevalence ratios (95% CI) of precarious workers for depression was 1.92 (1.09-2.93). In contrast, risk of poor mental health in precarious workers was not significant. Furthermore, financial strain was a strong mediator on the relationship, and a significant relationship was only observed in male workers. Sex difference and socioeconomic status might be important contributors on the relationship, which should be specified by a prospective study.
Regarding the first query, Jang et al. conducted a follow-up study to know the effect of precarious employment on the development of new-onset severe depressive symptoms (3). Severe depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale. ORs (95%...
Regarding the first query, Jang et al. conducted a follow-up study to know the effect of precarious employment on the development of new-onset severe depressive symptoms (3). Severe depressive symptoms were measured using the 11-item Center for Epidemiologic Studies Depression Scale. ORs (95% CIs) of precarious employment for the severe depressive symptoms were 1.52 (1.02-2.25) in male heads of household and 4.19 (1.70-10.32) in female heads of household. Although wide rages of 95% CI were observed in females, significant association was existed in males and females, respectively. Anyway, the causal association should be verified by adjusting financial information.
Second, Hämmig et al. reported that psychosocial working conditions, particularly work-life conflict, showed a strong association with all physical and mental health problems (4). Fan et al. also reported the association between stress and mental illness, confirming that job insecurity was significantly associated with anxiety and depression (5). These cross-sectional reports would present some evidence that depressive symptom might be related to precarious employment.
Precarious work is associated with the risk of serious psychological distress among middle-aged men (6), and there is a significant association between precarious employment and suicide ideation (7). Taken together, precarious work should be considered as a risk factor for adverse health status.
1. Choi JW, Kim J, Han E, Kim TH. Association of employment status and income with self-rated health among waged workers with disabilities in South Korea: population-based panel study. BMJ Open 2019;9(11):e032174.
2. Ferrante G, Fasanelli F, Gigantesco A, et al. Is the association between precarious employment and mental health mediated by economic difficulties in males? Results from two Italian studies. BMC Public Health 2019;19(1):869.
3. Jang SY, Jang SI, Bae HC, Shin J, Park EC. Precarious employment and new-onset severe depressive symptoms: a population-based prospective study in South Korea. Scand J Work Environ Health 2015;41(4):329-337.
4. Hämmig O, Bauer GF. Work, work-life conflict and health in an industrial work environment. Occup Med (Lond) 2014;64(1):34-38.
5. Fan LB, Blumenthal JA, Watkins LL, Sherwood A. Work and home stress: associations with anxiety and depression symptoms. Occup Med (Lond) 2015;65(2):110-116.
6. Kachi Y, Otsuka T, Kawada T. Precarious employment and the risk of serious psychological distress: a population-based cohort study in Japan. Scand J Work Environ Health 2014;40(5):465-472.
7. Min KB, Park SG, Hwang SH, Min JY. Precarious employment and the risk of suicidal ideation and suicide attempts. Prev Med 2015;71:72-76.