What is the impact of job precariousness on depression? Risk assessment and attributable fraction in Spain.

OBJECTIVES: The prevalence of depression related to precarious employment (PE) has become a significant public health concern, given the declining trend of the standard employment relationship. Research has focused on the mental health detrimental effects of employment conditions, whereas there is scarce evidence concerning the burden of depression that could be prevented by targeting precariousness. This paper estimates the impact of PE on the risk of depression and the attributable fraction within the active and working salaried population in Spain.

STUDY DESIGN: Observational cross-sectional on data drawn from the Spanish portion of European Health Survey 2020.

METHODS: After applying selection criteria and descriptives, binary logistic regression models stratified by sex are used to examine the associations between a 9-categories combination of employment precariousness and occupational social class, and depressive symptoms.

RESULTS: There is a higher risk of depression among individuals in PE and among those who are unemployed, with a notable gradient based on occupational social class for women. Adjusting by sex, age and foreign-born origin, we estimate that approximately 15.0% (95% confidence interval [CI]: 1.0%-26.2%) of depression cases among the working population and 33.3% (95% CI: 23.2%-43.2) among the active population can be attributed to PE.

CONCLUSIONS: These findings highlight the public health impact of PE on mental health, provide evidence to estimate the economic burden linked to employment-related mental health, and underscore the need for policy changes and interventions at the level of labour markets and workplaces to mitigate the detrimental effects of PE.