title: Household food insufficiency, financial strain, work-family spillover, and depressive symptoms in the working class: the Work, Family, and Health Network study.
abstract: OBJECTIVE
  We evaluated the association of household-level stressors with depressive symptoms among low-wage nursing home employees.
  
  
  METHODS
  Data were collected in 2006 and 2007 from 452 multiethnic primary and nonprimary wage earners in 4 facilities in Massachusetts. We used logistic regression to estimate the association of depressive symptoms with household financial strain, food insufficiency, and work-family spillover (preoccupation with work-related concerns while at home and vice versa).
  
  
  RESULTS
  Depressive symptoms were significantly associated with household financial strain (odds ratio [OR] = 1.82; 95% confidence interval [CI] = 1.03, 3.21) and food insufficiency (OR = 2.10; 95% CI = 1.10, 4.18). Among primary earners, stratified analyses showed that food insufficiency was associated with depressive symptoms (OR = 3.60; 95% CI = 1.42, 9.11) but financial strain was not. Among nonprimary wage earners, depressive symptoms correlated with financial strain (OR = 3.65; 95% CI = 1.48, 9.01) and work-family spillover (OR = 3.22; 95% CI = 1.11, 9.35).
  
  
  CONCLUSIONS
  Household financial strain, food insufficiency, and work-family spillover are pervasive problems for working populations, but associations vary by primary wage earner status. The prevalence of food insufficiency among full-time employees was striking and might have a detrimental influence on depressive symptoms and the health of working-class families.
authors.affiliation: Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA 02115, USA. cokechuk@hsph.harvard.edu
authors.forename: Cassandra A
authors.initials: CA
authors.lastname: Okechukwu
authors.forename: Alison M
authors.initials: AM
authors.lastname: El Ayadi
authors.forename: Sara L
authors.initials: SL
authors.lastname: Tamers
authors.forename: Erika L
authors.initials: EL
authors.lastname: Sabbath
authors.forename: Lisa
authors.initials: L
authors.lastname: Berkman
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D016001:Confidence Intervals; D003625:Data Collection; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data; D005191:Family Characteristics; D005260:Female; D005502:Food / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D011203:Poverty / Q000191:economics / Q000523:psychology* / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012923:Social Class; D012959:Socioeconomic Factors; D055815:Young Adult
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