title: Employment precariousness and poor mental health: evidence from Spain on a new social determinant of health.
abstract: BACKGROUND
  Evidence on the health-damaging effects of precarious employment is limited by the use of one-dimensional approaches focused on employment instability. This study assesses the association between precarious employment and poor mental health using the multidimensional Employment Precariousness Scale.
  
  
  METHODS
  Cross-sectional study of 5679 temporary and permanent workers from the population-based Psychosocial Factors Survey was carried out in 2004-2005 in Spain. Poor mental health was defined as SF-36 mental health scores below the 25th percentile of the Spanish reference for each respondent's sex and age. Prevalence proportion ratios (PPRs) of poor mental health across quintiles of employment precariousness (reference: 1st quintile) were calculated with log-binomial regressions, separately for women and men.
  
  
  RESULTS
  Crude PPRs showed a gradient association with poor mental health and remained generally unchanged after adjustments for age, immigrant status, socioeconomic position, and previous unemployment. Fully adjusted PPRs for the 5th quintile were 2.54 (95% CI: 1.95-3.31) for women and 2.23 (95% CI: 1.86-2.68) for men.
  
  
  CONCLUSIONS
  The study finds a gradient association between employment precariousness and poor mental health, which was somewhat stronger among women, suggesting an interaction with gender-related power asymmetries. Further research is needed to strengthen the epidemiological evidence base and to inform labour market policy-making.
authors: Departamento de Salud Pública, Facultad de Medicina, Pontificia Universidad Católica de Chile, 8330073 Santiago, Chile. alvives@med.puc.cl
authors: Alejandra
authors: A
authors: Vives
authors: Marcelo
authors: M
authors: Amable
authors: Montserrat
authors: M
authors: Ferrer
authors: Salvador
authors: S
authors: Moncada
authors: Clara
authors: C
authors: Llorens
authors: Carles
authors: C
authors: Muntaner
authors: Fernando G
authors: FG
authors: Benavides
authors: Joan
authors: J
authors: Benach
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000523:psychology*; D008875:Middle Aged; D057566:Self Report; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology*; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult