Do unfavourable working conditions explain mental health inequalities between ethnic groups? Cross-sectional data of the HELIUS study.
BACKGROUND
Ethnic inequalities in mental health have been found in many high-income countries. The purpose of this study is to test whether mental health inequalities between ethnic groups are mediated by exposure to unfavourable working conditions.


METHODS
Workers (n = 6278) were selected from baseline data of the multi-ethnic HELIUS study. Measures included two indices of unfavourable working conditions (lack of recovery opportunities, and perceived work stress), and two mental health outcomes (generic mental health: MCS-12 and depressive symptoms: PHQ-9). Mediation of the relationships between ethnicity and mental health by unfavourable working conditions was tested using the bias-corrected bootstrap confidence intervals technique. Linear models with and without the mediators included, and adjusted for gender and age. Attenuation was calculated as the change in B between the models with and without mediators.


RESULTS
The sample comprised Dutch (1355), African Surinamese (1290), South-Asian Surinamese (1121), Turkish (1090), Ghanaian (729), and Moroccan (693) workers. After controlling for age and gender, all ethnic minorities had a higher risk of mental health problems as compared to the Dutch host population, with the exception of Ghanaians in the case of depressive symptoms, and African Surinamese workers with regard to both outcomes. The Turkish group stands out with the lowest mental health on both mental health indices, followed by Moroccan and South-Asian Surinamese workers. A lack of recovery opportunities mediated the relationship between ethnic group and a higher risk of mental health problems. Perceived work stress did not contribute to the explanation of ethnic inequalities.


CONCLUSIONS
The higher risk of mental health problems in ethnic minority groups can be partly accounted for by a lack of recovery opportunities at work, but not by perceived work stress. This may imply that workplace prevention targeting recovery opportunities have the potential to reduce ethnic inequalities, but ethnic-specific experiences at the workplace need to be further explored.
Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, Amsterdam, The Netherlands. K.Nieuwenhuijsen@amc.nl.
Karen
K
Nieuwenhuijsen
Department of Psychiatry, Radboud University Medical Center, Reinier Postlaan 6, 6500 HB, Nijmegen, The Netherlands. Aart.Schene@radboudumc.nl.|Donders Institute for Brain, Cognition and Behavior, Radboud University, Geert Grooteplein Noord 21, 6525 EZ, Nijmegen, The Netherlands. Aart.Schene@radboudumc.nl.
Aart H
AH
Schene
Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, Amsterdam, The Netherlands. K.Stronks@amc.nl.
Karien
K
Stronks
Department of Public Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, Amsterdam, The Netherlands. m.b.snijder@amc.nl.
Marieke B
MB
Snijder
Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, Amsterdam, The Netherlands. M.Frings@amc.nl.
Monique H W
MH
Frings-Dresen
Coronel Institute of Occupational Health, Academic Medical Center (AMC), University of Amsterdam, P.O. Box 22700, Amsterdam, The Netherlands. J.Sluiter@amc.nl.
Judith K
JK
Sluiter
D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People; D044383:Black People; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000208:ethnology / Q000523:psychology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014504:Urban Health; D044465:White People; D017132:Workplace; D055815:Young Adult