title: Associations of neighborhood-level workplace violence with workers' mental distress problems: a multilevel analysis of Taiwanese employees.
abstract: OBJECTIVE
  Workplace violence is known to pose mental health risks. However, whether or not workplace violence in a surrounding area might further increase the risk of mental distress in workers has rarely been examined.
  
  
  METHODS
  The study subjects were 9,393 male and 7,716 female employees who participated in a nationwide survey in 2010. Their personal experiences of workplace violence over the past 1 year were ascertained by a standardized questionnaire. Also assessed were their psychosocial work characteristics and mental distress problems. Neighborhood-level workplace violence was computed based on aggregated data at the county level and was categorized into low-, medium-, and high-level categories. Multilevel logistic regression models were constructed to examine the associations between neighborhood-level workplace violence and individual-level mental distress problems, with adjustment of individual-level experience of workplace violence.
  
  
  RESULTS
  The neighborhood-level prevalence of workplace violence ranged from 4.7 to 14.7% in men and from 6.4 to 14.8% in women across 22 counties. As compared with those who live in counties of the lowest tertile of workplace violence, female workers who lived in counties of the highest tertile of workplace violence had a 1.72-fold increased risk for mental distress problems after controlling for individual experience of workplace violence and other psychosocial work characteristics.
  
  
  CONCLUSIONS
  Neighborhood-level workplace violence was associated with poor mental health in female workers. Preventative strategies targeting workplace violence should pay attention to neighborhood factors and gender-specific effects that might influence societal tolerance of abusive work practices and workers' vulnerability to mental health impacts of workplace violence.
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University.
authors.forename: Li-Chung
authors.initials: LC
authors.lastname: Pien
authors.forename: Duan-Rung
authors.initials: DR
authors.lastname: Chen
authors.forename: Chiou-Jong
authors.initials: CJ
authors.lastname: Chen
authors.forename: Kuei-Min
authors.initials: KM
authors.lastname: Liang
authors.forename: Yawen
authors.initials: Y
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D017132:Workplace / Q000523:psychology*; D064450:Workplace Violence / Q000706:statistics & numerical data*