title: Psychosocial work factors and social inequalities in psychological distress: a population-based study.
abstract: Mental health problems (MHP) are the leading cause of disability worldwide. The inverse association between socioeconomic position (SEP) and MHP has been well documented. There is prospective evidence that factors from the work environment, including adverse psychosocial work factors, could contribute to the development of MHP including psychological distress. However, the contribution of psychosocial work factors to social inequalities in MHP remains unclear. This study evaluates the contribution of psychosocial work factors from two highly supported models, the Demand-Control-Support (DCS) and the Effort-Reward Imbalance (ERI) models to SEP inequalities of psychological distress in men and women from a population-based sample of Quebec workers.
  
  
  
  Data were collected during a survey on working conditions, health and safety at work. SEP was evaluated using education, occupation and household income. Psychosocial work factors and psychological distress were assessed using validated instruments. Mean differences (MD) in the score of psychological distress were estimated separately for men and women.
  
  
  
  Low education level and low household income were associated with psychological distress among men (MD, 0.56 (95% CI 0.06; 1.05) and 1.26 (95% CI 0.79; 1.73) respectively). In men, the contribution of psychosocial work factors from the DCS and the ERI models to the association between household income and psychological distress ranged from 9% to 24%. No clear inequalities were observed among women.
  
  
  
  These results suggest that psychosocial work factors from the DCS and the ERI models contribute to explain a part of social inequalities in psychological distress among men. Psychosocial factors at work are frequent and modifiable. The present study supports the relevance of targeting these factors for the primary prevention of MHP and for health policies aiming to reduce social inequalities in mental health.
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada. caroline.duchaine@crchudequebec.ulaval.ca.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada. caroline.duchaine@crchudequebec.ulaval.ca.
authors.forename: Caroline S
authors.identifier: 0000-0002-3716-1911
authors.initials: CS
authors.lastname: Duchaine
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Ruth
authors.initials: R
authors.lastname: Ndjaboué
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Manon
authors.initials: M
authors.lastname: Levesque
authors.affiliation: Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Michel
authors.initials: M
authors.lastname: Vézina
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Xavier
authors.initials: X
authors.lastname: Trudel
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Mahée
authors.initials: M
authors.lastname: Gilbert-Ouimet
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Rehabilitation department, Faculty of Medicine, Laval University, 1050 avenue de la médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Clermont E
authors.initials: CE
authors.lastname: Dionne
authors.affiliation: Social and preventive medicine department, Public Health School, Montreal University, 7101 avenue du Parc, Montreal, H3N 1X9, QC, Canada.|Research Center CHU-Ste-Justine, 3175 Côte Ste-Catherine, Montréal, H3T 1C5, Québec, Canada.
authors.forename: Benoît
authors.initials: B
authors.lastname: Mâsse
authors.affiliation: Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Pearce
authors.affiliation: CHU de Québec-Université Laval Research Center, Population Health and Optimal Health Practices Unit, Saint-Sacrement Hospital, 1050 chemin Sainte-Foy, Quebec city, G1S 4L8, QC, Canada.|Social and preventive medicine department, Faculty of Medicine, Laval University, 1050 avenue de la Médecine, Quebec city, G1V 0A6, QC, Canada.
authors.forename: Chantal
authors.initials: C
authors.lastname: Brisson
mesh_terms: D000328:Adult; D004651:Employment / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D009790:Occupations / Q000706:statistics & numerical data; D011446:Prospective Studies; D011792:Quebec; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology; D017132:Workplace / Q000523:psychology*
keywords: Effort-reward imbalance; Job strain; Mental health problems; Psychological distress; Social inequalities