Objectives Women have a higher incidence of mental health problems compared with men. Psychosocial stressors at work are associated with mental health problems. However, few prospective studies have examined the association between these stressors and objectively measured outcomes of mental health. Moreover, evidence regarding potential differences between women and men in this association is scarce and inconsistent. This study investigates whether psychosocial stressors at work are associated with the 7.5-year incidence of medically certified work absence due to a mental health problem, separately for women and men.
Methods Data from a prospective cohort of white-collar workers in Canada (n=7138; 47.3% women) were used. We performed Cox regression models to examine the prospective association between self-reported psychosocial stressors at work (job strain model) at baseline and the 7.5-year HR of medically certified work absence of ≥5 days due to a mental health problem.
Results During follow-up, 11.9% of participants had a certified work absence, with a twofold higher incidence among women. Women (HR 1.40, 95% CI 1.01 to 1.93) and men (HR 1.41, 95% CI 0.97 to 2.05) exposed to high strain (high demands and low control) had a higher incidence of work absence compared with those unexposed. Among women only, those exposed to an active job situation (high demands and high control) also had a higher risk (HR 1.82, 95% CI 1.29 to 2.56).
Conclusions Prevention efforts aimed at reducing psychosocial stressors at work could help lower the risk of work absence for both women and men. However, important differences between women and men need to be further studied in order to orient these efforts.
- mental health
- sickness absence
- longitudinal studies
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Contributors ChB and MV were responsible for study concept and design, as well as supervising the data collection. Statistical analyses were conducted by ChB, CaB and BM. Data interpretation and manuscript drafting were done by MG-O, KA, MV, ChB, XT, RN and AM. The manuscript was critically reviewed and approved by all authors. MG-O had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding This study was supported by grants from the Medical Research Council (MRC) of Canada, the Social Sciences and Humanities Research Council of Canada (SSHRC), and the Canadian Heart and Stroke Foundation. The content, findings and views of this paper are solely those of the authors and should not be attributed to MRC, SSHRC or the Canadian Heart and Stroke Foundation.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval Ethical approval was obtained from the Research Ethics Committee of the CHU de Québec-Laval University Research Center.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data and study materials are available from the corresponding author on reasonable request.