RESEARCH REPORT

Psychological distress after employment transitions: the role of subjective financial position as a mediator

Claudia Thomas¹, Michaela Benzeval¹ and Stephen Stansfeld²

¹ Department of Geography, Queen Mary University of London, London, UK
² Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK

Correspondence to:
Correspondence to:
Dr C Thomas
Institute of Child Health, Centre for Paediatric Epidemiology and Biostatistics, 30 Guilford Street, London WC1N 1EH, UK; c.thomas{at}ich.ucl.ac.uk

Objective: To explore the extent to which the mental health effects of transitions into unemployment, or other forms of non-employment, and vice versa, are mediated by financial changes.

Methods: Longitudinal analysis of the British Household Panel Survey from 1991 to 2000. There were 89 264 person-years of observation from 14 686 individuals aged 16 years. Main outcome measure was psychological distress measured by the 12-item General Health Questionnaire.

Results: Transitions to unemployment were associated with increased risk of psychological distress for men (adjusted odds ratio (OR) 3.15 (95% confidence interval (CI) 2.50 to 3.98)) and for women (OR 2.60 (95% CI 1.97 to 3.43)). Women who left work to look after the family were also more likely to experience psychological distress (OR 1.72 (95% CI 1.45 to 2.05)). A reduced risk of psychological distress was seen for transitions from unemployment to paid employment for men (OR 0.52 (95% CI 0.41 to 0.68)) and for women (OR 0.68 (95% CI 0.69 to 1.40)). Financial difficulty partially mediated these relationships: men who became unemployed and were worse off financially were more likely to experience psychological distress (OR 4.19 (95% CI 3.20 to 5.50)) than men who were not (OR 1.48 (95% CI 0.95 to 2.33)). Conversely, the beneficial health effect for people who left unemployment and became employed was confined to those who were better off financially (OR 0.34 (0.25 to 0.48) for men).

Conclusions: Changes in employment status have both direct and indirect effects, through changes in financial circumstances, on subsequent psychological distress. The results support the view that the direction of causation runs from employment transitions to financial difficulties and psychological distress.

Abbreviations: BHPS, British Household Panel Survey; GHQ-12, 12-item General Health Questionnaire

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

In this issue

Carlos Alvarez-Dardet and John R Ashton
J Epidemiol Community Health 2007 61: 1. [Extract] [Full Text] [PDF]